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, Brian K P; Han, Ho-Seong; Chen, Kuo-Hsin; Chua, Darren W; Chan, Chung-Yip; Cipriani, Federica; Aghayan, Davit L; Fretland, Asmund A; Sijberden, Jasper; D'Silva, Mizelle; Siow, Tiing Foong; Kato, Yutaro; Lim, Chetana; Nghia, Phan Phuoc; Herman, Paulo; 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; Ruzzenente, Andrea; Yong, Chee-Chien; Yin, Mengqui; Chen, Zewei; Fondevila, Constantino; Efanov, Mikhail; Rotellar, Fernando; Choi, Gi-Hong; Campos, Ricardo R; Wang, Xiaoying; Sutcliffe, Robert P; Pratschke, Johann; Lai, Eric; Chong, Charing C; D'Hondt, Mathieu; Monden, Kazuteru; Lopez-Ben, Santiago; Coelho, Fabricio F; Kingham, Thomas Peter; Liu, Rong; Long, Tran Cong Duy; Ferrero, Alessandro; Sandri, Giovanni B Levi; Saleh, Mansour; Cherqui, Daniel; Scatton, Olivier; Soubrane, Olivier; Wakabayashi, Go; Troisi, Roberto I; Cheung, Tan-To; Sugioka, Atsushi; Hilal, Mohammad Abu; Fuks, David; Edwin, Bjørn; Aldrighetti, Luca. - 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
Vivarelli, Marco;
2023-01-01
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.
