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.