Factors Related to Textbook Outcome in Laparoscopic Liver Resections: a Single Western Centre Analysis.
J Gastrointest Surg
; 26(11): 2301-2310, 2022 11.
Article
em En
| MEDLINE
| ID: mdl-35962214
ABSTRACT
INTRODUCTION:
The selection of the most informative quality of care indicator for laparoscopic liver surgery (LLS) is still debated; among those proposed, textbook outcome (TO) seems to provide a compositive measure of the outcomes of surgery. The aim of this study was to investigate the factors related with the TO in a cohort of patients who underwent LLS.METHODS:
Patients who underwent LLS from 2014 to 2021 were included. TO for LLS (TOLLS) was defined as R0 resection, absence of intraoperative incidents, severe complications, reintervention, 30-day readmission and in-hospital mortality. When also considering no prolonged length of hospital stay (LOS), the outcome was called TOLLS+.RESULTS:
Four hundred twenty-one patients were included; TOLLS was achieved in 80.5%, TOLLS+ in 60.8% cases. R0 resection was obtained in 90.2% cases, intraoperative incidents occurred in 7.8%, severe complications in 5.0%, reintervention in 0.7%, readmission in 1.4% and in-hospital mortality in 0.2%. 32.5% of patients showed prolonged LOS. After univariate and multivariate analysis, factors influencing TOLLS were age (OR 0.967; p=0.003), concomitant surgery (OR 0.380; p=0.003), operative time (OR 0.996; p=0.008) and blood loss (OR 0.241; p<0.001); factors influencing TOLLS+ were ASA-score (OR 0.533; p=0.008), tumour histology (OR 0.421; p=0.021), concomitant surgery (OR 0.293; p<0.001), operative time (OR 0.997; p=0.016) and blood loss (OR 0.361; p=0.003).CONCLUSIONS:
TOLLS can be achieved in most patients undergoing LLR, and it seems to be influenced mostly by surgery-related factors; conversely, TOLLS+ is achieved less frequently and seems to be influenced also by patient- and tumour-related factors.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Laparoscopia
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Indicadores de Qualidade em Assistência à Saúde
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Hepatectomia
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Neoplasias Hepáticas
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article