Factors associated with and impact of open conversion on the outcomes of minimally invasive left lateral sectionectomies: An international multicenter study.
Conversion to Open Surgery
/ adverse effects
Hepatectomy
/ adverse effects
Humans
Hypertension, Portal
/ etiology
Laparoscopy
/ adverse effects
Length of Stay
Male
Minimally Invasive Surgical Procedures
/ adverse effects
Neoplasms
/ complications
Operative Time
Postoperative Complications
/ epidemiology
Retrospective Studies
Treatment Outcome
Journal
Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
11
02
2022
revised:
16
03
2022
accepted:
25
03
2022
pubmed:
11
6
2022
medline:
19
7
2022
entrez:
10
6
2022
Statut:
ppublish
Résumé
Despite the rapid advances that minimally invasive liver resection has gained in recent decades, open conversion is still inevitable in some circumstances. In this study, we aimed to determine the risk factors for open conversion after minimally invasive left lateral sectionectomy, and its impact on perioperative outcomes. This is a post hoc analysis of 2,445 of 2,678 patients who underwent minimally invasive left lateral sectionectomy at 45 international centers between 2004 and 2020. Factors related to open conversion were analyzed via univariate and multivariate analyses. One-to-one propensity score matching was used to analyze outcomes after open conversion versus non-converted cases. The open conversion rate was 69/2,445 (2.8%). On multivariate analyses, male gender (3.6% vs 1.8%, P = .011), presence of clinically significant portal hypertension (6.1% vs 2.6%, P = .009), and larger tumor size (50 mm vs 32 mm, P < .001) were identified as independent factors associated with open conversion. The most common reason for conversion was bleeding in 27/69 (39.1%) of cases. After propensity score matching (65 open conversion vs 65 completed via minimally invasive liver resection), the open conversion group was associated with increased operation time, blood transfusion rate, blood loss, and postoperative stay compared with cases completed via the minimally invasive approach. Male sex, portal hypertension, and larger tumor size were predictive factors of open conversion after minimally invasive left lateral sectionectomy. Open conversion was associated with inferior perioperative outcomes compared with non-converted cases.
Sections du résumé
BACKGROUND
Despite the rapid advances that minimally invasive liver resection has gained in recent decades, open conversion is still inevitable in some circumstances. In this study, we aimed to determine the risk factors for open conversion after minimally invasive left lateral sectionectomy, and its impact on perioperative outcomes.
METHODS
This is a post hoc analysis of 2,445 of 2,678 patients who underwent minimally invasive left lateral sectionectomy at 45 international centers between 2004 and 2020. Factors related to open conversion were analyzed via univariate and multivariate analyses. One-to-one propensity score matching was used to analyze outcomes after open conversion versus non-converted cases.
RESULTS
The open conversion rate was 69/2,445 (2.8%). On multivariate analyses, male gender (3.6% vs 1.8%, P = .011), presence of clinically significant portal hypertension (6.1% vs 2.6%, P = .009), and larger tumor size (50 mm vs 32 mm, P < .001) were identified as independent factors associated with open conversion. The most common reason for conversion was bleeding in 27/69 (39.1%) of cases. After propensity score matching (65 open conversion vs 65 completed via minimally invasive liver resection), the open conversion group was associated with increased operation time, blood transfusion rate, blood loss, and postoperative stay compared with cases completed via the minimally invasive approach.
CONCLUSION
Male sex, portal hypertension, and larger tumor size were predictive factors of open conversion after minimally invasive left lateral sectionectomy. Open conversion was associated with inferior perioperative outcomes compared with non-converted cases.
Identifiants
pubmed: 35688742
pii: S0039-6060(22)00221-5
doi: 10.1016/j.surg.2022.03.037
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
617-624Investigateurs
Chung-Yip Chan
(CY)
Nicholas Syn
(N)
Mikel Prieto
(M)
Henri Schotte
(H)
Celine De Meyere
(C)
Felix Krenzien
(F)
Moritz Schmelzle
(M)
Kit-Fai Lee
(KF)
Diana Salimgereeva
(D)
Ruslan Alikhanov
(R)
Lip Seng Lee
(LS)
Jae Young Jang
(JY)
Kevin P Labadie
(KP)
Masayuki Kojima
(M)
Yutaro Kato
(Y)
Asmund Avdem Fretland
(AA)
Jacob Ghotbi
(J)
Fabricio Ferreira Coelho
(FF)
Jaime Arthur Pirola Kruger
(JA)
Victor Lopez-Lopez
(V)
Paolo Magistri
(P)
Bernardo Dalla Valle
(BD)
Margarida Casellas I Robert
(M)
Kohei Mishima
(K)
Giuseppe Maria Ettorre
(GM)
Federico Mocchegiani
(F)
Prashant Kadam
(P)
Franco Pascual
(F)
Mansour Saleh
(M)
Alessandro Mazzotta
(A)
Roberto Montalti
(R)
Mariano Giglio
(M)
Boram Lee
(B)
Mizelle D'Silva
(M)
Phan Phuoc Nghia
(PP)
Chetana Lim
(C)
Qu Liu
(Q)
Eric C Lai
(EC)
Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.