Defining Global Benchmarks for Robotic Liver Resections: An International Multicenter Study.
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Goh Brian K P, Sucandy Iswanto, Chua Darren W, Liu Qu, Edwin Bjørn, Aghayan Davit, Millet Guillaume, Ratti Francesca, Zhang Wanguang, Scatton Olivier, Coelho Fabricio Ferreira, Dokmak Safi, Mazzaferro Vincenzo, Chiow Adrian K H, Primavesi Florian, Ivanecz Arpad, Choi Sung-Hoon, Lee Jae Hoon, Prieto Mikel, Vivarelli Marco, Giuliante Felice, Ruzzenente Andrea, Yong Chee-Chien, Yin Mengqiu, Fondevila Constantino, Efanov Mikhail, Morise Zenichi, Di Benedetto Fabrizio, Brustia Raffaele, Valle Raffaele Dalla, Boggi Ugo, Geller David, Belli Andrea, Memeo Riccardo, Hasegawa Kiyoshi, Croner Roland S, Gruttadauria Salvatore, Hawksworth Jason, Park James O, Rotellar Fernando, Choi Gi-Hong, Robles-Campos Ricardo, Wang Xiaoying, Sutcliffe Robert P, Krenzien Felix, Pratschke Johann, Lai Eric C H, Chong Charing C N, Ishizawa Takeaki, Monden Kazuteru, Lopez-Ben Santiago, Kingham T Peter, Ferrero Alessandro, Ettorre Giuseppe Maria, Liang Xiao, Mejia Alejandro, Marino Marco V, Swijnenburg Rutger-Jan, Wakabayashi Go, Troisi Roberto I, Cheung Tan-To, Sugioka Atsushi, Sugimoto Motokazu, Labgaa Ismail, Schmelzle Moritz, Hatano Etsuro, Cillo Umberto, Long Tran Cong Duy, Peng Yufu, Wei Yonggang, Yong Zha, El Adel Soufyan, Han Ho-Seong, Soubrane Olivier, Fuks David, Chen Kuo-Hsin, D'Hondt Mathieu, Abu Hilal Mohammad, Aldrighetti Luca, Liu Rong, International robotic and laparoscopic liver resection study group investigators
Аннотация
BACKGROUND: In recent years, minimally invasive liver resections and in particular R-LR has seen an increase in uptake in recent years. Although, benchmark outcomes have been recently established for laparoscopic (L) -LR, this has not been established for R-LR.
METHODS: This is a post hoc analysis of a multicenter database of 5,213 patients undergoing R-LR in 51 international centers between 2016 and 2022. Benchmark cutoffs for 16 outcome indicators of low-risk R-LR were established. The 75 th percentile of individual center medians for a given outcome indicator was set as the benchmark cutoff. Four procedures were selected for benchmarking: left lateral sectionectomy(LLS)/H23, left hepatectomy(LH)/H234±1, right hepatectomy(RH)/H5678±1 and right posterior sectionectomy/H67 (RPS).
RESULTS: There were 1,654 R-LR cases (528 LLS/H23, 432 LH/H234±1, 408 RH/H5678±1, 286 RPS/H67) performed in 24 expert centers, of which 518 (31.3%) R-LR cases qualified as low risk benchmark cases. Benchmark outcomes were established for R-LLS/H23, R-LH/ H234±1, R-RH/ H5678±1 and R-RPS/H67 for operation time (190, 323, 474, 413) min, open conversion rate (0.0, 0.0, 1.3, 0.0)%, estimated blood loss (100, 250, 600, 550) mls, blood transfusion rate (0.0 ,0.0, 20.0, 29.2)%, postoperative major morbidity (0.0 ,0.0, 20.9, 16.7)%, 90-day mortality (0.0, 0.0,0.0, 0.0)% and textbook outcome (12.5,24.3,0,0)%.
CONCLUSIONS: The present study established the first global benchmark values for R-LR. It provided an up-to-date reference of best achievable outcomes for auditing and benchmarking.