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13-01-2022 | Liver Resection | Original Article

Achievement of textbook outcomes and comparisons with benchmark values after laparoscopic left lateral sectionectomy

Authors: Mizelle D’Silva, Jai Young Cho, Ho-Seong Han, Yoo-Seok Yoon, Hae Won Lee, Jun Suh Lee, Boram Lee, Moonhwan Kim

Published in: Updates in Surgery | Issue 4/2022

Abstract

Laparoscopic left lateral sectionectomy (LLLS) is considered a standard approach for patients. Textbook outcomes (TOs) with benchmark values have been developed to help centers assess their outcomes of LLLS. The aim of our study was to identify factors associated with achieving TOs after LLLS. This is a retrospective cohort study including 195 patients undergoing LLLS between January 2004 and December 2018. Our outcomes were compared to benchmark values and graded as similar, better, or worse. A TO was achieved in 106 patients (54.4%). The main determinant for achieving a TO was prolonged hospital stay. Year of surgery [P = 0.002; odds ratio (OR) 3.913, 95% confidence interval (CI) 1.666–9.188], American Society of Anesthesiologists (ASA) score (P = 0.015; OR 0.104, 95% CI 0.017–0.650), body mass index (BMI) score (P = 0.075; OR 1.135, 95% CI 0.988–1.304), inflow clamping > 40 min (P = 0.037; OR 0.090, 95% CI 0.009–0.867) and operation time (P = 0.002; OR 0.991, 95% CI 0.985–0.997) were the factors associated with achieving a TO. Our outcomes were similar to the benchmark values for all criteria, except for the transfusion rate (our study vs benchmark values; 6.2% vs 3.8%), which was worse in our patients. We achieved better outcomes with a lower conversion rate (4.6% vs 7.2%), fewer patients requiring massive transfusion (4.1% vs 8.3%), lower rate of prolonged inflow clamping (3.9% vs 6.3%), lower overall complication rate (11.9% vs 19.8%), lower reoperation rate (0% vs 3.4%), and fewer patients with a positive margin (1.5% vs 10.8%). Year of surgery, ASA score, inflow clamping > 40 min and operation time were independently associated with failure to achieve a TO. TOs are useful tools to measure the surgical outcomes and compare surgical performance with benchmark values. TOs also offer a new method to retrospectively compare outcomes.

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Title: Achievement of textbook outcomes and comparisons with benchmark values after laparoscopic left lateral sectionectomy
Authors: Mizelle D’Silva
Jai Young Cho
Ho-Seong Han
Yoo-Seok Yoon
Hae Won Lee
Jun Suh Lee
Boram Lee
Moonhwan Kim
Publication date: 13-01-2022
Publisher: Springer International Publishing
Keywords: Liver Resection
Liver Resection
Hepatocellular Carcinoma
Hepatocellular Carcinoma
Published in: Updates in Surgery / Issue 4/2022
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-022-01237-1

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Achievement of textbook outcomes and comparisons with benchmark values after laparoscopic left lateral sectionectomy

Abstract

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Abstract

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