To investigate the application value of hepatectomy via anterior approach in the surgery of primary liver cancer.

Clinical data of 138 patients with primary liver cancer undergoing hepatectomy in Sun Yat-sen Memorial Hospital and Lingnan Branch, the Third Affiliated Hospital of Sun Yat-sen University from June 2011 to June 2014 were retrospectively analyzed. There were 97 males and 41 females, aged 36 to 87 years with a median age of 52 years. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into the anterior approach hepatectomy group (anterior group, n=63) and traditional approach hepatectomy group (traditional group, n=75). Preoperative general data, intra-, post-operative parameters of two groups were compared using t test or Chi-square test.

In the anterior group, the percentage of patients with Child-Pugh liver function grade B and C, multiple tumors and tumor diameter > 10 cm was 73% (46/63), 44% (28/63) and 16%(16/63) respectively, which were significantly higher compared with 37% (28/75), 17% (13/75) and 5%(4/75) in the traditional group (χ²=20.444, 12.051, 8.144; P<0.05). In the anterior group, the average intraoperative blood loss, transfusion volume of plasma and red blood cells were (428±17), (470±14) and (300±7) ml, which were significantly lower compared with (517±11), (630±15) and (420±11) ml in the traditional group (t=-6.097, -2.927, -8.928; P<0.05). The rate of postoperative complications in anterior group was 10% (6/63), which was significantly lower compared with 17% (13/75) in the traditional group (χ²=1.759, P<0.05).

For patients with poor liver function, multiple and large tumors, hepatectomy via anterior approach is a preferential surgical procedure rather than the traditional approach hepatectomy.