当前位置： SCI文献检索 > ANNALS OF SURGERY期刊下所有文献 > Conversion for Unfavorable Intraoperative Events Results in Significantly Worse Outcomes During Laparoscopic Liver Resection: Lessons Learned From a Multicenter Review of 2861 Cases.

Conversion for Unfavorable Intraoperative Events Results in Significantly Worse Outcomes During Laparoscopic Liver Resection: Lessons Learned From a Multicenter Review of 2861 Cases.

Abstract：

OBJECTIVE:To investigate the risk factors for conversion during laparoscopic liver resection and its effect on patient outcome in a large cohort of patients. Additional analysis of outcomes in patients who required conversion for unfavorable intraoperative findings and conversion for unfavorable intraoperative events will be performed to establish if the cause of conversion effects outcome. SUMMARY BACKGROUND DATA:Multiple previous studies demonstrate that laparoscopic liver surgery reduces intraoperative blood loss, hospital stay, and morbidity while maintaining comparable oncological and survival outcomes when compared with open liver resections. However, limited information is available regarding the possible sequelae of conversion to open surgery, especially with regards to cause of conversion. METHODS:A retrospective analysis of 2861 cases from prospectively maintained databases of 7 tertiary liver centers across Europe was performed. RESULTS:Neo-adjuvant chemotherapy, previous liver resection(s), resections for malignant lesions, postero-superior location, and the extent of the resection are associated with an increased risk of conversion. Patients who require conversion have longer operations with higher blood loss; a longer HDU and total hospital stay, increased frequency and severity of complications and higher 30- and 90-day mortality. Patients who had an elective conversion for an unfavorable intraoperative finding had better outcomes than patients who had an emergency conversion secondary to an unfavorable intraoperative event in terms of HDU and total hospital stay, severity of complication, and 90-day mortality. CONCLUSIONS:Our study highlights the risk factors for conversion and suggests that conversion for unfavorable intraoperative events is associated with worse outcomes.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Halls MC,Cipriani F,Berardi G,Barkhatov L,Lainas P,Alzoubi M,D'Hondt M,Rotellar F,Dagher I,Aldrighetti L,Troisi RI,Edwin B,Abu Hilal M

doi

10.1097/SLA.0000000000002332

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

1051-1057

issue

eissn

0003-4932

issn

1528-1140

journal_volume

268

pub_type

杂志文章,多中心研究

在线工具

Conversion for Unfavorable Intraoperative Events Results in Significantly Worse Outcomes During Laparoscopic Liver Resection: Lessons Learned From a Multicenter Review of 2861 Cases.