Objective: To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR). Background: There is limited published data to date on the best achievable outcomes after L-LR. Methods: This is a post hoc analysis of a multicenter database of 11,983 patients undergoing L-LR in 45 international centers in 4 continents between 2015 and 2020. Three specific procedures: left lateral sectionectomy (LLS), left hepatectomy (LH), and right hepatectomy (RH) were selected to represent the 3 difficulty levels of L-LR. Fifteen outcome indicators were selected to establish benchmark cutoffs. Results: There were 3519 L-LR (LLS, LH, RH) of which 1258 L-LR (40.6%) cases performed in 34 benchmark expert centers qualified as low-risk benchmark cases. These included 659 LLS (52.4%), 306 LH (24.3%), and 293 RH (23.3%). The benchmark outcomes established for operation time, open conversion rate, blood loss ≥500 mL, blood transfusion rate, postoperative morbidity, major morbidity, and 90-day mortality after LLS, LH, and RH were 209.5, 302, and 426 minutes; 2.1%, 13.4%, and 13.0%; 3.2%, 20%, and 47.1%; 0%, 7.1%, and 10.5%; 11.1%, 20%, and 50%; 0%, 7.1%, and 20%; and 0%, 0%, and 0%, respectively. Conclusions: This study established the first global benchmark outcomes for L-LR in a large-scale international patient cohort. It provides an up-to-date reference regarding the "best achievable" results for L-LR for which centers adopting L-LR can use as a comparison to enable an objective assessment of performance gaps and learning curves.
Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study / Goh, B. K. P.; Han, H. -S.; Chen, K. -H.; Chua, D. W.; Chan, C. -Y.; Cipriani, F.; Aghayan, D. L.; Fretland, A. A.; Sijberden, J.; D'Silva, M.; Siow, T. F.; Kato, Y.; Lim, C.; Nghia, P. P.; Herman, P.; Marino, M. V.; Mazzaferro, V.; Chiow, A. K. H.; Sucandy, I.; Ivanecz, A.; Choi, S. H.; Lee, J. H.; Gastaca, M.; Vivarelli, M.; Giuliante, F.; Ruzzenente, A.; Yong, C. -C.; Yin, M.; Chen, Z.; Fondevila, C.; Efanov, M.; Rotellar, F.; Choi, G. -H.; Campos, R. R.; Wang, X.; Sutcliffe, R. P.; Pratschke, J.; Lai, E.; Chong, C. C.; D'Hondt, M.; Monden, K.; Lopez-Ben, S.; Coelho, F. F.; Kingham, T. P.; Liu, R.; Long, T. C. D.; Ferrero, A.; Sandri, G. B. L.; Saleh, M.; Cherqui, D.; Scatton, O.; Soubrane, O.; Wakabayashi, G.; Troisi, R.; Cheung, T. -T.; Sugioka, A.; Hilal, M. A.; Fuks, D.; Edwin, B.; Aldrighetti, L.; Syn, N.; Prieto, M.; Schotte, H.; De Meyere, C.; Krenzien, F.; Schmelzle, M.; Lee, K. -F.; Salimgereeva, D.; Alikhanov, R.; Lee, L. -S.; Jang, J. Y.; Kojima, M.; Ghotbi, J.; Kruger, J. A. P.; Lopez-Lopez, V.; Valle, B. D.; Casellas I Robert, M.; Mishima, K.; Montalti, R.; Giglio, M.; Mazzotta, A.; Lee, B.; Wang, H. -P.; Pascual, F.; Kadam, P.; Tang, C. -N.; Yu, S.; Ardito, F.; Vani, S.; Giustizieri, U.; Citterio, D.; Mocchegiani, F.; Ettorre, G. M.; Colasanti, M.; Guzman, Y.. - In: ANNALS OF SURGERY. - ISSN 0003-4932. - 277:4(2023), pp. E839-E848. [10.1097/SLA.0000000000005530]
Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study
Wang X.;Troisi R.;Montalti R.;Giglio M.;
2023
Abstract
Objective: To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR). Background: There is limited published data to date on the best achievable outcomes after L-LR. Methods: This is a post hoc analysis of a multicenter database of 11,983 patients undergoing L-LR in 45 international centers in 4 continents between 2015 and 2020. Three specific procedures: left lateral sectionectomy (LLS), left hepatectomy (LH), and right hepatectomy (RH) were selected to represent the 3 difficulty levels of L-LR. Fifteen outcome indicators were selected to establish benchmark cutoffs. Results: There were 3519 L-LR (LLS, LH, RH) of which 1258 L-LR (40.6%) cases performed in 34 benchmark expert centers qualified as low-risk benchmark cases. These included 659 LLS (52.4%), 306 LH (24.3%), and 293 RH (23.3%). The benchmark outcomes established for operation time, open conversion rate, blood loss ≥500 mL, blood transfusion rate, postoperative morbidity, major morbidity, and 90-day mortality after LLS, LH, and RH were 209.5, 302, and 426 minutes; 2.1%, 13.4%, and 13.0%; 3.2%, 20%, and 47.1%; 0%, 7.1%, and 10.5%; 11.1%, 20%, and 50%; 0%, 7.1%, and 20%; and 0%, 0%, and 0%, respectively. Conclusions: This study established the first global benchmark outcomes for L-LR in a large-scale international patient cohort. It provides an up-to-date reference regarding the "best achievable" results for L-LR for which centers adopting L-LR can use as a comparison to enable an objective assessment of performance gaps and learning curves.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
