Objective      To evaluate the clinical efficacy of laparoscopic anatomical segmentectomy for hepatocellular carcinoma (HCC).       Methods      Clinical data of 29 patients with HCC who received laparoscopic hepatectomy in the Southwest hospital from January 2011 to April 2014 were retrospectively analyzed.       Results      Three patients were converted to laparotomy

and the rate of conversion to laparotomy was 10.3%. Twenty-six patients received laparoscopic anatomical segmentectomy

and the resection segments were as follows: segment Ⅰ 3 cases

segment Ⅱ 2 cases

segment Ⅲ 3 cases

segment Ⅳ 4 cases

segment V 6 cases

segment Ⅵ 7 cases

segment Ⅶ 2 cases

and segment Ⅷ 2 cases. The operation time was 220.17±61.56 min

blood loss 311.72±127.70 mL

perioperative blood transfusion rate 3.44%

tumor diameter 3.66±1.14 cm

resection margin 2.11±0.87 cm

time to diet 1.69±0.71 d

postoperative hospital stay 8.72±2.95 d

postoperative complication rate 10.3% and no perioperative death was observed. HCC were confirmed in all the patients

including 6 cases of highly differentiated HCC

20 cases of moderately differentiated HCC

and 3 cases of lowly differentiated HCC. Twenty-nine patients were followed up for 12 to 48 months

and the median follow-up time was 26 months. Overall survival rate and tumor-free survival rate were 92.8% and 81.7%

respectively

in the 1st year

and 89.5% and 71.7%

respectively

in the 3rd year. The patients were divided into the anterolateral liver segment group (segment Ⅱ/Ⅲ/Ⅳb/Ⅴ/Ⅵ) (AL group: 19 cases) and the posterosuperior liver segment group (segment Ⅰ/Ⅳa/Ⅶ/Ⅷ) (PS group: 10 cases). Statistically significant differences were found between the PS group and AL group in terms of operation time

intraoperative blood loss

inflow occlusion rate

duration of inflow occlusion and postoperative hospital stay

but there were no statistically significant differences in the perioperative blood transfusion rate

conversion to laparotomy rate

time to diet

resection margin

and complication incidence. One-year and three-year overall survival rates and tumor-free survival rates had no statistically significant differences.       Conclusion      Laparoscopic anatomical segmentectomy is safe and feasible in the selected patients with HCC

and has good recent effect and low early recurrence. Meanwhile

laparoscopic anatomical segmentectomy can be applied not only to the lesions located at the anterolateral liver segments

but also to the lesions located at the posterosuperior liver segments with high operation difficulty and risk.