Right side hepatic resection under right thoracoabdominal incision with special reference to a highly anatomical systematized method.

The results of 31 right side hepatic resections approached through thoracoabdominal incision are described, with emphasis on the benefit of the approach and systematized liver resection. Regarding postoperative mortality rate (0%) and morbidity rate (32.3%), the thoracoabdominal approach for right side hepatic resection seemed as safe and effective as the conventional abdominal approach. Even though there were no significant differences in the complications, the fluctuation of alanine aminotransferase and the hospital stay, the average operation time for the right segmentectomy through the thoracoabdominal approach was 1.3 hours less (p = 0.0078) than that of the abdominal approach. Technically, this approach was accomplished in almost the same fashion as in the abdominal approach by the utilization of systematized hepatic resection. Thoracotomy itself was not more harmful than the abdominal approach, even in patients with impaired liver function. This combination could take the advantage of a shorter operation time.