Structuring process approach to laparoscopic anatomical liver central lobectomy for hepatocellular carcinoma

Objective: To investigate the feasibility and oncological efficacy of structuring process approach to laparoscopic anatomical liver central lobectomy for hepatocellular carcinoma. Methods: The clinical data of 65 patients with hepatocellular carcinoma who underwent laparoscopic anatomical liver central lobectomy at the Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital from April 2017 to April 2021 was retrospectively analyzed. There were 39 males and 26 females,aged (M(QR)) 61.2 (29.5) years (range:25 to 80 years).The body mass index was (24.2±3.8) kg/m2 (range:19.5 to 26.1 kg/m2) and the tumor diameter was (6.7±2.9)cm(range:3.4 to 10.5 cm).This structuring process approach was designed using a series of main vessels as the plane markers, along which liver transection was carried out. The perioperative indicators and early oncological efficacy were then analyzed. Results: All the procedures were successfully carried out laparoscopically. The operative time was (190.5±70.4) minutes (range:90 to 280 minutes). The blood loss was (370.6±120.8)ml(range:100 to 1 050 ml). No patient received blood transfusion or converted to laparotomy. Postoperative complications occurred in 8 cases(12.3%). Postoperative hospital stay was (7.5±2.5) days(range:5 to 18 days).There was no perioperative death and rehospitalization within 30 days. Pathological study showed all the operations to be R0 resections, the average surgical margin was (2.4±1.9)cm(range:0.5 to 3.1 cm).The tumor recurrence rate was 12.3% after 1 year follow-up. Conclusion: Structuring process approach to laparoscopic anatomical liver central lobectomy could be used to treat patients with hepatocellular carcinoma.