A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

Li, Long; Ding, Jie; Han, Jun; Wu, Hong

doi:10.1097/md.0000000000007198

Cited by 16 publications

(10 citation statements)

References 35 publications

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“…We found that patients who underwent repeat hepatectomy were more likely to develop SSIs, consistent with previous studies[25-28]. One explanation for this finding is that, to ensure minimum trauma for patients, the original incision site was usually considered as the optimal operation approach for repeat hepatectomy.…”

Section: Discussionsupporting

confidence: 90%

Predicting surgical site infections using a novel nomogram in patients with hepatocelluar carcinoma undergoing hepatectomy

Tang

Zong

Shen

et al. 2019

WJCC

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BACKGROUND Surgical site infections (SSI) remain a major cause of morbidity after hepatectomy for hepatocellular carcinoma (HCC). AIM To identify the risk factors associated with SSI, and develop a nomogram to predict SSI among patients undergoing hepatectomy. METHODS We retrospectively reviewed the data of patients diagnosed with HCC undergoing hepatectomy at two academic institutions in China, and evaluated the occurrence of SSI. Independent risk factors for SSI were identified using univariate and multivariate analyses. Based on these independent risk factors, a nomogram was established using the data of patients in the first institution, and was validated using data from an external independent cohort from the second institution. RESULTS The nomogram was established using data from 309 patients, whereas the validation cohort used data from 331 patients. The operation duration, serum albumin level, repeat hepatectomy, and ASA score were identified as independent risk factors. The concordance index (C-index) of the nomogram for SSI prediction in the training cohort was 0.86; this nomogram also performed well in the external validation cohort, with a C-index of 0.84. Accordingly, we stratified patients into three groups, with a distinct risk range based on the nomogram prediction, to guide clinical practice. CONCLUSION Our novel nomogram offers good preoperative prediction for SSIs in patients undergoing hepatectomy.

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Section: Discussionsupporting

confidence: 90%

Predicting surgical site infections using a novel nomogram in patients with hepatocelluar carcinoma undergoing hepatectomy

Tang

Zong

Shen

et al. 2019

WJCC

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“…15 The LC operation was performed in accordance with previously published literature. 4,8 ERCP operation was also performed according to the description of Li et al 16…”

Section: Methodsmentioning

confidence: 99%

Clinical Efficacy Analysis of the Combination of the Laparoscope and Preoperative or Intraoperative Duodenoscope in the Treatment of Cholecystolithiasis with Choledocholithiasis: A Retrospective Study

Jiang

Yang

Wang

et al. 2019

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Aim: This study aims to analyze the efficacy and safety of the combination of laparoscope and preoperative (PODL) or intraoperative (IODL) duodenoscope in the treatment of cholecystolithiasis with choledocholithiasis. Materials and Methods: From January 2015 to February 2017, 51 patients with cholecystolithiasis and choledocholithiasis, who were treated with the PODL (n = 29) or IODL (n = 22), were reviewed retrospectively. The efficacy and safety were evaluated and compared between these two groups. Results: The success rates were 100% in IODL group and 96.6% in PODL group. There was no statistical significance in the difference of stone clearance rate and residual stone rate between two groups (P > .05). There were no significant differences in complications, like aspiration, gastrointestinal perforation, and acute cholangitis between two groups (P > .05). IODL significantly decreased numeric rating scale (NRS) scoring, reduced surgery cost and shortened hospitalization time compared to that of PODL group (P < .05). No cholangitis, reoccurrence of stones or biliary obstruction occurred in all 51 patients. Conclusion: In this retrospective study, IODL was found superior to PODL. And the IODL can significantly decrease NRS scoring, reduce surgery cost and shorten hospitalization time.

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“…Therefore, to identify the risk indicators for PPOI and determine optimal management strategies, a risk prediction model is urgently required. Of all the available models, a nomogram can provide a highly accurate, individualized evidence-based risk estimation[14,15]. Nomograms predicting survival of patients with unresectable or metastatic GC were well established[16].…”

Section: Introductionmentioning

confidence: 99%

Nomogram to predict prolonged postoperative ileus after gastrectomy in gastric cancer

Liang

Zhang

Cui

et al. 2019

WJG

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BACKGROUNDProlonged postoperative ileus (PPOI) is one of the common complications in gastric cancer patients who underwent gastrectomy. Evidence on the predictors of PPOI after gastrectomy is limited and few prediction models of nomogram are used to estimate the risk of PPOI. We hypothesized that a predictive nomogram can be used for clinical risk estimation of PPOI in gastric cancer patients.AIMTo investigate the risk factors for PPOI and establish a nomogram for clinical risk estimation.METHODSBetween June 2016 and March 2017, the data of 162 patients with gastrectomy were obtained from a prospective and observational registry database. Clinical data of patients who fulfilled the criteria were obtained. Univariate and multivariable logistic regression models were performed to detect the relationship between variables and PPOI. A nomogram for PPOI was developed and verified by bootstrap resampling. The calibration curve was employed to detect the concentricity between the model probability curve and ideal curve. The clinical usefulness of our model was evaluated using the net benefit curve.RESULTSThis study analyzed 14 potential variables of PPOI in 162 gastric cancer patients who underwent gastrectomy. The incidence of PPOI was 19.75% in patients with gastrectomy. Age older than 60 years, open surgery, advanced stage (III–IV), and postoperative use of opioid analgesic were independent risk factors for PPOI. We developed a simple and easy-to-use prediction nomogram of PPOI after gastrectomy. This nomogram had an excellent diagnostic performance [area under the curve (AUC) = 0.836, sensitivity = 84.4%, and specificity = 75.4%]. This nomogram was further validated by bootstrapping for 500 repetitions. The AUC of the bootstrap model was 0.832 (95%CI: 0.741–0.924). This model showed a good fitting and calibration and positive net benefits in decision curve analysis.CONCLUSIONWe have developed a prediction nomogram of PPOI for gastric cancer. This novel nomogram might serve as an essential early warning sign of PPOI in gastric cancer patients.

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A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

Cited by 16 publications

References 35 publications

Predicting surgical site infections using a novel nomogram in patients with hepatocelluar carcinoma undergoing hepatectomy

Predicting surgical site infections using a novel nomogram in patients with hepatocelluar carcinoma undergoing hepatectomy

Clinical Efficacy Analysis of the Combination of the Laparoscope and Preoperative or Intraoperative Duodenoscope in the Treatment of Cholecystolithiasis with Choledocholithiasis: A Retrospective Study

Nomogram to predict prolonged postoperative ileus after gastrectomy in gastric cancer

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