Background : Laparoscopic liver resection has become increasingly prevalent. Numerous efforts have been made to reduce the number of incisions, paving the way for single-port laparoscopic surgery(SPLH). However, few studies have provided long-term follow-up information, and the number of patients with HCC in previous studies has been small. The purpose in this study is to compare the long-term oncological outcomes of HCC patients who underwent SPLH with those of patients who underwent multi-port laparoscopic hepatectomy(MPLH).

Methods : We retrospectively reviewed the medical records of 135 patients with HCC who underwent laparoscopic liver between January 2008 and December 2018. Of the 135 patients, 53 underwent MPLH, and 82 underwent SPLH.

Results : From January 2008 to December 2018, 135 patients underwent laparoscopic hepatectomy for HCC. Among them, 82 patients underwent SPLH, and 53 patients underwent MPLH. Neither long-term overall survival (log rank=0.849) nor recurrence-free survival (log rank=0.057) differed significantly between the two groups, even though the recurrence rate was higher in the SPLH group. In univariable analysis of risk factors for recurrence, multiple tumors, SPLH method, and portal vein invasion were statistically significant (p < 0.05). Multivariable analysis showed that the SPLH method and portal vein invasion were independent adverse prognostic factors for recurrence-free survival.

Conclusions : In terms of both short-term and long-term outcomes, the SPLH method seems to be a feasible approach for HCC in selected patients. Because the potential risk of margin recurrence might produce poor oncological outcomes, strict patient selection is essential to ensure that an adequate safety margin can be secured.