To compare the clinical effects of three different approaches used in laparoscopic anatomical left lateral liver resection.

A retrospective analysis was performed on the clinical data of 102 patients undergoing hepatic resection from February 2019 to February 2021. According to the different surgical approach，the patients were divided into group A（resection via Glisson’s external anatomic route，n=33 cases）and group B（resection via ligamentum teres fissure，n=35 cases），group C（resection via liver parenchyma via priority approach，n=34 cases）. Statistical software SPSS 23.0 was used for data analysis. Perioperative indexes，liver function indexes，oxidative stress indexes and other measurement data were expressed by（

The operative time，intraoperative blood loss and postoperative hospitalization time in group C were less than those in groups A and B（P<0.05）. On 1 d after surgery，total bilirubin（TBIL），glutamic-oxalacetic transaminase（AST）and glutamic-pyruvic transaminase（ALT）in three groups were significantly increased（P<0.05），while albumin（ALB）and pre-albumin（PAB）were significantly decreased（P<0.05）；The TBIL，AST，ALT and ALB in the three groups was close to that before operation（P>0.05），and the recovery of PAB was slow（P<0.05）.The total antioxidant capacity（T-AOC）and superoxide dismutase（SOD）in groups B and C were significantly higher than those in group A，and oxidized glutathione（GSSG）and malondialdehyde（MDA）of group B and C were significantly lower than those in group A at 1 and 3 days after operation（P<0.05）. There was no statistical difference in liver function indexes at any time point（P>0.05）.

Compared with Glisson's extracapsular dissection，transligamentum teres fissure approach and transhepatic parenchyma priority approach have shorter duration，less bleeding and faster recovery，which can reduce liver oxidative stress response and contribute to recovery of residual liver function.