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Zhang et al. Hepatoma Res 2020;6:77 Hepatoma Research
DOI: 10.20517/2394-5079.2020.74

Review Open Access

Advances in minimally invasive surgery for
hepatocellular carcinoma

Cun-Zhen Zhang, Nan Li

Department of Hepatic Surgery, Shanghai Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, China.
Correspondence to: Dr. Nan Li, Department of Hepatic Surgery, Shanghai Eastern Hepatobiliary Surgery Hospital, 255 Changhai
Road, Yangpu District, Shanghai 200438, China. E-mail: liparislisi@aliyun.com

How to cite this article: Zhang CZ, Li N. Advances in minimally invasive surgery for hepatocellular carcinoma. Hepatoma Res
2020;6:77. http://dx.doi.org/10.20517/2394-5079.2020.74

Received: 30 Jul 2020 First Decision: 17 Sep 2020 Revised: 14 Oct 2020 Accepted: 26 Oct 2020 Published: 6 Nov 2020

Academic Editor: Ho-Seong Han Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third leading cause of cancer-related
Received: First Decision: Revised: Accepted: Published: death worldwide. Surgical resection is still regarded as the first choice of treatment for HCC. With advances in
technology and techniques, minimally invasive surgery has now become the standard of care in almost every
Science Editor: Copy Editor: Production Editor: Jing Yu field in general surgery, including hepatectomy surgery. This review focuses on the latest advances in minimally
invasive surgical treatment of HCC, including laparoscopic hepatectomy (LH), robotic hepatectomy (RH) and
other minimally invasive treatment technologies. Although some limitation in LH or RH exists, these minimally
invasive techniques may be performed for hepatectomy with benefits, and have a promising future. With the
development of technology and the improvement of surgical operations, patients will benefit from this.

Keywords: Hepatocellular carcinoma, minimally invasive surgery, laparoscopic hepatectomy, robotic hepatectomy

INTRODUCTION
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third leading cause of cancer-
related death worldwide [1-4] . Because its early symptoms are not typical, most liver cancers clinically
[5]
diagnosed belong to the advanced stage . In addition, most of these patients are accompanied by portal
[6,7]
vein tumor thrombus or pulmonary metastasis . Surgical resection is still regarded as the first choice of
HCC treatment [8-12] . However, due to intrahepatic metastasis and early recurrence, postoperative patients’
[19]
prognosis is poor [13-18] , and the 5-year survival rate is relatively low . The high recurrence and vascular

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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