Defining global benchmarks for laparoscopic liver resections: An international multicenter study Journal Article
| Authors: | 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. I.; Cheung, T. T.; Sugioka, A.; Hilal, M. A.; Fuks, D.; Edwin, B.; Aldrighetti, L.; and International Robotic and Laparoscopic Liver Resection Study Group Investigators |
| Article Title: | Defining global benchmarks for laparoscopic liver resections: An international multicenter study |
| 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. © 2023 Lippincott Williams and Wilkins. All rights reserved. |
| Keywords: | adult; controlled study; treatment outcome; aged; retrospective studies; major clinical study; clinical trial; liver cell carcinoma; liver neoplasms; antineoplastic agent; laparoscopy; cohort analysis; retrospective study; high risk patient; postoperative complication; postoperative complications; length of stay; liver; multicenter study; liver tumor; operation duration; blood transfusion; surgical mortality; benchmarking; hepatectomy; bile duct carcinoma; neoadjuvant chemotherapy; minimally invasive; laparoscopic liver resection; post hoc analysis; clinical outcome; global; procedures; low risk patient; colorectal liver metastasis; quality assessment; conversion to open surgery; operative blood loss; humans; human; male; female; article; left lateral sectionectomy; multiple tumor; benchmark |
| Journal Title: | Annals of Surgery |
| Volume: | 277 |
| Issue: | 4 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2023-04-01 |
| Start Page: | e839 |
| End Page: | e848 |
| Language: | English |
| DOI: | 10.1097/sla.0000000000005530 |
| PUBMED: | 35837974 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in PubMed and PDF -- Source: Scopus |
