title: Laparoscopic hepatectomy for HCC in elderly patients: risks and feasibility.
abstract: BACKGROUND
  Laparoscopic liver resection (LLR) appears to be safe and effective as open liver resection (OLR) for hepatocellular carcinoma (HCC). However, studies comparing LLR with ORL in elderly patients are limited. The purpose of this study is to compare the clinical outcomes of LLR versus OLR for HCC in elderly patients.
  
  
  METHODS
  A retrospective analysis was made comparing laparoscopic (n = 11) and open (n = 18) liver resections in elderly patients performed at the University of Naples "Federico II" between January 2010 and December 2014. Demographic data, operative and postoperative outcomes were analyzed.
  
  
  RESULTS
  Demographic and tumor characteristics of laparoscopic and OLRs were similar. There were also no significant differences in operating room time. Patients undergoing OLR had increased rate of minor complications (33 vs. 0%), longer lengths of stay (6 vs. 3 days) and higher blood loss (310 ± 84 vs. 198 ± 34 ml). There were no significant differences in major complication rates or 90-day mortality.
  
  
  CONCLUSIONS
  LLR is safe and feasible as OLR for treatment of HCC in selected elderly patients.
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Via S. Pansini, 5, 80131, Naples, Italy. bruno.amato@unina.it.
authors.forename: Bruno
authors.identifier: http://orcid.org/0000-0002-4262-8467
authors.initials: B
authors.lastname: Amato
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Aprea
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: De Rosa
authors.affiliation: Division of General Surgery, Department of Surgical Sciences and Nephrology, School of Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Milone
authors.affiliation: Division of General Surgery, Department of Surgical Sciences and Nephrology, School of Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: Lorenza
authors.initials: L
authors.lastname: di Domenico
authors.affiliation: Division of General Surgery, Department of Surgical Sciences and Nephrology, School of Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Amato
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Compagna
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Santoro
authors.affiliation: Division of Colorectal Surgery and Pelvic Floor Centre, Department of Clinical Sciences, Malmö University Hospital, Lund University, Terni, Italy.
authors.forename: Louis Banka
authors.initials: LB
authors.lastname: Johnson
authors.affiliation: General Surgery and Surgical Specialties Unit, Medical School, S. Maria University Hospital, University of Perugia, Terni, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sanguinetti
authors.affiliation: General Surgery and Surgical Specialties Unit, Medical School, S. Maria University Hospital, University of Perugia, Terni, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Polistena
authors.affiliation: General Surgery and Surgical Specialties Unit, Medical School, S. Maria University Hospital, University of Perugia, Terni, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies
keywords: Elder; HCC; Hepathectomy; Laparoscopic surgery