Introduction
Hepatocellular carcinoma (HCC) was the sixth most common neoplasm and
the third leading cause of cancer death worldwide in 2020, with 905,677
diagnosed cases and 830,180 deaths[1]. The Barcelona Clinic Liver
Cancer strategy identifies hepatectomy as one of the treatment options
for HCC[2]. Since the first laparoscopic hepatectomy (LH) described
in 1991[3], it has gradually been developed as a surgical option.
After the first feasibility study of LH published in 2000[4], plenty
of studies were merged to confirm the safety of the laparoscopic
approach for hepatectomy under different conditions, such as tumor
size[5], previous abdominal surgery[6], cirrhotic
patients[7], and elder patients[8]. Furthermore, the benefit of
LH included many advantages, including a smaller incision size, shorter
operation time, lower transfusion rate, lower major complication rate,
shorter hospital stay, and would not compromise similar overall survival
and disease-free survival compared with OH[9-12].
A variety of difficulties, including liver mobilization, hemorrhage
control, loss of manual palpation, deeper surgical field, and
intraoperative hazards, makes it difficult for institutions to develop
aptitude for LH[13, 14]. Recent studies on the feasibility and
safety of LH were mostly conducted by well-developed centers and lacked
data from developing centers or from their development period.
Furthermore, the impact of location in LH has not been clearly
elucidated.
The aim of this study was to evaluate the safety and effectiveness of
our initial experience of LH for HCC located at favorable location and
focus on the short-term and long-term outcomes during the development
period.