Benchmarking postoperative outcomes after open liver surgery for cirrhotic patients with hepatocellular carcinoma in a national cohort

Famularo, Simone; Russolillo, Nadia; Donadon, Matteo; Cipriani, Federica; Ardito, Francesco; Perri, Pasquale; Giani, Alessandro; Stefano, Francesca De; Lai, Quirino; Molfino, Sarah; Zanello, Matteo; Iaria, Maurizio; Barba, Giuliano La; Pinotti, Enrico; Germani, Paola; Conci, Simone; Ferrari, Cecilia; Fumagalli, Luca; Romano, Maurizio; Antonucci, Adelmo; Zimmitti, Giuseppe; Troci, Albert; Floridi, Antonio; Ferraro, Valentina; Patauner, Stefan; Frena, Antonio; Méméo, Riccardo; Crespi, Michele; Hilal, Mohammed Abu; Zanus, Giacomo; Chiarelli, Marco; Percivale, Andrea; Ruzzenente, Andrea; Tarchi, Paola; Zago, Mauro; Ercolani, Giorgio; Valle, Raffaele Dalla; Jovine, Elio; Baiocchi, Gian Luca; Rossi, Massimo; Maestri, Marcello; Romano, Fabrizio; Grazi, Gian Luca; Giuliante, Felice; Aldrighetti, Luca; Ferrero, Alessandro; Torzilli, Guido; Costa, Guido; Milana, Flavio; Fazio, Federico; Ratti, Francesca; Razionale, Francesco; Peppo, Valerio De; Carissimi, Francesca; Graziano, Giorgio Maria Paolo; Laurerio, Zoe Larghi; Giuffrida, Mario; Cucchetti, Alessandro; Montuori, Mauro; Cosola, Davide; Corleone, Pio; Lazzari, Giovanni; Franceschi, Angelo; Calcagno, Pietro; Salvador, Laura; Manzoni, Alberto; Pennacchi, Luca; Libia, Annarita; Notte, Francesca; Bernasconi, Davide Paolo; Mori, Silvia; Gaudesi, Davide

doi:10.1016/j.hpb.2022.02.008

Cited by 9 publications

(7 citation statements)

References 33 publications

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“…Benchmarking has been reported in esophagectomy, liver transplantation, hepatobiliary surgery, pancreatic surgery, and bariatric surgery 16 17 18 19 21 22 23 26 27 28 30 31 32 33 34 37 . Russolillo et al 24 adopted the definition that benchmark was the performance of the top 10% ranked providers adjusted by sample sizes of each provider according to the ‘Achievable Benchmark of Care’ (ABC) method 29 , 36 , 50 . As shown in Table 1 , the definitions of benchmarking evolved over time, reflecting heterogeneity and multiplicity.…”

Section: Resultsmentioning

confidence: 99%

“…After initially reading the titles and abstracts, 166 full-text articles were identified for eligibility. Of these, 143 articles were excluded, and only 23 studies were included in qualitative assessment and synthesis after screening the full text 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 .…”

Section: Resultsmentioning

confidence: 99%

“…Outcome comparisons in surgery also include other clinically relevant outcome parameters such as readmission, length of stay, and comprehensive complication index (CCI) 12 13 14 . Currently, benchmarking targeting clinically relevant outcome measures for complex surgical procedures has become the focus in surgery 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 .…”

Section: Introductionmentioning

confidence: 99%

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Benchmarking: a novel measuring tool for outcome comparisons in surgery

Yuan

et al. 2023

International Journal of Surgery

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Introduction: Benchmarking, a novel measuring tool for outcome comparisons, is a recent concept in surgery. The objectives of this review are to examine the concept, definition, and evolution of benchmarking and its application in surgery. Methods: The literature about benchmarking was reviewed through an ever-narrowing search strategy, commencing from the concept, definition, and evolution of benchmarking to the application of benchmarking and experiences of benchmarking in surgery. PubMed, Web of Science, Embase, and Science Direct databases were searched until 20 September 2022, in the English language according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Results: In the first phase of the literature search, the development of benchmarking was identified. The definitions of benchmarking evolved from a surveying term to a novel quality-improvement tool to assess the best achievable results in surgery. In the second phase, a total of 23 studies were identified about benchmarking in surgery, including esophagectomy, hepatic surgery, pancreatic surgery, rectum resection, and bariatric surgery. All studies were multicenter analyses from national, international, or global expert centers. Most studies (87.0%) adopted the definition that benchmark was the 75th percentile of the median values of centers. Performance metrics to define benchmarks were clinically relevant intraoperative and postoperative outcome indicators. Conclusion: Benchmarking in surgery is a novel quality-improvement tool to define and measure the best achievable results, establishing a meaningful reference to evaluate surgical performance.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Benchmarking: a novel measuring tool for outcome comparisons in surgery

Yuan

et al. 2023

International Journal of Surgery

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“…These activities can help patients relax and reduce feelings of tension and anxiety. [27][28][29][30] TACE intervention surgery is an invasive procedure, and the surgical incision can cause varying degrees of postoperative pain in patients. Additionally, the surgical process may stimulate the digestive system, thereby affecting postoperative digestive function.…”

Section: Discussionmentioning

confidence: 99%

The impact of preoperative interview and prospective nursing on perioperative psychological stress and postoperative complications in patients undergoing TACE intervention for hepatocellular carcinoma

Gao,

Chen,

Qin

et al. 2024

Medicine

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TACE has become one of the main methods for the treatment of liver cancer. The study aimed to investigate the effects of preoperative interview and prospective nursing in patients with hepatic carcinoma undergoing transcatheter chemoembolization (TACE). Eighty-six patients with hepatocellular carcinoma who underwent TACE intervention treatment at our hospital between 2020 and 2023 were selected and randomly assigned to 2 groups using computerized randomization. The control group (n = 43) received routine nursing care, while the study group (n = 43) received preoperative interviews in combination with prospective nursing during the procedure. The patients’ heart rate, mean arterial pressure, and blood pressure variations were recorded, along with their mood changes after intervention. The postoperative pain and satisfaction levels were compared between the 2 groups of patients, and the incidence of postoperative complications was observed. The heart rate, systolic blood pressure, and diastolic blood pressure of the 2 groups of patients were compared 1 day before the operation (P > .05). Compared to 1 day before the operation, there was no significant change for the study group at 10 minutes after entering the room. However, the control group showed an increase. Both groups showed an increase in heart rate, systolic blood pressure, and diastolic blood pressure after the operation, with the study group having lower values than the control group (P < .05). The levels of tension, fatigue, anxiety, energy, anger, depression, self-esteem, and POMS index were compared between the 2 groups before intervention (P > .05). After intervention, there were significant differences between the 2 groups(P < .05). Immediately after the operation, the NRS scores of the 2 groups of patients were compared (P > .05). Compared to the control group, the study group showed a decrease in NRS scores at 12, 24, and 48 hours after the operation (P < .05). The nursing satisfaction rate of the study group patients was 97.67% (42/43), which was higher than the nursing satisfaction rate of the control group of 76.74% (33/43) (P < .05). Compared to routine nursing, preoperative visits and prospective nursing interventions can effectively alleviate patients’ psychological stress reactions, relieve pain, reduce the incidence of complications, and improve patients’ satisfaction with nursing care.

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“…Accordingly, benchmarks have already been established for breast 3 , liver [4][5][6][7][8] , oesophageal 9 , and pancreatic [10][11][12][13] surgery. For pancreatic surgery, benchmarks have only been applied to open pancreatoduodenectomy 10,11 , open distal pancreatectomy 12 or minimally invasive distal pancreatectomy with splenectomy 13 , and none have been defined for spleen-preserving distal pancreatectomy (SPDP).…”

Section: Introductionmentioning

confidence: 99%

Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods

Ramshorst

Giani

Mazzola

et al. 2022

British Journal of Surgery

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Background Benchmarking is an important tool for quality comparison and improvement. However, no benchmark values are available for minimally invasive spleen-preserving distal pancreatectomy, either laparoscopically or robotically assisted. The aim of this study was to establish benchmarks for these techniques using two different methods. Methods Data from patients undergoing laparoscopically or robotically assisted spleen-preserving distal pancreatectomy were extracted from a multicentre database (2006–2019). Benchmarks for 10 outcomes were calculated using the Achievable Benchmark of Care (ABC) and best-patient-in-best-centre methods. Results Overall, 951 laparoscopically assisted (77.3 per cent) and 279 robotically assisted (22.7 per cent) procedures were included. Using the ABC method, the benchmarks for laparoscopically assisted and robotically assisted spleen-preserving distal pancreatectomy respectively were: 150 and 207 min for duration of operation, 55 and 100 ml for blood loss, 3.5 and 1.7 per cent for conversion, 0 and 1.7 per cent for failure to preserve the spleen, 27.3 and 34.0 per cent for overall morbidity, 5.1 and 3.3 per cent for major morbidity, 3.6 and 7.1 per cent for pancreatic fistula grade B/C, 5 and 6 days for duration of hospital stay, 2.9 and 5.4 per cent for readmissions, and 0 and 0 per cent for 90-day mortality. Best-patient-in-best-centre methodology revealed milder benchmark cut-offs for laparoscopically and robotically assisted procedures, with operating times of 254 and 262.5 min, blood loss of 150 and 195 ml, conversion rates of 5.8 and 8.2 per cent, rates of failure to salvage spleen of 29.9 and 27.3 per cent, overall morbidity rates of 62.7 and 55.7 per cent, major morbidity rates of 20.4 and 14 per cent, POPF B/C rates of 23.8 and 24.2 per cent, duration of hospital stay of 8 and 8 days, readmission rates of 20 and 15.1 per cent, and 90-day mortality rates of 0 and 0 per cent respectively. Conclusion Two benchmark methods for minimally invasive distal pancreatectomy produced different values, and should be interpreted and applied differently.

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Benchmarking postoperative outcomes after open liver surgery for cirrhotic patients with hepatocellular carcinoma in a national cohort

Cited by 9 publications

References 33 publications

Benchmarking: a novel measuring tool for outcome comparisons in surgery

Benchmarking: a novel measuring tool for outcome comparisons in surgery

The impact of preoperative interview and prospective nursing on perioperative psychological stress and postoperative complications in patients undergoing TACE intervention for hepatocellular carcinoma

Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods

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