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Article: Sub-classification of laparoscopic left hepatectomy based on hierarchic interaction of tumor location and size with perioperative outcomes

TitleSub-classification of laparoscopic left hepatectomy based on hierarchic interaction of tumor location and size with perioperative outcomes
Authors
Keywordsdifficulty
laparoscopy
left hepatectomy
location
tumor size
Issue Date1-Sep-2023
PublisherSpringer
Citation
Journal of Hepato-Biliary-Pancreatic Sciences, 2023, v. 30, n. 9, p. 1098-1110 How to Cite?
Abstract

Background: The aim of this multicentric study was to investigate the impact of tumor location and size on the difficulty of Laparoscopic- Left Hepatectomy (L- LH).Methods: Patients who underwent L- LH performed across 46 centers from 2004 to 2020 were analyzed. Of 1236 L- LH, 770 patients met the study criteria. Baseline clinical and surgical characteristics with a potential impact on LLR were included in a multi-label conditional interference tree. Tumor size cut -off was algorithmically determined. Results: Patients were stratified into 3 groups based on tumor location and dimension: 457 in antero-lateral location (Group 1), 144 in postero-superior segment (4a) with tumor size = 40 mm (Group 2), and 169 in postero-superior segment (4a) with tumor size >40 mm (Group 3). Patients in the Group 3 had higher conversion rate (7.0% vs. 7.6% vs. 13.0%, p- value .048), longer operating time (median, 240 min vs. 285 min vs. 286 min, p-value <.001), greater blood loss (median, 150 mL vs. 200 mL vs. 250 mL, p-value <.001) and higher intraoperative blood transfusion rate (5.7% vs. 5.6% vs. 11.3%, p- value .039). Pringle's maneu-ver was also utilized more frequently in Group 3 (66.7%), compared to Group 1 (53.2%) and Group 2 (51.8%) (p = .006). There were no significant differences in postoperative stay, major morbidity, and mortality between the three groups. Conclusion: L- LH for tumors that are >40 mm in diameter and located in PS Segment 4a are associated with the highest degree of technical difficulty. However, post-operative outcomes were not different from L- LH of smaller tumors located in PS segments, or tumors located in the antero-lateral segments.


Persistent Identifierhttp://hdl.handle.net/10722/338479
ISSN
2023 Impact Factor: 3.2
2023 SCImago Journal Rankings: 1.045
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorRuzzenente, A-
dc.contributor.authorValle, B-
dc.contributor.authorPoletto, E-
dc.contributor.authorSyn, N-
dc.contributor.authorKabir, T-
dc.contributor.authorSugioka, A-
dc.contributor.authorCipriani, F-
dc.contributor.authorCherqui, D-
dc.contributor.authorHan, HS-
dc.contributor.authorArmstrong, T-
dc.contributor.authorLong, TCD-
dc.contributor.authorScatton, O-
dc.contributor.authorHerman, P-
dc.contributor.authorPratschke, J-
dc.contributor.authorAghayan, D-
dc.contributor.authorLiu, R-
dc.contributor.authorMarino, M-
dc.contributor.authorChiow, AKH-
dc.contributor.authorSucandy, I-
dc.contributor.authorIvanecz, A-
dc.contributor.authorVivarelli, M-
dc.contributor.authorBenedetto, F Di-
dc.contributor.authorChoi, SH-
dc.contributor.authorLee, JH-
dc.contributor.authorPrieto, 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, X-
dc.contributor.authorSutcliffe, RP-
dc.contributor.authorLai, ECH-
dc.contributor.authorChong, CC-
dc.contributor.authorD'Hondt, M-
dc.contributor.authorYong, CC-
dc.contributor.authorTroisi, RI-
dc.contributor.authorKingham, TP-
dc.contributor.authorFerrero, A-
dc.contributor.authorSandri, GBL-
dc.contributor.authorSoubrane, O-
dc.contributor.authorYin, M-
dc.contributor.authorLopez-Ben, S-
dc.contributor.authorMazzaferro, V-
dc.contributor.authorGiuliante, F-
dc.contributor.authorMonden, K-
dc.contributor.authorMishima, K-
dc.contributor.authorWakabayashi, G-
dc.contributor.authorCheung, TT-
dc.contributor.authorFuks, D-
dc.contributor.authorHilal, MA-
dc.contributor.authorChen, KHn-
dc.contributor.authorAldrighetti, L-
dc.contributor.authorEdwin, B-
dc.contributor.authorGoh, BKP-
dc.contributor.authorGastaca, M-
dc.contributor.authorSchotte, H-
dc.contributor.authorde Meyere, C-
dc.contributor.authorKrenzien, F-
dc.contributor.authorSchmelzle, M-
dc.contributor.authorLee, KF-
dc.contributor.authorSalimgereeva, D-
dc.contributor.authorAlikhanov, R-
dc.contributor.authorLee, LS-
dc.contributor.authorJang, JY-
dc.contributor.authorKato, Y-
dc.contributor.authorKojima, M-
dc.contributor.authorFretland, AA-
dc.contributor.authorGhotbi, J-
dc.contributor.authorCoelho, FF-
dc.contributor.authorKruger, JAP-
dc.contributor.authorLopez-Lopez, V-
dc.contributor.authorMagistri, P-
dc.contributor.authorRobert, MCI-
dc.contributor.authorMontalti, R-
dc.contributor.authorGiglio, M-
dc.contributor.authorMazzotta, A-
dc.contributor.authorLee, B-
dc.contributor.authorD'Silva, M-
dc.contributor.authorWang, HP-
dc.contributor.authorSaleh, M-
dc.contributor.authorPascual, F-
dc.contributor.authorNghia, PP-
dc.contributor.authorLim, C-
dc.contributor.authorLiu, Q-
dc.contributor.authorKadam, P-
dc.contributor.authorTang, CN-
dc.contributor.authorChen, Z-
dc.contributor.authorYu, S-
dc.contributor.authorGiustizieri, U-
dc.contributor.authorCitterio, D-
dc.contributor.authorArdito, F-
dc.contributor.authorVani, S-
dc.contributor.authorSiow, TF-
dc.contributor.authorMocchegianni, F-
dc.contributor.authorEttorre, GM-
dc.contributor.authorColasanti, M-
dc.date.accessioned2024-03-11T10:29:13Z-
dc.date.available2024-03-11T10:29:13Z-
dc.date.issued2023-09-01-
dc.identifier.citationJournal of Hepato-Biliary-Pancreatic Sciences, 2023, v. 30, n. 9, p. 1098-1110-
dc.identifier.issn1868-6974-
dc.identifier.urihttp://hdl.handle.net/10722/338479-
dc.description.abstract<p>Background: The aim of this multicentric study was to investigate the impact of tumor location and size on the difficulty of Laparoscopic- Left Hepatectomy (L- LH).Methods: Patients who underwent L- LH performed across 46 centers from 2004 to 2020 were analyzed. Of 1236 L- LH, 770 patients met the study criteria. Baseline clinical and surgical characteristics with a potential impact on LLR were included in a multi-label conditional interference tree. Tumor size cut -off was algorithmically determined. Results: Patients were stratified into 3 groups based on tumor location and dimension: 457 in antero-lateral location (Group 1), 144 in postero-superior segment (4a) with tumor size = 40 mm (Group 2), and 169 in postero-superior segment (4a) with tumor size >40 mm (Group 3). Patients in the Group 3 had higher conversion rate (7.0% vs. 7.6% vs. 13.0%, p- value .048), longer operating time (median, 240 min vs. 285 min vs. 286 min, p-value <.001), greater blood loss (median, 150 mL vs. 200 mL vs. 250 mL, p-value <.001) and higher intraoperative blood transfusion rate (5.7% vs. 5.6% vs. 11.3%, p- value .039). Pringle's maneu-ver was also utilized more frequently in Group 3 (66.7%), compared to Group 1 (53.2%) and Group 2 (51.8%) (p = .006). There were no significant differences in postoperative stay, major morbidity, and mortality between the three groups. Conclusion: L- LH for tumors that are >40 mm in diameter and located in PS Segment 4a are associated with the highest degree of technical difficulty. However, post-operative outcomes were not different from L- LH of smaller tumors located in PS segments, or tumors located in the antero-lateral segments.<br></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.subjectlaparoscopy-
dc.subjectleft hepatectomy-
dc.subjectlocation-
dc.subjecttumor size-
dc.titleSub-classification of laparoscopic left hepatectomy based on hierarchic interaction of tumor location and size with perioperative outcomes-
dc.typeArticle-
dc.identifier.doi10.1002/jhbp.1323-
dc.identifier.scopuseid_2-s2.0-85152433393-
dc.identifier.volume30-
dc.identifier.issue9-
dc.identifier.spage1098-
dc.identifier.epage1110-
dc.identifier.eissn1868-6982-
dc.identifier.isiWOS:000960712000001-
dc.identifier.issnl1868-6974-

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