To investigate the clinical efficacy and prognosis of anatomic hepatectomy for patients with hepatocellular carcinoma with tumor diameter ≤2 cm and microhemangioma invasion（MVI）.

A retrospective analysis was performed on the clinical data of 113 patients with hepatocellular carcinoma with tumor diameter ≤2 cm and complicated with MVI who underwent surgical treatment from January 2017 to December 2020. They were divided into anatomic hepatectomy group（n=46 cases）and non-anatomic hepatectomy group（n=67 cases）. SPSS 24.0 statistical software was used for clinical data analysis. Perioperative indicators and other measurement data were expressed as（

Compared with NAR group，AR group had longer operation time and less intraoperative blood loss，the differences were statistically significant（P<0.05）. There were no significant differences in the overall incidence of postoperative complications，1-year and 3-year cumulative overall survival rate between the two groups（P>0.05）. The 1-year and 3-year cumulative disease-free survival rates were 84.8% and 51.1% in the AR group and 72.4% and 36.6% in the NAR group，respectively，with statistically significant differences（χ²=4.105，P=0.043）. All patients were divided into M1 group and M2 group according to MVI grading. There was no significant difference in 1-year and 3-year cumulative overall survival of AR subgroup and NAR subgroup in M1 or M2 subgroups（P>0.05）. However，the 1-year and 3-year cumulative disease-free survival rates of AR subgroup and NAR subgroup were significantly different（P<0.05）.

For the hepatocellular carcinoma patients with with diameter≤2 cm and microvascular invasion，AR has longer operative time and less intraoperative blood loss than NAR.In both M1 and M2 patients，AR can benefit patients in postoperative disease-free survival.