Objective   To evaluate the surgical results and mid-term survival of the cases undergoing total laparoscopic anatomic hepatectomy(LAH) for hepatocellular carcinoma(HCC) in the left lobe.

  Methods   From June 2006 to December 2009, clinical records of 21 patients with HCC in the left lobe who underwent a total LAH operation were included in the LAH study group.During the same period, data on the matched-pair group of another 21 patients who underwent open anatomic hepatectomy were included in the LAH matched-pair group.The two groups were compared in terms of age, type of resection, tumor size, and severity of liver cirrhosis.

  Results   The laparoscopic approach resulted in shorter duration of surgery(156.67±32.15 min, P=0.036) and less blood loss(157.14±40.51 mL, P=0.000) in the LAH study group, compared to the LAH matched-pair group.Statistically significant differences were found in the primary-porta-hepatic surgery duration between the LAH study group and the matched-pair group(P=0.001).The mean duration of the secondary-porta-hepatic surgery was similar for the two groups(P=0.061).In the LAH study group, the mean time for required analgesic medication(2.19±0.51 d vs.3.10±1.04 d), food intake(2.24±0.44 d vs.3.81±0.40 d), first ambulation time(2.71±0.78 d vs.3.52±0.93 d), and average stay (7.86±1.24 d vs.10.95±1.40 d) were all better than those of the matched-pair group(P < 0.05).No statistical significance in the perioperative morbidity and mortality rate were found between the two groups.After a median follow up of 21 months, the 1 and 3-year overall survival rates after liver excision for HCC were 86%and 62%in LAH study group, respectively, and those in the matched-pair group were 90%and 67%, respectively.No significant differences were observed in the survival curves in the present study.

  Conclusion   The total LAH of HCC in the left lobe is feasible and safe for the selected patients and may result in good surgical results, with similar benefits in the overall survival.