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Implementation and outcome of minor and major minimally invasive liver surgery in the Netherlands.
- Source :
-
HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2019 Dec; Vol. 21 (12), pp. 1734-1743. Date of Electronic Publication: 2019 Jun 21. - Publication Year :
- 2019
-
Abstract
- Background: While most of the evidence on minimally invasive liver surgery (MILS) is derived from expert centers, nationwide outcomes remain underreported. This study aimed to evaluate the implementation and outcome of MILS on a nationwide scale.<br />Methods: Electronic patient files were reviewed in all Dutch liver surgery centers and all patients undergoing MILS between 2011 and 2016 were selected. Operative outcomes were stratified based on extent of the resection and annual MILS volume.<br />Results: Overall, 6951 liver resections were included, with a median annual volume of 50 resections per center. The overall use of MILS was 13% (n = 916), which varied from 3% to 36% (P < 0.001) between centers. The nationwide use of MILS increased from 6% in 2011 to 23% in 2016 (P < 0.001). Outcomes of minor MILS were comparable with international studies (conversion 0-13%, mortality <1%). In centers which performed ≥20 MILS annually, major MILS was associated with less conversions (14 (11%) versus 41 (30%), P < 0.001), shorter operating time (184 (117-239) versus 200 (139-308) minutes, P = 0.010), and less overall complications (37 (30%) versus 58 (42%), P = 0.040).<br />Conclusion: The nationwide use of MILS is increasing, although large variation remains between centers. Outcomes of major MILS are better in centers with higher volumes.<br /> (Copyright © 2019 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Attitude of Health Personnel
Conversion to Open Surgery statistics & numerical data
Female
Humans
Learning Curve
Male
Middle Aged
Netherlands epidemiology
Operative Time
Postoperative Complications epidemiology
Retrospective Studies
Surgeons
Surveys and Questionnaires
Hepatectomy statistics & numerical data
Laparoscopy statistics & numerical data
Liver surgery
Robotic Surgical Procedures statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1477-2574
- Volume :
- 21
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- HPB : the official journal of the International Hepato Pancreato Biliary Association
- Publication Type :
- Academic Journal
- Accession number :
- 31235430
- Full Text :
- https://doi.org/10.1016/j.hpb.2019.05.002