Evaluation of the Iwate Model for Predicting the Difficulty of Laparoscopic Liver Resection: Does Tumor Size Matter?

Ivanecz, Arpad; Plahuta, Irena; Magdalenić, T.; Ilijevec, Bojan; Mencinger, Matej; Peruš, Iztok; Potrč, Stojan

doi:10.1007/s11605-020-04657-9

Cited by 10 publications

(17 citation statements)

References 24 publications

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“…Our first propensity score matching study of simultaneous resection of CLM and primary tumors in 20 patients was published in 2018 (16) and was internationally acknowledged (35)(36)(37). Since 2017, 74 patients underwent liver resection for CLM, which was performed laparoscopically in 35 (47.3%) patients (17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

Achievements in surgical treatment for colorectal liver metastases from 2000 until 2020

Plahuta

Magdalenić

Turk

et al. 2022

AMB

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Namen: Rak debelega črevesa in danke (RDČD) je v svetovnem merilu tretja najpogostejša maligna bolezen in najpogosteje zaseva v jetra. Namen raziskave je predstaviti možnosti kirurškega zdravljenja jetrnih zasevkov in rezultate zdravljenja. Metode: Opravili smo retrospektivni pregled prospektivno vodene datoteke resekcij jetrnih zasevkov RDČD na Kliničnem oddelku za abdominalno in splošno kirurgijo Univerzitetnega kliničnega centra Maribor. Raziskava temelji na principu pristopa k zdravljenju z namenom ozdravitve. Analizirali smo število posegov, ponovne posege, zaplete in preživetje. Rezultati: Od januarja 2000 do decembra 2020 je bilo izvedenih 631 kirurških posegov zaradi jetrnih zasevkov RDČD. 352 (74,4 %) bolnikov je bolnikov več kot enega. Resekcij jeter je bilo 541 (85,7 %), in sicer 389 manjših in 152 velikih resekcij. Radiofrekvenčno ablacijo smo opravili v 61 (9,7 %) in eksploracijo v 29 (4,6 %) primerih. Ponovnih posegov je bilo 138 (21,9 %). Hudi zapleti (stopnja ≥ 3a po klasifikaciji Clavien-Dindo) so se pojavili po 84 (13,3 %) posegih. 90-dnevna pooperativna smrtnost je znašala 3,8 %. Mediano preživetje pri seštevku 0 v Clinical Risk Score je 69 mesecev; 5- in 10-letni preživetji sta 57-% oziroma 38-%. Zaključek: Kirurška odstranitev jetrnih zasevkov v celoti in ugodni prognostični dejavniki omogočajo dolgoročno preživetje bolnikov z jetrnimi zasevki RDČD.

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Section: Discussionmentioning

confidence: 99%

Achievements in surgical treatment for colorectal liver metastases from 2000 until 2020

Plahuta

Magdalenić

Turk

et al. 2022

AMB

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“…13,14,16 To sum up, this conversion rate reflected the surgeon's reliance on the open method when dealing with adverse intraoperative findings. 20 Although the first anatomical LLR was performed in 1996 31 , the first difficulty score was published not earlier than 2014. 32 Our first LLR was performed in 2008, and the surgeon had to lean on his experience from open liver surgery.…”

Section: Discussionmentioning

confidence: 99%

“… 13 , 14 , 16 To sum up, this conversion rate reflected the surgeon’s reliance on the open method when dealing with adverse intraoperative findings. 20 …”

Section: Discussionmentioning

confidence: 99%

“… 11 The surgical technique for LLR has been extensively described by others 17 and performed as reported previously. 18 , 19 , 20 …”

Section: Methodsmentioning

confidence: 99%

“…11 The surgical technique for LLR has been extensively described by others 17 and performed as reported previously. [18][19][20] At the time of the operation all patients had given their written consent that anonymous data can be used for research purposes. Patient records were anonymized and de-identified before analysis.…”

Section: Patientsmentioning

confidence: 99%

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The learning curve of laparoscopic liver resection utilising a difficulty score

Ivanecz

Plahuta

Mencinger

et al. 2021

Radiology and Oncology

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Background This study aimed to quantitatively evaluate the learning curve of laparoscopic liver resection (LLR) of a single surgeon. Patients and methods A retrospective review of a prospectively maintained database of liver resections was conducted. 171 patients undergoing pure LLRs between April 2008 and April 2021 were analysed. The Halls difficulty score (HDS) for theoretical predictions of intraoperative complications (IOC) during LLR was applied. IOC was defined as blood loss over 775 mL, unintentional damage to the surrounding structures, and conversion to an open approach. Theoretical association between HDS and the predicted probability of IOC was utilised to objectify the shape of the learning curve. Results The obtained learning curve has resulted from thirteen years of surgical effort of a single surgeon. It consists of an absolute and a relative part in the mathematical description of the additive function described by the logarithmic function (absolute complexity) and fifth-degree regression curve (relative complexity). The obtained learning curve determines the functional dependency of the learning outcome versus time and indicates several local extreme values (peaks and valleys) in the learning process until proficiency is achieved. Conclusions This learning curve indicates an ongoing learning process for LLR. The proposed mathematical model can be applied for any surgical procedure with an existing difficulty score and a known theoretically predicted association between the difficulty score and given outcome (for example, IOC).

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Systematic review and meta‐analysis of difficulty scoring systems for laparoscopic and robotic liver resections

Linn

Han

et al. 2022

J Hepato Biliary Pancreat

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Introduction:The ability to stratify the difficulty of minimally invasive liver resection (MILR) allows surgeons at different phases of the learning curve to tackle cases of appropriate difficulty safely. Several difficulty scoring systems (DSS) have been formulated which attempt to accurately stratify this difficulty. The present study aims to review the literature pertaining to the existing DSS for MILR. Methods:We performed a systematic review and metanalysis of the literature reporting on the formulation, supporting data, and comparison of DSS for MILR.Results: A total of 11 studies were identified which reported on the formulation of unique DSS for MILR. Five of these (Ban, Iwate, Hasegawa, Institut Mutaliste

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Evaluation of the Iwate Model for Predicting the Difficulty of Laparoscopic Liver Resection: Does Tumor Size Matter?

Cited by 10 publications

References 24 publications

Achievements in surgical treatment for colorectal liver metastases from 2000 until 2020

Achievements in surgical treatment for colorectal liver metastases from 2000 until 2020

The learning curve of laparoscopic liver resection utilising a difficulty score

Systematic review and meta‐analysis of difficulty scoring systems for laparoscopic and robotic liver resections

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