Details

Autor(en) / Beteiligte

• Ruzzenente, Andrea
• Valle, Bernardo Dalla
• Poletto, Edoardo
• Syn, Nicholas L
• Kabir, Tousif
• Sugioka, Atsushi
• Cipriani, Federica
• Cherqui, Daniel
• Han, Ho-Seong
• Armstrong, Thomas
• Long, Tran Cong Duy
• Scatton, Olivier
• Herman, Paolo
• Pratschke, Johann
• Aghayan, Davit L
• Liu, Rong
• Marino, Marco V
• Chiow, Adrian K H
• Sucandy, Iswanto
• Ivanecz, Arpad
• Vivarelli, Marco
• Di Benedetto, Fabrizio
• Choi, Sung-Hoon
• Lee, Jae Hoon
• Prieto, Mikel
• Fondevila, Constantino
• Efanov, Mikhail
• Rotellar, Fernando
• Choi, Gi-Hong
• Robles-Campos, Ricardo
• Wang, Xiaoying
• Sutcliffe, Robert P
• Lai, Eric C H
• Chong, Charing C
• D'Hondt, Mathieu
• Yong, Chee Chien
• Troisi, Roberto I
• Kingham, T Peter
• Ferrero, Alessandro
• Levi Sandri, Giovanni Battista
• Soubrane, Olivier
• Yin, Mengqiu
• Lopez-Ben, Santiago
• Mazzaferro, Vincenzo
• Giuliante, Felice
• Monden, Kazateru
• Mishima, Kohei
• Wakabayashi, Go
• Cheung, Tan-To
• Fuks, David
• Abu Hilal, Mohammad
• Chen, Kuo-Hsin
• Aldrighetti, Luca
• Edwin, Bjorn
• Goh, Brian K P

Titel

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

Ist Teil von

• Journal of hepato-biliary-pancreatic sciences, 2023-09, Vol.30 (9), p.1098-1110

Ort / Verlag

Japan: Wiley Subscription Services, Inc

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• 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). 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. 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 maneuver 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. 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.