Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study.
Journal
Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
pubmed:
16
7
2022
medline:
14
3
2023
entrez:
15
7
2022
Statut:
ppublish
Résumé
To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR). There is limited published data to date on the best achievable outcomes after L-LR. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 35837974
doi: 10.1097/SLA.0000000000005530
pii: 00000658-202304000-00040
doi:
Types de publication
Multicenter Study
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e839-e848Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Investigateurs
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)
Masayuki Kojima
(M)
Jacob Ghotbi
(J)
Jaime Arthur Pirola Kruger
(JAP)
Victor Lopez-Lopez
(V)
Bernardo Dalla Valle
(BD)
Margarida Casellas I Robert
(M)
Kohei Mishima
(K)
Roberto Montalti
(R)
Mariano Giglio
(M)
Alessandro Mazzotta
(A)
Boram Lee
(B)
Hao-Ping Wang
(HP)
Franco Pascual
(F)
Prashant Kadam
(P)
Chung-Ngai Tang
(CN)
Shian Yu
(S)
Francesco Ardito
(F)
Simone Vani
(S)
Ugo Giustizieri
(U)
Davide Citterio
(D)
Federico Mocchegiani
(F)
Giuseppe Maria Ettorre
(GM)
Marco Colasanti
(M)
Yoelimar Guzmán
(Y)
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
B.K.P.G. has received travel grants and honorarium from Johnson and Johnson, Olympus, and Transmedic the local distributor for the Da Vinci Robot. M.V.M. is a consultant for CAVA robotics LLC. J.P. reports a research grant from Intuitive Surgical Deutschland GmbH and personal fees or nonfinancial support from Johnson & Johnson, Medtronic, AFS Medical, Astellas, CHG Meridian, Chiesi, Falk Foundation, La Fource Group, Merck, Neovii, NOGGO, pharma-consult Peterson, and Promedicis. M.S. reports personal fees or other support outside of the submitted work from Merck, Bayer, ERBE, Amgen, Johnson & Johnson, Takeda, Olympus, Medtronic, and Intuitive. A.F. reports receiving speaker fees from Bayer. F.R. reports speaker fees and support outside the submitted work from Integra, Medtronic, Olympus, Corza, Sirtex, and Johnson & Johnson. The remaining authors report no conflicts of interest.
Références
Von Eiff W. International benchmarking and best practice management: in search of health care and hospital excellence. Adv Health Care Manag. 2015;17:223–252.
Staiger RD, Schwandt H, Puhan MA, et al. Improving surgical outcomes through benchmarking. Br J Surg. 2019;106:59–64.
Clavien PA, Puhan MA. Measuring and achieving the best possible outcomes in surgery. Br J Surg. 2017;104:1121–1122.
Porter ME. What is the value of health care? N Engl J Med. 2010;363:2477–2481.
Sanchez-Velazquez P, Muller X, Malleo G, et al. Benchmarks in pancreatic surgery: a novel tool for unbiased outcome comparisons. Ann Surg. 2019;270:211–218.
Muller X, Marcon F, Sapisochin G, et al. Defining benchmarks in liver transplantation: a multicenter outcome analysis determining best achievable results. Ann Surg. 2018;267:419–425.
Gero D, Raptis DA, Vleeschouwers W, et al. Defining global benchmarks in bariatric surgery: a retrospective multicenter analysis of minimally invasive roux-en-y gastric bypass and sleeve gastrectomy. Ann Surg. 2019;270:859–867.
Rossler F, Sapisochin G, Song GW, et al. Defining benchmarks for major liver surgery: a multicenter analysis of 5202 living liver donors. Ann Surg. 2016;264:492–500.
Ciria R, Cherqui D, Geller DA, et al. Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg. 2016;263:761–777.
Goh BK, Lee SY, Teo JY, et al. Changing trends and outcomes associated with the adoption of minimally invasive hepatectomy: a contemporary single-institution experience with 400 consecutive resections. Surg Endosc. 2018;32:4658–4665.
Hobeika C, Fuks D, Cauchy F, et al. Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers. J Hepatol. 2020;73:1100–1108.
Russolillo N, Aldrighetti L, Cillo U, et al. Risk-adjusted benchmarks in laparoscopic liver surgery in a national cohort. Br J Surg. 2020;107:845–853.
Chua D, Syn N, Koh YX, et al. Learning curves in minimally invasive hepatectomy: systematic review and meta-regression analysis. Br J Surg. 2021;108:351–358.
Goh BK, Prieto M, Syn N, et al. Critical appraisal of the learning curve of minimally invasive hepatectomy: experience with the first 200 cases of a Southeast Asian Early adopted. ANZ J Surg. 2020;90:1092–1098.
Kawaguchi Y, Fuks D, Kokudo N, et al. Difficulty of laparoscopic liver resection: proposal for a new classification. Ann Surg. 2018;267:13–17.
Halls MC, Berardi G, Cipriani F, et al. Development and validation of a difficulty score to predict intraoperative complications during laparoscopic liver resection. Br J Surg. 2018;105:1182–1191.
Wakabayashi G. What has changed after the Morioka consensus conference 2014 on laparoscopic liver resection? Hepatobiliary Surg Nutr. 2016;5:281–2819.
Goh BK, Prieto M, Syn N, et al. Validation and comparison of the Iwate, IMM, Southampton and Hasegawa difficulty scoring systems for primary laparoscopic hepatectomies. HPB. 2021;23:770–776.
Van der poel MJ, Fichteinger RS, Bemelmans M, et al. Implementation and outcome of minor and major minimally invasive liver surgery in The Netherlands. HPB. 2019;21:1734–1743.
Cheung TT, Wang X, Efanov M, et al. Minimally invasive liver resection for huge (≥10 cm) tumors: an international multicenter matched cohort study with regression discontinuity analyses. Hepatobiliary Surg Nutr. 2021;10:587–597.
Troisi RI, Berardi G, Morise Z, et al. Laparoscopic and open liver resection for hepatocellular carcinoma with Child-Pugh B cirrhosis: multicentre propensity score-matched study. Br J Surg. 2021;108:196–204.
Gorgec B, Cacciaguerra AB, Lanari J, et al. Assessment of textbook outcome in laparoscopic and open liver surgery. JAMA Surg. 2021;156:e212064.
Mueller M, Breuer E, Mizuno T, et al. Perihilar cholangiocarcinoma-novel benchmark values for surgical and oncological outcomes from 24 expert centers. Ann Surg. 2021;274:780–788.
Vigano L, Torzilli G, Aldrighetti L, et al. Stratification of major hepatectomies according to their outcome: analysis if 2212 consecutive open resections in patients without cirrhosis. Ann Surg. 2020;272:827–833.
Strasberg SM. Nomenclature of hepatic anatomy and resection: a review of Brisbane 2000 system. J Hepatobiliary Pancreat Surg. 2005;12:351–355.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–213.
Ghaferi AA, Birkmeyer JD, Dimick JB. Complications, failure to rescue, and mortality with inpatient surgery in Medicare patients. Ann Surg. 2009;250:1029–1034.
Fretland AA, Dagenborg VJ, Bjornelv GM, et al. Laparoscopic versus open resection for colorectal liver metastases: the OSLO-COMET randomized controlled trial. Ann Surg. 2019;267:199–207.
Syn N, Kabir T, Koh YX, et al. Survival advantage of laparoscopic versus open resection for colorectal liver metastases: a meta-analysis of individual patient data from randomized trials and propensity-score matched studies. Ann Surg. 2020;272:253–265.
Goh BK. Letter regarding “Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers”. J Hepatol. 2020;73:1576.
Weissman N, Allison J, Kiefe C, et al. Achievable benchmarks of care: the ABCs of benchmarking. J Eval Clin Pract. 1999;5:269–281.
Goh BK, Lee SY, Koh YX, et al. Minimally invasive major hepatectomies: a Southeast Asian single institution contemporary experience with its first 120 consecutive cases. ANZ J Surg. 2020;90:553–557.
Russolillo N, Aldrighetti L, Guglielmi A, et al. Correspondence on “Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers. J Hepatol, 2021;74:985–986.
Tsilimigras DI, Sahara K, Moris D, et al. Assessing textbook outcomes following liver surgery for primary liver cancer over a 12-year time period at major hepatobiliary centers. Ann Surg Oncol. 2020;27:3318–3327.
Goh BK, Wang Z, Koh YX, et al. Evolution and trends in the adoption of laparoscopic liver resection in Singapore: analysis of 300 cases based on a single surgeon experience. Ann Acad Med Singapore. 2021;50:742–750.
Aldrighetti L, Cipriani F, Fiorentini G, et al. A stepwise learning curve to define the standard for technical improvement in laparoscopic liver resections: complexity-based analysis in 1032 procedures. Updates Surg. 2019;71:273–283.
Aghayan DL, Kazaryan AM, Fretland AA, et al. Evolution of laparoscopic liver surgery: 20-year experience of a Norwegian high-volume referral center. Surg Endosc. 2022;36:2818–2826.