TY - JOUR
T1 - Factors associated with and impact of open conversion on the outcomes of minimally invasive left lateral sectionectomies
T2 - An international multicenter study
AU - Wang, Hao Ping
AU - Yong, Chee Chien
AU - Wu, Andrew G. R.
AU - Cherqui, Daniel
AU - Troisi, Roberto I.
AU - Cipriani, Federica
AU - Aghayan, Davit
AU - Marino, Marco V.
AU - Belli, Andrea
AU - Chiow, Adrian K. H.
AU - Sucandy, Iswanto
AU - Ivanecz, Arpad
AU - Vivarelli, Marco
AU - di Benedetto, Fabrizio
AU - Choi, Sung-Hoon
AU - Lee, Jae Hoon
AU - Park, James O.
AU - Gastaca, Mikel
AU - Fondevila, Constantino
AU - Efanov, Mikhail
AU - Rotellar, Fernando
AU - Choi, Gi-Hong
AU - Campos, Ricardo Robles
AU - Wang, Xiaoying
AU - Sutcliffe, Robert P.
AU - Pratschke, Johann
AU - Tang, Chung Ngai
AU - Chong, Charing C.
AU - D'Hondt, Mathieu
AU - Ruzzenente, Andrea
AU - Herman, Paolo
AU - Kingham, T. Peter
AU - Scatton, Olivier
AU - Liu, Rong
AU - Ferrero, Alessandro
AU - Levi Sandri, Giovanni Battista
AU - Soubrane, Olivier
AU - Mejia, Alejandro
AU - Lopez-Ben, Santiago
AU - Sijberden, Jasper
AU - Monden, Kazuteru
AU - Wakabayashi, Go
AU - Sugioka, Atsushi
AU - Cheung, Tan-To
AU - Long, Tran Cong Duy
AU - Edwin, Bjorn
AU - Han, Ho-Seong
AU - Fuks, David
AU - Aldrighetti, Luca
AU - Abu Hilal, Mohamed
AU - Goh, Brian K. P.
AU - International Robotic and Laparoscopic Liver Resection Study Group Investigators
AU - Chan, Chung-Yip
AU - Syn, Nicholas
AU - Prieto, Mikel
AU - Schotte, Henri
AU - de Meyere, Celine
AU - Krenzien, Felix
AU - Schmelzle, Moritz
AU - Lee, Kit-Fai
AU - Salimgereeva, Diana
AU - Alikhanov, Ruslan
AU - Lee, Lip Seng
AU - Jang, Jae Young
AU - Labadie, Kevin P.
AU - Kojima, Masayuki
AU - Kato, Yutaro
AU - Fretland, Asmund Avdem
AU - Ghotbi, Jacob
AU - Coelho, Fabricio Ferreira
AU - Pirola Kruger, Jaime Arthur
AU - Lopez-Lopez, Victor
AU - Magistri, Paolo
AU - Valle, Bernardo Dalla
AU - Casellas I Robert, Margarida
AU - Mishima, Kohei
AU - Ettorre, Giuseppe Maria
AU - Mocchegiani, Federico
AU - Kadam, Prashant
AU - Pascual, Franco
AU - Saleh, Mansour
AU - Mazzotta, Alessandro
AU - Montalti, Roberto
AU - Giglio, Mariano
AU - Lee, Boram
AU - D'Silva, Mizelle
AU - Nghia, Phan Phuoc
AU - Lim, Chetana
AU - Liu, Qu
AU - Lai, Eric C.
N1 - Funding Information:
(1) Dr Goh BK has received travel grants and honorarium from Johnson and Johnson and Transmedic the local distributor for the Da Vinci Robot; (2) Dr Marino MV is a consultant for CAVA robotics LLC; (3) Johann Pratschke reports a research grant from Intuitive Surgical Deutschland GmbH and personal fees or non-financial support from Johnson & Johnson, Medtronic, AFS Medical, Astellas, CHG Meridian, Chiesi, Falk Foundation, La Fource Group, Merck, Neovii, NOGGO, pharma-consult Peterson, and Promedicis; (4) Moritz Schmelzle reports personal fees or other support outside of the submitted work from Merck, Bayer, ERBE, Amgen, Johnson & Johnson, Takeda, Olympus, Medtronic, and Intuitive; (5) Asmund Fretland reports receiving speaker fees from Bayer; (6) Fernando Rotellar reports speaker fees and support outside the submitted work from Integra, Medtronic, Olympus, Corza, Sirtex, and Johnson & Johnson.
Funding Information:
International Robotic and Laparoscopic Liver Resection Study Group Investigators:, 1. Chung-Yip Chan (Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and Duke-NUS Medical School) 2. Nicholas Syn (Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and Ministry of Health Holdings Singapore) 3. Mikel Prieto (Hepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Bilbao, Spain) 4. Henri Schotte (Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium) 5. Celine De Meyere (Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium) (Department of Surgery, AZ Groeninge Hospital, Kortrijk, Belgium) 6. Felix Krenzien (Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, and Berlin Institute of Health, Berlin, Germany) 7. Moritz Schmelzle (Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, and Berlin Institute of Health, Berlin, Germany) 8. Kit-Fai Lee (Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China 9. Diana Salimgereeva (Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia) 10. Ruslan Alikhanov (Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia) 11. Lip Seng Lee (Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore) 12. Jae Young Jang (Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea) 13. Kevin P. Labadie (Department of Surgery, University of Washington Medical Center. Seattle, USA) 14. Masayuki Kojima (Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan) 15. Yutaro Kato (Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan) 16. Asmund Avdem Fretland (The Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Oslo, Norway) 17. Jacob Ghotbi (The Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Oslo, Norway) 18. Fabricio Ferreira Coelho (Liver Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil) 19. Jaime Arthur Pirola Kruger (Liver Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil) 20. Victor Lopez-Lopez (Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain) 21. Paolo Magistri (Hepatopancreatobiliary Surgery and Liver Transplant Unit, University of Modena and Reggio Emilia, Modena, Italy) 22. Bernardo Dalla Valle (General and Hepatobiliary Surgery, Department of Surgery, Dentistry, Gynecology and Pediatrics University of Verona, GB Rossi Hospital, Verona, Italy) 23. Margarida Casellas I Robert (Hepatobiliary and Pancreatic Surgery Unit, Department of Surgery, Dr. Josep Trueta Hospital, IdIBGi, Girona, Spain) 24. Kohei Mishima (Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Saitama, Japan) 25. Giuseppe Maria Ettorre (Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Italy) 26. Marco Colasanti (Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Italy) 27. Federico Mocchegiani (HPB Surgery and Transplantation Unit, United Hospital of Ancona, Department of Sperimental and Clinical Medicine Polytechnic University of Marche) 28. Prashant Kadam (Department of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom) 29. Franco Pascual (Department of Hepatobiliary Surgery, Assistance Publique Hopitaux de Paris, Centre Hepato-Biliaire, Paul-Brousse Hospital, Villejuif, France) 30. Mansour Saleh (Department of Hepatobiliary Surgery, Assistance Publique Hopitaux de Paris, Centre Hepato-Biliaire, Paul-Brousse Hospital, Villejuif, France) 31. Alessandro Mazzotta (Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France) 32. Roberto Montalti (Department of Clinical Medicine and Surgery, Division of HPB, Minimally Invasive and Robotic Surgery, Federico II University Hospital Naples, Naples, Italy) 33. Mariano Giglio (Department of Clinical Medicine and Surgery, Division of HPB, Minimally Invasive and Robotic Surgery, Federico II University Hospital Naples, Naples, Italy) 34. Boram Lee Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea 35. Mizelle D'Silva, Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea 36. Phan Phuoc Nghia, (HPB Surgery Department, University Medical Center, Ho Chi Minh City, Vietnam) 37. Chetana Lim, Department of Digestive, HBP and Liver Transplantation, Pitie-Salpetriere Hospital, Sorbonne University, Paris, France 38. Qu Liu, Faculty of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China 39. Eric C. Lai (Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China)
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/8
Y1 - 2022/8
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85131800771
U2 - 10.1016/j.surg.2022.03.037
DO - 10.1016/j.surg.2022.03.037
M3 - Article
C2 - 35688742
SN - 0039-6060
VL - 172
SP - 617
EP - 624
JO - Surgery (United States)
JF - Surgery (United States)
IS - 2
ER -