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Published in:

01-12-2017

A novel model for prediction of pure laparoscopic liver resection surgical difficulty

Authors: Yasushi Hasegawa, Go Wakabayashi, Hiroyuki Nitta, Takeshi Takahara, Hirokatsu Katagiri, Akira Umemura, Kenji Makabe, Akira Sasaki

Published in: Surgical Endoscopy | Issue 12/2017

Abstract

Background

Extending the clinical indications for laparoscopic liver resection (LLR) should be carefully considered based on a surgeon’s experience and skill. However, objective indexes to help surgeons assess the estimated difficulty of LLR are scarce. The aim of our study was to develop the first objective numerical rating scale to predict the surgical difficulty of various LLR procedures.

Methods

We performed a retrospective review of the operative outcomes of 187 patients who underwent a pure LLR. First, the value of preoperative factors for predicting surgical time was evaluated by multivariate linear regression analyses, and a scoring system was constructed. Next, the integrity of our predictive linear model was evaluated against the documented operative outcomes for patients forming our study group.

Results

Four predictive factors were identified and scored based on the weighted contribution of each factor predicting surgical time: extent of resection (scored 0, 2, or 3); location of tumor (scored 0, 1, or 2); obesity (scored 0 or 1); and platelet count (scored 0 or 1). The scores were summed to classify surgical difficulty into three levels: low (total score ≤1); medium (total score 2–3); and high (total score ≥4). Operative outcomes, including surgical time, volume of blood loss, length of hospital stay, and rate of morbidity, were significantly different between the three surgical difficulty levels.

Conclusion

Our novel model will be useful for surgeons to predict the difficulty of an LLR procedure relative to their own experience and skill.

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Title: A novel model for prediction of pure laparoscopic liver resection surgical difficulty
Authors: Yasushi Hasegawa
Go Wakabayashi
Hiroyuki Nitta
Takeshi Takahara
Hirokatsu Katagiri
Akira Umemura
Kenji Makabe
Akira Sasaki
Publication date: 01-12-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 12/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-017-5616-8

At a glance: The STEP trials

Springer Medicine

A novel model for prediction of pure laparoscopic liver resection surgical difficulty

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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