Utility of the Iwate difficulty scoring system for laparoscopic right posterior sectionectomy: do surgical outcomes differ for tumors in segments VI and VII?
Difficulty score
Iwate
Laparoscopic hepatectomy
Laparoscopic liver
Right posterior sectionectomy
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
03
04
2022
accepted:
19
06
2022
pubmed:
20
7
2022
medline:
16
11
2022
entrez:
19
7
2022
Statut:
ppublish
Résumé
The Iwate Score (IS) have not been well-validated for specific procedures, especially for right posterior sectionectomy (RPS). In this study, the utility of the IS was determined for laparoscopic (L)RPS and the effect of tumor location on surgical outcomes was investigated. Post-hoc analysis of 647 L-RPS performed in 40 international centers of which 596L-RPS cases met the inclusion criteria. Baseline characteristics and perioperative outcomes of patients stratified based on the Iwate score were compared to determine whether a correlation with surgical difficulty existed. A 1:1 Mahalanobis distance matching was utilized to investigate the effect of tumor location on L-RPS outcomes. The patients were stratified into 3 levels of difficulty (31 intermediate, 143 advanced, and 422 expert) based on the IS. When using a stepwise increase of the IS excluding the tumor location score, only Pringle's maneuver was more frequently used in the higher surgical difficulty level (35.5%, 54.6%, and 65.2%, intermediate, advanced, and expert levels, respectively, Z = 3.34, p = 0.001). Other perioperative results were not associated with a statistical gradation toward higher difficulty level. 80 of 85 patients with a segment VI lesion and 511 patients with a segment VII lesion were matched 1:1. There were no significant differences in the perioperative outcomes of the two groups including open conversion, operating time, blood loss, intraoperative blood transfusion, postoperative stay, major morbidity, and mortality. Among patients undergoing L-RPS, the IS did not significantly correlate with most outcome measures associated with intraoperative difficulty and postoperative outcomes. Similarly, tumor location had no effect on L-RPS outcomes.
Identifiants
pubmed: 35851819
doi: 10.1007/s00464-022-09404-6
pii: 10.1007/s00464-022-09404-6
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
9204-9214Investigateurs
Incheon Kang
(I)
Jae Young Jang
(JY)
Chung-Yip Chan
(CY)
Mizelle D'Silva
(M)
Henri Schotte
(H)
Celine De Meyere
(C)
Eric Lai
(E)
Felix Krenzien
(F)
Moritz Schmelzle
(M)
Prashant Kadam
(P)
Roberto Montalti
(R)
Mariano Giglio
(M)
Qu Liu
(Q)
Kit-Fai Lee
(KF)
Diana Salimgereeva
(D)
Ruslan Alikhanov
(R)
Lip-Seng Lee
(LS)
Mikel Prieto
(M)
Chetana Lim
(C)
Phan Phuoc Nghia
(PP)
Masayuki Kojima
(M)
Yutaro Kato
(Y)
Fabio Forchino
(F)
Paulo Herman
(P)
Jaime Arthur Pirola Kruger
(JAP)
Mansour Saleh
(M)
Franco Pascual
(F)
Bernardo Dalla Valle
(B)
Victor Lopez-Lopez
(V)
Margarida Casellas-Robert
(M)
Ugo Giustizieri
(U)
Davide Citterio
(D)
Kohei Mishima
(K)
Asmund Avdem Fretland
(AA)
Jacob Ghotbi
(J)
Giuseppe Maria Ettorre
(GM)
Marco Colasanti
(M)
Yoelimar Guzmán
(Y)
Francesco Ardito
(F)
Simone Vani
(S)
Hao-Ping Wang
(HP)
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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