Journal of hepato-biliary-pancreatic sciences · 2018
Difficulty scoring system in laparoscopic distal pancreatectomy.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ohtsuka Takao, Ban Daisuke, Nakamura Yoshiharu, Nagakawa Yuichi, Tanabe Minoru, Gotoh Yoshitaka, Velasquez Vittoria Vanessa D M, Nakata Kohei, Sahara Yatsuka, Takaori Kyoichi, Honda Goro, Misawa Takeyuki, Kawai Manabu, Yamaue Hiroki, Morikawa Takanori, Kuroki Tamotsu, Mou Yiping, Lee Woo-Jung, Shrikhande Shailesh V, Tang Chung Ngai, Conrad Claudius, Han Ho-Seong, Palanivelu Chinnusamy, Asbun Horacio J, Kooby David A, Wakabayashi Go, Takada Tadahiro, Yamamoto Masakazu, Nakamura Masafumi
Аннотация
BACKGROUND: Several factors affect the level of difficulty of laparoscopic distal pancreatectomy (LDP). The purpose of this study was to develop a difficulty scoring (DS) system to quantify the degree of difficulty in LDP.
METHODS: We collected clinical data for 80 patients who underwent LDP. A 10-level difficulty index was developed and subcategorized into a three-level difficulty index; 1-3 as low, 4-6 as intermediate, and 7-10 as high index. The automatic linear modeling (LINEAR) statistical tool was used to identify factors that significantly increase level of difficulty in LDP.
RESULTS: The operator's 10-level DS concordance between the 10-level DS by the reviewers, LINEAR index DS, and clinical index DS systems were analyzed, and the weighted Cohen's kappa statistic were at 0.869, 0.729, and 0.648, respectively, showing good to excellent inter-rater agreement. We identified five factors significantly affecting level of difficulty in LDP; type of operation, resection line, proximity of tumor to major vessel, tumor extension to peripancreatic tissue, and left-sided portal hypertension/splenomegaly.
CONCLUSIONS: This novel DS for LDP adequately quantified the degree of difficulty, and can be useful for selecting patients for LDP, in conjunction with fitness for surgery and prognosis.
METHODS: We collected clinical data for 80 patients who underwent LDP. A 10-level difficulty index was developed and subcategorized into a three-level difficulty index; 1-3 as low, 4-6 as intermediate, and 7-10 as high index. The automatic linear modeling (LINEAR) statistical tool was used to identify factors that significantly increase level of difficulty in LDP.
RESULTS: The operator's 10-level DS concordance between the 10-level DS by the reviewers, LINEAR index DS, and clinical index DS systems were analyzed, and the weighted Cohen's kappa statistic were at 0.869, 0.729, and 0.648, respectively, showing good to excellent inter-rater agreement. We identified five factors significantly affecting level of difficulty in LDP; type of operation, resection line, proximity of tumor to major vessel, tumor extension to peripancreatic tissue, and left-sided portal hypertension/splenomegaly.
CONCLUSIONS: This novel DS for LDP adequately quantified the degree of difficulty, and can be useful for selecting patients for LDP, in conjunction with fitness for surgery and prognosis.