Impact of Tumor Size on the Difficulty of Laparoscopic Major Hepatectomies: An International Multicenter Study

Kato, Y.; Sugioka, A.; Kojima, M.; Syn, N.L.; Zhongkai, W.; Liu, R.; Cipriani, F.; Armstrong, T.; Aghayan, D.L.; Siow, T.; Lim, C.; Scatton, O.; Herman, P.; Coelho, F.F.; Marino, M.V.; Mazzaferro, V.; Chiow Adrian, K.H.; Sucandy, I.; Ivanecz, A.; Choi, S.H.; Lee, J.H.; Gastaca, M.; Vivarelli, M.; Giuliante, F.; Dalla, V.B.; Ruzzenente, A.; Yong, C.; Fondevila, C.; Efanov, M.; Di Benedetto, F.; Belli, A.; Park, J.O.; Rotellar, F.; Choi, G.; Robles-Campos, R.; Wang, X.; Sutcliffe, R.P.; Schmelzle, M.; Pratschke, J.; Lai Eric, C.H.; Chong Charing, C.N.; D’Hondt, M.; Monden, K.; Lopez-Ben, S.; Kingham, T.P.; Forchino, F.; Ferrero, A.; Ettorre, G.M.; Levi Sandri, G.B.; Pascual, F.; Cherqui, D.; Soubrane, O.; Wakabayashi, G.; Troisi, R.I.; Cheung, T.; Chen, Z.; Yin, M.; D’Silva, M.; Han, H.; Nghia, P.P.; Long Tran, C.d.; Edwin, B.; Fuks, D.; Chen, K.; Abu, H.M.; Aldrighetti, L.; Goh Brian, K.P.; Prieto, M.; De Meyere, C.; Meurs, J.; Lee, K.; Salimgereeva, D.; Alikhanov, R.; Lee, L.; Jang, J.Y.; Kruger Jaime, A.P.; Lopez-Lopez, V.; Casellas, I.R.; Montalti, R.; Lee, B.; Wang, H.; Saleh, M.; Vani, S.; Ardito, F.; Giustizieri, U.; Citterio, D.; Mocchegiani, F.; Colasanti, M.; Guzmán, Y.; Labadie, K.P.; Magistri, P.; Mishima, K.; Krenzien, F.; Kadam, P.; Tang, C.N.; Ghotbi, J.; Fretland, Å.A.; Giglio, M.; Mazzotta, A.; Liu, Q.; Yu, S.

Авторы: Kato Yutaro, Sugioka Atsushi, Kojima Masayuki, Syn Nicholas L., Zhongkai Wang, Liu Rong, Cipriani Federica, Armstrong Thomas, Aghayan Davit L., Siow Tiing-Foong, Lim Chetana, Scatton Olivier, Herman Paulo, Coelho Fabricio Ferreira, Marino Marco V., Mazzaferro Vincenzo, Chiow Adrian K.H., Sucandy Iswanto, Ivanecz Arpad, Choi Sung Hoon, Lee Jae Hoon, Gastaca Mikel, Vivarelli Marco, Giuliante Felice, Dalla Valle Bernardo, Ruzzenente Andrea, Yong Chee-Chien, Fondevila Constantino, Efanov Mikhail, Di Benedetto Fabrizio, Belli Andrea, Park James O., Rotellar Fernando, Choi Gi-Hong, Robles-Campos Ricardo, Wang Xiaoying, Sutcliffe Robert P., Schmelzle Moritz, Pratschke Johann, Lai Eric C.H., Chong Charing C.N., D’Hondt Mathieu, Monden Kazuteru, Lopez-Ben Santiago, Kingham T.Peter, Forchino Fabio, Ferrero Alessandro, Ettorre Giuseppe Maria, Levi Sandri Giovanni Battista, Pascual Franco, Cherqui Daniel, Soubrane Olivier, Wakabayashi Go, Troisi Roberto I., Cheung Tan-To, Chen Zewei, Yin Mengqiu, D’Silva Mizelle, Han Ho-Seong, Nghia Phan Phuoc, Long Tran Cong duy, Edwin Bjørn, Fuks David, Chen Kuo-Hsin, Abu Hilal Mohammad, Aldrighetti Luca, Goh Brian K.P., Prieto Mikel, De Meyere Celine, Meurs Juul, Lee Kit-Fai, Salimgereeva Diana, Alikhanov Ruslan, Lee Lip-Seng, Jang Jae Young, Kruger Jaime Arthur Pirola, Lopez-Lopez Victor, Casellas I.Robert Margarida, Montalti Roberto, Lee Boram, Wang Hao-Ping, Saleh Mansour, Vani Simone, Ardito Francesco, Giustizieri Ugo, Citterio Davide, Mocchegiani Federico, Colasanti Marco, Guzmán Yoelimar, Labadie Kevin P., Magistri Paolo, Mishima Kohei, Krenzien Felix, Kadam Prashant, Tang Chung Ngai, Ghotbi Jacob, Fretland Åsmund Avdem, Giglio Mariano, Mazzotta Alessandro, Liu Qu, Yu Shian
Журнал: Annals of Surgical Oncology
Том: 30
Номер: 11
Год издания: 2023
Издательство: Lippincott Williams & Wilkins Ltd.
Местоположение издательства: United States
Первая страница: 6628
Последняя страница: 6636
DOI: 10.1245/s10434-023-13863-z
Аннотация: Introduction Although tumor size (TS) is known to affect surgical outcomes in laparoscopic liver resection (LLR), its impact on laparoscopic major hepatectomy (L-MH) is not well studied. The objectives of this study were to investigate the impact of TS on the perioperative outcomes of L-MH and to elucidate the optimal TS cutoff for stratifying the difficulty of L-MH. Methods This was a post-hoc analysis of 3008 patients who underwent L-MH at 48 international centers. A total 1396 patients met study criteria and were included. The impact of TS cutoffs was investigated by stratifying TS at each 10-mm interval. The optimal cutoffs were determined taking into consideration the number of endpoints which showed a statistically significant split around the cut-points of interest and the magnitude of relative risk after correction for multiple risk factors. Results We identified 2 optimal TS cutoffs, 50 mm and 100 mm, which segregated L-MH into 3 groups. An increasing TS across these 3 groups (≤ 50 mm, 51–100 mm, > 100 mm), was significantly associated with a higher open conversion rate (11.2%, 14.7%, 23.0%, P < 0.001), longer operating time (median, 340 min, 346 min, 365 min, P = 0.025), increased blood loss (median, 300 ml, ml, 400 ml, P = 0.002) and higher rate of intraoperative blood transfusion (13.1%, 15.9%, 27.6%, P < 0.001). Postoperative outcomes such as overall morbidity, major morbidity, and length of stay were comparable across the three groups. Conclusion Increasing TS was associated with poorer intraoperative but not postoperative outcomes after L-MH. We determined 2 TS cutoffs (50 mm and 10 mm) which could optimally stratify the surgical difficulty of L-MH.
Добавил в систему: Тарасова Елена Владимировна

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Impact of Tumor Size on the Difficulty of Laparoscopic Major Hepatectomies: An International Multicenter Studyстатья