{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:42:19Z","timestamp":1792590139566,"version":"4.5.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":123,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Minimally invasive extended left hepatectomy (MI\u2010ExLH) remains a technically challenging procedure that is not yet standardized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed cases of minimally invasive left hepatectomy (MI\u2010LH) and MI\u2010ExLH performed between 2018 and 2025 at a single institution. Surgical strategies were classified into three categories according to the tri\u2010scenario\u2010based MAICOHAN strategy (\n                      <jats:italic>M<\/jats:italic>\n                      HV\u2010based\n                      <jats:italic>A<\/jats:italic>\n                      ssessment and\n                      <jats:italic>I<\/jats:italic>\n                      nvolvement\/non\u2010involvement in\n                      <jats:italic>C<\/jats:italic>\n                      audate\u2013hilum\u2010dependent\n                      <jats:italic>O<\/jats:italic>\n                      ptimal extended left\n                      <jats:italic>H<\/jats:italic>\n                      epatectomy\n                      <jats:italic>A<\/jats:italic>\n                      lgorithmic\n                      <jats:italic>N<\/jats:italic>\n                      avigation): (1) the cranio\u2010dorsal or cranio\u2010ventral approach, selected depending on the tumor\u2010middle hepatic vein (MHV) relationship, (2) the Arantius\u2010first or caudate lobe resection approach, chosen based on caudate lobe involvement, and (3) the liver\u2010transection\u2010first or left\u2010hepatic\u2010duct\u2010dissection\u2010first approach, based on the tumor\u2010left hepatic hilum relationship. We divided the cases into two groups\u2014the MAICOHAN strategy group (MS group) and the non\u2010MAICOHAN strategy group (non\u2010MS group), where procedures were and were not performed according to the abovementioned scenarios, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven MI\u2010LH and 12 MI\u2010ExLH cases were included (MS group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911; non\u2010MS group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912). Operative time and length of hospital stay were significantly shorter in the MS group than in the non\u2010MS group (262 vs. 376\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023; 6 vs. 9\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). In the subgroup analysis restricted to MI\u2010ExLH cases, the incidence of positive surgical margins was significantly lower in the MS group (0% vs. 50%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The tri\u2010scenario\u2010based MAICOHAN strategy provides a practical framework that may contribute to guiding surgeons in planning and performing MI\u2010ExLH more safely and consistently.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70304","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:02:24Z","timestamp":1777942944000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tri\u2010Scenario\u2010Based\n                    <scp>MAICOHAN<\/scp>\n                    Strategy for Minimally Invasive Extended Left Hepatectomy"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8740-8468","authenticated-orcid":false,"given":"Yusuke","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Morimura","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taisuke","family":"Imamura","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidemasa","family":"Kubo","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rie","family":"Shibata","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5879-9826","authenticated-orcid":false,"given":"Hiroyuki","family":"Inoue","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kento","family":"Kurashima","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiji","family":"Nishibeppu","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3169-360X","authenticated-orcid":false,"given":"Kenji","family":"Nanishi","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0787-1955","authenticated-orcid":false,"given":"Jun","family":"Kiuchi","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Arita","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Kosuga","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4899-8944","authenticated-orcid":false,"given":"Hirotaka","family":"Konishi","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Kyoto Prefectural University of Medicine  Kyoto 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