Comparison and validation of three difficulty scoring systems in laparoscopic liver surgery: a retrospective analysis on 300 cases

Russolillo, Nadia; Maina, Cecilia; Fleres, Francesco; Langella, Serena; Tesoriere, Roberto Lo; Ferrero, Alessandro

doi:10.1007/s00464-019-07345-1

Cited by 25 publications

(35 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We defined “proximity to major vessels” as tumors located less than 1 cm away from relevant vascular structures in given preoperative sectional imaging. The complete scoring system was described elsewhere [ 15 , 23 , 24 ]. The total score (0–12 points) was calculated and the following difficulty levels were defined: low difficulty (1–3 points), intermediate difficulty (4–6 points), and high difficulty (requiring advanced/expert surgeons, > 6 points).…”

Section: Methodsmentioning

confidence: 99%

Robotic and laparoscopic liver resection—comparative experiences at a high-volume German academic center

Lorenz

Arend

Franz

et al. 2021

Langenbecks Arch Surg

View full text Add to dashboard Cite

Purpose Minimally invasive liver surgery (MILS) is a feasible and safe procedure for benign and malignant tumors. There has been an ongoing debate on whether conventional laparoscopic liver resection (LLR) or robotic liver resection (RLR) is superior and if one approach should be favored over the other. We started using LLR in 2010, and introduced RLR in 2013. In the present paper, we report on our experiences with these two techniques as early adopters in Germany. Methods The data of patients who underwent MILS between 2010 and 2020 were collected prospectively in the Magdeburg Registry for Minimally Invasive Liver Surgery (MD-MILS). A retrospective analysis was performed regarding patient demographics, tumor characteristics, and perioperative parameters. Results We identified 155 patients fulfilling the inclusion criteria. Of these, 111 (71.6%) underwent LLR and 44 (29.4%) received RLR. After excluding cystic lesions, 113 cases were used for the analysis of perioperative parameters. Resected specimens were significantly bigger in the RLR vs. the LLR group (405 g vs. 169 g, p = 0.002); in addition, the tumor diameter was significantly larger in the RLR vs. the LLR group (5.6 cm vs. 3.7 cm, p = 0.001). Hence, the amount of major liver resections (three or more segments) was significantly higher in the RLR vs. the LLR group (39.0% vs. 16.7%, p = 0.005). The mean operative time was significantly longer in the RLR vs. the LLR group (331 min vs. 181 min, p = 0.0001). The postoperative hospital stay was significantly longer in the RLR vs. the LLR group (13.4 vs. LLR 8.7 days, p = 0.03). The R0 resection rate for solid tumors was higher in the RLR vs. the LLR group but without statistical significance (93.8% vs. 87.9%, p = 0.48). The postoperative morbidity ≥ Clavien-Dindo grade 3 was 5.6% in the LLR vs. 17.1% in the RLR group (p = 0.1). No patient died in the RLR but two patients (2.8%) died in the LLR group, 30 and 90 days after surgery (p = 0.53). Conclusion Minimally invasive liver surgery is safe and feasible. Robotic and laparoscopic liver surgery shows similar and adequate perioperative oncological results for selected patients. RLR might be advantageous for more advanced and technically challenging procedures.

show abstract

Section: Methodsmentioning

confidence: 99%

Robotic and laparoscopic liver resection—comparative experiences at a high-volume German academic center

Lorenz

Arend

Franz

et al. 2021

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…Previously suggested scoring systems for LLR have been validated and included a range of LLR procedures, from peripheral wedge resection to major hepatectomy. [16][17][18][22][23][24][25][26][27] Therefore, our study focused on the surgical outcomes of complex LLR and the particular difficulties of the different procedures.…”

Section: Discussionmentioning

confidence: 99%

“…In our experience, it is generally more difficult to prepare the right, anterior, and posterior Glissonean pedicles than the left Glissonean pedicle, which requires more time and more frequently results in postoperative bile leaks. As the liver 14 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) 18 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) 16 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) 11 (9)(10)(11)(12)(13)(14)(15)(16)(17) 11 (8)…”

Section: Discussionmentioning

confidence: 99%

“…Technical difficulties of LLR for the surgeon result from movement restrictions and a limited view that may cause disorientation; however, they also depend on the type of hepatectomy performed. Previously suggested scoring systems for LLR have been validated and included a range of LLR procedures, from peripheral wedge resection to major hepatectomy 16–18,22–27 . Therefore, our study focused on the surgical outcomes of complex LLR and the particular difficulties of the different procedures.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical outcomes of 118 complex laparoscopic liver resections: a single‐ center experience

Hasegawa

Nitta

Takahara

et al. 2020

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

Laparoscopic liver resection (LLR) is a surgical technique that is increasingly used worldwide because of recent technical advances in the medical field and its several clinical advantages compared to open liver resection. 1-9 Moreover, the indications for extended LLR are continuously expanding at different institutions as physicians accumulate more experience and better skills. 10-13 To foster the development of skilled surgeons capable of safely and reliably performing highly difficult procedures,

show abstract

“…After that, this difficulty scoring system was revised after discussion at the Second ICCLLR and renamed the IWATE criteria [69,70]. Although this scoring system could predict short-term surgical outcomes, the surgical difficulty assessment system is still not perfect, and various new difficulty assessment systems are even being proposed [71][72][73][74].…”

Section: Minimally Invasive Surgery For Hccmentioning

confidence: 99%

The Recent Development of the Surgical Treatment for Hepatocellular Carcinoma

et al. 2021

View full text Add to dashboard Cite

The optimal treatment for hepatocellular carcinoma (HCC) should be selected based on tumor conditions, liver functional reserve, and performance status. Surgical treatment, such as liver resection and liver transplantation, is the most favorable treatment method; however, its indication criteria differ according to each country’s guidelines. In Western countries, liver resection is indicated only for early-stage HCC patients with Barcelona-Clinic Liver Cancer staging classification (BCLC) 0/A. While in Asian countries, liver resection is one of the treatment options for advanced HCC, such as BCLC B/C. Recently, the treatment of HCC is about to enter a drastic transitional period. It started with the widespread use of minimally invasive surgery for HCC, followed by a high rate of hepatitis C virus eradication with the advent of direct acting antivirals and developing a multidisciplinary treatment for highly advanced HCC. As a result, the importance of liver resection for HCC is increasing, and it is time to reconsider the criteria for selecting treatment methods for HCC patients. This article outlines current topics in the surgical treatment of HCC.

show abstract

Comparison and validation of three difficulty scoring systems in laparoscopic liver surgery: a retrospective analysis on 300 cases

Cited by 25 publications

References 31 publications

Robotic and laparoscopic liver resection—comparative experiences at a high-volume German academic center

Robotic and laparoscopic liver resection—comparative experiences at a high-volume German academic center

Surgical outcomes of 118 complex laparoscopic liver resections: a single‐ center experience

The Recent Development of the Surgical Treatment for Hepatocellular Carcinoma

Contact Info

Product

Resources

About