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Article: Impact of tumor size on the difficulty of laparoscopic left lateral sectionectomies

TitleImpact of tumor size on the difficulty of laparoscopic left lateral sectionectomies
Authors
Keywordsdifficulty
laparoscopic hepatectomy
laparoscopic liver
left lateral sectionectomy
size
Issue Date5-Dec-2022
PublisherSpringer
Citation
Journal of Hepato-Biliary-Pancreatic Sciences, 2022, v. 30, n. 5, p. 558-569 How to Cite?
Abstract

Background

Tumor size (TS) represents a critical parameter in the risk assessment of laparoscopic liver resections (LLR). Moreover, TS has been rarely related to the extent of liver resection. The aim of this study was to study the relationship between tumor size and difficulty of laparoscopic left lateral sectionectomy (L-LLS).

Methods

The impact of TS cutoffs was investigated by stratifying tumor size at each 10 mm-interval. The optimal cutoffs were chosen taking into consideration the number of endpoints which show a statistically significant split around the cut-points of interest and the magnitude of relative risk after correction for multiple risk factors.

Results

A total of 1910 L-LLS were included. Overall, open conversion and intraoperative blood transfusion were 3.1 and 3.3%, respectively. The major morbidity rate was 2.7% and 90-days mortality 0.6%. Three optimal TS cutoffs were identified: 40-, 70-, and 100-mm. All the selected cutoffs showed a significant discriminative power for the prediction of open conversion, operative time, blood transfusion and need of Pringle maneuver. Moreover, 70- and 100-mm cutoffs were both discriminative for estimated blood loss and major complications. A stepwise increase in rates of open conversion rate (Z = 3.90, P < .001), operative time (Z = 3.84, P < .001), blood loss (Z = 6.50, P < .001), intraoperative blood transfusion rate (Z = 5.15, P < .001), Pringle maneuver use (Z = 6.48, P < .001), major morbidity(Z = 2.17, P = .030) and 30-days readmission (Z = 1.99, P = .047) was registered as the size increased.

Conclusion

L-LLS for tumors of increasing size was associated with poorer intraoperative and early postoperative outcomes suggesting increasing difficulty of the procedure. We determined three optimal TS cutoffs (40-, 70- and 100-mm) to accurately stratify surgical difficulty after L-LLS.


Persistent Identifierhttp://hdl.handle.net/10722/331234
ISSN
2023 Impact Factor: 3.2
2023 SCImago Journal Rankings: 1.045
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorAizza, G-
dc.contributor.authorRussolillo, N-
dc.contributor.authorFerrero, A-
dc.contributor.authorSyn, NL-
dc.contributor.authorCipriani, F-
dc.contributor.authorAghayan, D-
dc.contributor.authorMarino, MV-
dc.contributor.authorMemeo, R-
dc.contributor.authorMazzaferro, V-
dc.contributor.authorChiow, AKH-
dc.contributor.authorSucandy, I-
dc.contributor.authorIvanecz, A-
dc.contributor.authorVivarelli, M-
dc.contributor.authorDi Benedetto, F-
dc.contributor.authorChoi, SH-
dc.contributor.authorLee, JH-
dc.contributor.authorPark, JO-
dc.contributor.authorGastaca, M-
dc.contributor.authorFondevila, C-
dc.contributor.authorEfanov, M-
dc.contributor.authorRotellar, F-
dc.contributor.authorChoi, GH-
dc.contributor.authorRobles-Campos, R-
dc.contributor.authorWang, XY-
dc.contributor.authorSutcliffe, RP-
dc.contributor.authorPratschke, J-
dc.contributor.authorTang, CN-
dc.contributor.authorChong, CC-
dc.contributor.authorD'Hondt, M-
dc.contributor.authorYong, CC-
dc.contributor.authorRuzzenente, A-
dc.contributor.authorHerman, P-
dc.contributor.authorKingham, TP-
dc.contributor.authorScatton, O-
dc.contributor.authorLiu, R-
dc.contributor.authorSandri, GBL-
dc.contributor.authorSoubrane, O-
dc.contributor.authorMejia, A-
dc.contributor.authorLopez-Ben, S-
dc.contributor.authorMonden, K-
dc.contributor.authorWakabayashi, G-
dc.contributor.authorCherqui, D-
dc.contributor.authorTroisi, RI-
dc.contributor.authorYin, MQ-
dc.contributor.authorGiuliante, F-
dc.contributor.authorGeller, D-
dc.contributor.authorSugioka, A-
dc.contributor.authorEdwin, B-
dc.contributor.authorCheung, TT-
dc.contributor.authorLong, TCD-
dc.contributor.authorAbu Hilal, M-
dc.contributor.authorFuks, D-
dc.contributor.authorChen, KH-
dc.contributor.authorAldrighetti, L-
dc.contributor.authorHan, HS-
dc.contributor.authorGoh, BKP-
dc.date.accessioned2023-09-21T06:53:55Z-
dc.date.available2023-09-21T06:53:55Z-
dc.date.issued2022-12-05-
dc.identifier.citationJournal of Hepato-Biliary-Pancreatic Sciences, 2022, v. 30, n. 5, p. 558-569-
dc.identifier.issn1868-6974-
dc.identifier.urihttp://hdl.handle.net/10722/331234-
dc.description.abstract<h3>Background</h3><p>Tumor size (TS) represents a critical parameter in the risk assessment of laparoscopic liver resections (LLR). Moreover, TS has been rarely related to the extent of liver resection. The aim of this study was to study the relationship between tumor size and difficulty of laparoscopic left lateral sectionectomy (L-LLS).</p><h3>Methods</h3><p>The impact of TS cutoffs was investigated by stratifying tumor size at each 10 mm-interval. The optimal cutoffs were chosen taking into consideration the number of endpoints which show a statistically significant split around the cut-points of interest and the magnitude of relative risk after correction for multiple risk factors.</p><h3>Results</h3><p>A total of 1910 L-LLS were included. Overall, open conversion and intraoperative blood transfusion were 3.1 and 3.3%, respectively. The major morbidity rate was 2.7% and 90-days mortality 0.6%. Three optimal TS cutoffs were identified: 40-, 70-, and 100-mm. All the selected cutoffs showed a significant discriminative power for the prediction of open conversion, operative time, blood transfusion and need of Pringle maneuver. Moreover, 70- and 100-mm cutoffs were both discriminative for estimated blood loss and major complications. A stepwise increase in rates of open conversion rate (Z = 3.90, <em>P</em> < .001), operative time (Z = 3.84, <em>P</em> < .001), blood loss (Z = 6.50, <em>P</em> < .001), intraoperative blood transfusion rate (Z = 5.15, <em>P</em> < .001), Pringle maneuver use (Z = 6.48, <em>P</em> < .001), major morbidity(Z = 2.17, <em>P</em> = .030) and 30-days readmission (Z = 1.99, <em>P</em> = .047) was registered as the size increased.</p><h3>Conclusion</h3><p>L-LLS for tumors of increasing size was associated with poorer intraoperative and early postoperative outcomes suggesting increasing difficulty of the procedure. We determined three optimal TS cutoffs (40-, 70- and 100-mm) to accurately stratify surgical difficulty after L-LLS.</p>-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofJournal of Hepato-Biliary-Pancreatic Sciences-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectdifficulty-
dc.subjectlaparoscopic hepatectomy-
dc.subjectlaparoscopic liver-
dc.subjectleft lateral sectionectomy-
dc.subjectsize-
dc.titleImpact of tumor size on the difficulty of laparoscopic left lateral sectionectomies-
dc.typeArticle-
dc.identifier.doi10.1002/jhbp.1279-
dc.identifier.scopuseid_2-s2.0-85160203878-
dc.identifier.volume30-
dc.identifier.issue5-
dc.identifier.spage558-
dc.identifier.epage569-
dc.identifier.eissn1868-6982-
dc.identifier.isiWOS:000928244400001-
dc.identifier.issnl1868-6974-

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