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 / B.K.P. Goh, H. Han, K. Chen, D.W. Chua, C. Chan, F. Cipriani, D.L. Aghayan, A.A. Fretland, J. Sijberden, M. D'Silva, T.F. Siow, Y. Kato, C. Lim, P.P. Nghia, P. Herman, M.V. Marino, V. Mazzaferro, A.K.H. Chiow, I. Sucandy, A. Ivanecz, S.H. Choi, J.H. Lee, M. Gastaca, M. Vivarelli, F. Giuliante, A. Ruzzenente, C. Yong, M. Yin, Z. Chen, C. Fondevila, M. Efanov, F. Rotellar, G. Choi, R.R. Campos, X. Wang, R.P. Sutcliffe, J. Pratschke, E. Lai, C.C. Chong, M. D'Hondt, K. Monden, S. Lopez-Ben, F.F. Coelho, T.P. Kingham, R. Liu, T.C.D. Long, A. Ferrero, G.B.L. Sandri, M. Saleh, D. Cherqui, O. Scatton, O. Soubrane, G. Wakabayashi, R.I. Troisi, T. Cheung, A. Sugioka, M.A. Hilal, D. Fuks, B. Edwin, L. Aldrighetti. - In: ANNALS OF SURGERY. - ISSN 0003-4932. - Publish Ahead of Print:(2022). [Epub ahead of print] [10.1097/SLA.0000000000005530]

Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study

V. Mazzaferro;
2022

Abstract

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.
Settore MED/18 - Chirurgia Generale
15-lug-2022
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/937107
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