Validation of the Institute Mutualiste Montsouris system for the stratification of laparoscopic liver resections: an international multicenter study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mazzotta Alessandro, Fuks David, Soubrane Olivier, Tan Hwee-Leong, Syn Nicholas L, Dokmak Safi, Gruttadauria Salvatore, Cipriani Federica, Zimmitti Giuseppe, Alzoubi Mohammad, Sugioka Atsushi, Scatton Olivier, Herman Paulo, Peng Yufu, Marino Marco V, Croner Roland S, Mazzaferro Vincenzo, Chiow Adrian K H, Sucandy Iswanto, Ivanecz Arpad, Choi Sung-Hoon, Lee Jae Hoon, Gastaca Mikel, Vivarelli Marco, Giuliante Felice, Ruzzenente Andrea, Yong Chee-Chien, Yin Mengqiu, Fondevila Constantino, Efanov Mikhail, Morise Zenichi, Di Benedetto Fabrizio, Brustia Raffaele, Dalla Valle Raffaele, Boggi Ugo, Geller David, Belli Andrea, Memeo Riccardo, Mejia Alejandro, Park James O, Rotellar Fernando, Choi Gi-Hong, Robles-Campos Ricardo, Hasegawa Kiyoshi, Kawaguchi Yoshikuni, Wang Xiaoying, Sutcliffe Robert P, Pratschke Johann, Lai Eric C H, Chong Charing C N, D'Hondt Mathieu, Monden Kazuteru, Lopez-Ben Santiago, Kingham T Peter, Liu Rong, Ferrero Alessandro, Ettorre Giuseppe Maria, Cherqui Daniel, Liang Xiao, Wakabayashi Go, Troisi Roberto I, Cheung Tan-To, Sugimoto Motokazu, Han Ho-Seong, Long Tran Cong Duy, Zhang Wanguang, Wei Yonggang, Aghayan Davit L, Edwin Bjorn, Chen Kuo-Hsin, Abu Hilal Mohammad, Aldrighetti Luca, Goh Brian K P, International Robotic and Laparoscopic Liver Resection Study Group Investigators
Аннотация
METHODS: A retrospective cohort study of 22,252 patients undergoing LLR across 64 centers worldwide between 2005 and 2021 was performed. Baseline characteristics and perioperative outcomes were analyzed across the three difficulty levels and 11 procedure types of the IMM complexity classification.
RESULTS: A total of 14,765 patients were included in our final analysis. The main indications for LLR in our study was hepatocellular carcinoma or intrahepatic cholangiocarcinoma (n=7,781, 52.7%) followed by liver metastasectomy (n=3,911, 26.5%). In terms of underlying liver pathology, 5,127 (34.7%) cases had cirrhosis, and 1,214 (8.3%) had portal hypertension. Perioperative outcomes including operative time, open conversion rate, intraoperative blood loss, need for intraoperative blood transfusion, need for Pringle's application, length of stay, postoperative morbidity, major postoperative morbidity and 90-day mortality all demonstrated a significant increasing trend with increasing IMM complexity grades (P<0.001). These trends remained significant following adjustment for baseline characteristics (P<0.001). Notably, when examining the 11 LLR procedure types, all procedures within each IMM complexity grade were individually higher than all procedures in the preceding complexity grade for operative time, blood loss, length of stay, postoperative morbidity and major postoperative morbidity.
CONCLUSIONS: The three IMM complexity grades were well associated with LLR complexity as determined by key surrogate perioperative measures. Our findings also supported the categorization of the 11 distinct LLR procedures into the three complexity levels.