Factors associated with and impact of open conversion on the outcomes of minimally invasive left lateral sectionectomies: An international multicenter study.
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Author
Wang, Hao PingYong, Chee Chien
Wu, Andrew G R
Cherqui, Daniel
Troisi, Roberto I
Cipriani, Federica
Aghayan, Davit
Marino, Marco V
Belli, Andrea
Chiow, Adrian K H
Sucandy, Iswanto
Ivanecz, Arpad
Vivarelli, Marco
Di Benedetto, Fabrizio
Choi, Sung-Hoon
Lee, Jae Hoon
Park, James O
Gastaca, Mikel
Fondevila, Constantino
Efanov, Mikhail
Rotellar, Fernando
Choi, Gi-Hong
Campos, Ricardo Robles
Wang, Xiaoying
Sutcliffe, Robert P
Pratschke, Johann
Tang, Chung Ngai
Chong, Charing C
D'Hondt, Mathieu
Ruzzenente, Andrea
Herman, Paolo
Kingham, T Peter
Scatton, Olivier
Liu, Rong
Ferrero, Alessandro
Levi Sandri, Giovanni Battista
Soubrane, Olivier
Mejia, Alejandro
Lopez-Ben, Santiago
Sijberden, Jasper
Monden, Kazuteru
Wakabayashi, Go
Sugioka, Atsushi
Cheung, Tan-To
Long, Tran Cong Duy
Edwin, Bjorn
Han, Ho-Seong
Fuks, David
Aldrighetti, Luca
Abu Hilal, Mohamed
Goh, Brian K P
Publication date
2022-06-07
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Background: Despite the rapid advances that minimally invasive liver resection has gained in recent decades, open conversion is still inevitable in some circumstances. In this study, we aimed to determine the risk factors for open conversion after minimally invasive left lateral sectionectomy, and its impact on perioperative outcomes. Methods: This is a post hoc analysis of 2,445 of 2,678 patients who underwent minimally invasive left lateral sectionectomy at 45 international centers between 2004 and 2020. Factors related to open conversion were analyzed via univariate and multivariate analyses. One-to-one propensity score matching was used to analyze outcomes after open conversion versus non-converted cases. Results: The open conversion rate was 69/2,445 (2.8%). On multivariate analyses, male gender (3.6% vs 1.8%, P = .011), presence of clinically significant portal hypertension (6.1% vs 2.6%, P = .009), and larger tumor size (50 mm vs 32 mm, P < .001) were identified as independent factors associated with open conversion. The most common reason for conversion was bleeding in 27/69 (39.1%) of cases. After propensity score matching (65 open conversion vs 65 completed via minimally invasive liver resection), the open conversion group was associated with increased operation time, blood transfusion rate, blood loss, and postoperative stay compared with cases completed via the minimally invasive approach. Conclusion: Male sex, portal hypertension, and larger tumor size were predictive factors of open conversion after minimally invasive left lateral sectionectomy. Open conversion was associated with inferior perioperative outcomes compared with non-converted cases.Citation
Wang HP, Yong CC, Wu AGR, Cherqui D, Troisi RI, Cipriani F, Aghayan D, Marino MV, Belli A, Chiow AKH, Sucandy I, Ivanecz A, Vivarelli M, Di Benedetto F, Choi SH, Lee JH, Park JO, Gastaca M, Fondevila C, Efanov M, Rotellar F, Choi GH, Campos RR, Wang X, Sutcliffe RP, Pratschke J, Tang CN, Chong CC, D'Hondt M, Ruzzenente A, Herman P, Kingham TP, Scatton O, Liu R, Ferrero A, Levi Sandri GB, Soubrane O, Mejia A, Lopez-Ben S, Sijberden J, Monden K, Wakabayashi G, Sugioka A, Cheung TT, Long TCD, Edwin B, Han HS, Fuks D, Aldrighetti L, Abu Hilal M, Goh BKP; International Robotic and Laparoscopic Liver Resection Study Group Investigators. Factors associated with and impact of open conversion on the outcomes of minimally invasive left lateral sectionectomies: An international multicenter study. Surgery. 2022 Aug;172(2):617-624. doi: 10.1016/j.surg.2022.03.037. Epub 2022 Jun 7Type
ArticleAdditional Links
https://www.sciencedirect.com/journal/surgeryPMID
35688742Journal
SurgeryPublisher
Mosbyae974a485f413a2113503eed53cd6c53
10.1016/j.surg.2022.03.037