Laparoscopic Extended Left Lateral Sectionectomy for Hepatocellular Carcinoma in a Patient with Right-Sided Ligamentum Teres: A Case Report and Literature Review

Round 1

Reviewer 1 Report

“Laparoscopic extended left lateral sectionectomy for hepatocellular carcinoma in a patient with right-sided ligamentum teres: case report and literature review” by Yuki Adachi, Hiroyuki Takahashi, Tomohiro Yamamoto, Masahiro Hagiwara, Koji Imai and Hideki Yokoo is a well-presented case report of a rare anatomic variant of the right-sided ligamentum teres (RSLT), in which the fetal umbilical vein connects to the right portal vein. Such patients with RSLT frequently presents anomalies of the hepatic vasculature and bile duct, with increased risk of complications during hepatectomy. A 69-year-old man with hepatocellular carcinoma (HCC) located in the left liver was thoroughly investigated based on three-dimensional computed tomography (CT) and magnetic resonance imaging (MRI), which also demonstrated RSLT. CT scan revealed independent right-sided abnormalities of the portal vein and bile duct. To present this case report, the authors used contrast-enhanced CT, MRI and three-dimensional CT, as well as intra-operative photographs, all with very good accuracy. The results were presented and discussed well. In discussions, the authors presented also 15 previously reported cases of hepatectomy for malignant tumor in patients with RSLT. The manuscript is not loaded with useless details.

Final conclusions are to the point. This case report proves that laparoscopic hepatectomy in such cases can be performed safely when a careful surgical planning is conducted using preoperative three-dimensional CT analysis and intraoperative ultrasonography is applied, inspiring clinicians and surgeons.

However, this article has several shortcomings as follows:

The Title should be written in Title Case.

A List of abbreviations must be completed, carefully revised and integrated into the manuscript.

More English and style issues could be improved by a native English speaker at a final reading on the MDPI platform.

Overall, I congratulate the authors for preparing this very interesting case report, which required a lot of dedicated work.

Thank you very much!

More English and style issues could be improved by a native English speaker at a final reading on the MDPI platform.

Thank you very much!

Author Response

Dear Reviewer,

We sincerely appreciate your time and effort in reviewing our manuscript "Laparoscopic Extended Left Lateral Sectionectomy for Hepatocellular Carcinoma in a Patient with Right-Sided Ligamentum Teres: Case Report and Literature Review." Your constructive feedback has been immensely valuable to us, and we are grateful for your thoughtful evaluation of our work.

We have carefully considered your suggestions for improvement and we have addressed the highlighted issues as bellow.

Point 1: The Title should be written in Title Case.

Response 1: We have duly modified the title to adhere to the Title Case format, giving it the appropriate capitalization.

Point 2: A List of abbreviations must be completed, carefully revised and integrated into the manuscript.

Response 2: All abbreviations used in the manuscript have been meticulously reviewed, completed, and integrated into the text. 

Point 3: More English and style issues could be improved by a native English speaker at a final reading on the MDPI platform.

Response 3: To ensure the accuracy and coherence of the manuscript, we have utilized the English language editing service provided by MDPI's platform. 

We have made all the mentioned modifications to the manuscript, and we have used yellow highlights to mark the corrected sections.

Once again, we extend our deepest gratitude for your valuable feedback and kind words. Your insights have significantly contributed to the improvement of our work. Should you have any further suggestions or comments, please do not hesitate to share them with us.

Thank you very much for your time and support.

Sincerely,

Yuki Adachi

Reviewer 2 Report

Congratulations for the authors in writing this paper in an interesting area of  of liver surgery.The method is   sufficiently described to allow  to be repeated or to increase the likelihood of a  change in surgical technique. The presentation of the work is clear.

Author Response

Dear Reviewer,

We would like to express our heartfelt gratitude for your thoughtful and positive review of our paper. Your encouraging feedback means a lot to us, and we are pleased to hear that you found our research interesting.

We hope that our work will positively impact the field of liver surgery.

Once again, thank you for your time and support.

Sincerely,

Yuki Adachi