Textbook outcome in liver surgery: open vs minimally invasive hepatectomy among patients with hepatocellular carcinoma

Endo, Yutaka; Tsilimigras, Diamantis I.; Munir, Muhammad Musaab; Woldesenbet, Selamawit; Yang, Jason; Katayama, Erryk; Guglielmi, Alfredo; Ratti, Francesca; Marques, Hugo P.; Cauchy, François; Lam, Vincent; Poultsides, George A.; Kitago, Minoru; Popescu, Irinel; Alexandrescu, Sorin; Martel, Guillaume; Gleisner, Ana; Hugh, Tom; Aldrighetti, Luca; Shen, Feng; Endo, Itaru; Pawlik, Timothy M.

doi:10.1016/j.gassur.2024.01.037

Journal of Gastrointestinal Surgery

2024

DOI: 10.1016/j.gassur.2024.01.037

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Textbook outcome in liver surgery: open vs minimally invasive hepatectomy among patients with hepatocellular carcinoma

Yutaka Endo,

Diamantis I. Tsilimigras,

Muhammad Musaab Munir

et al.

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2024

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Textbook outcome of laparoscopic hepatectomy: Another tool to personalize the care?

Barabino,

Santambrogio

2024

Digestive and Liver Disease

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Textbook outcome of laparoscopic hepatectomy: Another tool to personalize the care?

Barabino,

Santambrogio

2024

Digestive and Liver Disease

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Rates of Textbook Outcome Achieved in Patients Undergoing Liver and Pancreatic Surgery

Villodre,

Alcázar-López,

Carbonell-Morote

et al. 2024

JCM

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Backgorund: Textbook outcome (TO) is a composite measure that reflects the most desirable surgical results as a single indicator. The aim of this study was to assess the achievement of TO at a hepatopancreatobiliary (HPB) surgery unit in a Spanish tertiary hospital. Methods: We performed a retrospective observational study of all consecutive patients who underwent HPB surgery over a 4-year period. Morbidity according to the Clavien-Dindo classification at 30 days, hospital stay, risk of morbidity and mortality according to the POSSUM, and mortality and readmissions at 90 days were recorded. TO was considered when a patient presented no major complications (≥IIIA), no mortality, no readmission, and no prolonged length of stay (≤75th). Results: 283 patients were included. Morbidity >IIIA was reported in 21.6%, and 5.7% died; the median postoperative stay was 4 days. TO was achieved in 56.2% of patients. Comparing patients who presented TO with those who did not, significant differences were recorded for the type of procedure and the expected risk of morbidity and mortality calculated according to the POSSUM scale. There were significant differences between patients with major resections (TO rates: major hepatectomy (46.3%) and major pancreatectomy (52.5%)) and those with minor resections (TO rates minor hepatectomy (67.7%) and minor pancreatectomy (40.4%)). Conclusions: TO is a useful management tool for assessing postoperative results.

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A Decade of Experience Between Open and Minimally Invasive Hepatectomies for Hepatocellular Carcinoma

Park,

Kwon,

Savsani

et al. 2024

Medicina

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Background and Objectives: Hepatic resection offers promising outcomes for patients with hepatocellular carcinoma (HCC) but can be constrained by factors like patient suitability. Continuous advancements in laparoscopic and robotic technologies have made minimally invasive hepatectomies (MIHs) a viable alternative to open hepatectomies with benefits in terms of recovery and complications. Materials and Methods: We completed a retrospective review on 138 HCC patients who underwent OH or MIH between 2010 and 2020 at the Hume-Lee Transplant Center. Univariate and multivariate analyses were completed on demographic, clinical, and tumor-specific data to assess the impact of these variables on overall and disease-free survival at 1, 3, and 5 years. Preoperative metrics like length of hospital stay (LOS) and operation duration were also evaluated. Results: Of the 109 OH and 29 MIH patients, MIH patients demonstrated shorter LOS and operative times. However, overall survival (OS) and disease-free survival (DFS) were similar between groups, with no significant variations in 1-, 3-, and 5-year survival rates. Age > 60 years and a lack of preoperative transcatheter arterial chemoembolization (TACE) were significant predictors of inferior OS and DFS in multivariate analyses. Conclusions: MIH is an efficient substitute for OH with comparable survival, even in older patients. The reduced LOS and operation time enhance its feasibility, and older patients previously denied for curative resection may qualify for MIH. Preoperative TACE also enhances survival outcomes, emphasizing its general role in managing resectable HCCs. Both robotic and laparoscopic hepatectomies offer acceptable short- and long-term clinical outcomes, highlighting MIH as the standard choice for HCC patients.

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Textbook outcome in liver surgery: open vs minimally invasive hepatectomy among patients with hepatocellular carcinoma

Cited by 3 publications

References 46 publications

Textbook outcome of laparoscopic hepatectomy: Another tool to personalize the care?

Textbook outcome of laparoscopic hepatectomy: Another tool to personalize the care?

Rates of Textbook Outcome Achieved in Patients Undergoing Liver and Pancreatic Surgery

A Decade of Experience Between Open and Minimally Invasive Hepatectomies for Hepatocellular Carcinoma

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