Comparing practice and outcome of laparoscopic liver resection between high-volume expert centres and nationwide low-to-medium volume centres.

Autor:	Görgec B; Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.; Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.; Department of Surgery, Fondazione Poliambulanza - Istituto Ospedaliero, Brescia, Italy., Fichtinger RS; Department of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands and RWTH Aachen, Germany., Ratti F; Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy., Aghayan D; Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway.; The Intervention Centre, Oslo University Hospital - Rikshospitalet, Oslo, Norway.; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Norway., Van der Poel MJ; Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands., Al-Jarrah R; Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Armstrong T; Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Cipriani F; Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy., Fretland ÅA; Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway.; The Intervention Centre, Oslo University Hospital - Rikshospitalet, Oslo, Norway., Suhool A; Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Bemelmans M; Department of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands and RWTH Aachen, Germany., Bosscha K; Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands., Braat AE; Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., De Boer MT; Department of Surgery, University Medical Centre Groningen, Groningen, the Netherlands., Dejong CHC; Department of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands and RWTH Aachen, Germany., Doornebosch PG; Department of Surgery, IJsselland Hospital, Capelle aan den IJssel, the Netherlands., Draaisma WA; Department of Surgery, Meander Medical Centre, Amersfoort, the Netherlands., Gerhards MF; Department of Surgery, OLVG, Amsterdam, the Netherlands., Gobardhan PD; Department of Surgery, Amphia Hospital, Breda, the Netherlands., Hagendoorn J; Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands., Kazemier G; Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands., Klaase J; Department of Surgery, University Medical Centre Groningen, Groningen, the Netherlands.; Department of Surgery, Medical Spectrum Twente, Enschede, the Netherlands., Leclercq WKG; Department of Surgery, Máxima Medical Centre, Veldhoven, the Netherlands., Liem MS; Department of Surgery, Medical Spectrum Twente, Enschede, the Netherlands., Lips DJ; Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.; Department of Surgery, Medical Spectrum Twente, Enschede, the Netherlands., Marsman HA; Department of Surgery, OLVG, Amsterdam, the Netherlands., Mieog JSD; Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Molenaar QI; Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands., Nieuwenhuijs VB; Department of Surgery, Isala, Zwolle, the Netherlands., Nota CL; Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands., Patijn GA; Department of Surgery, Isala, Zwolle, the Netherlands., Rijken AM; Department of Surgery, Amphia Hospital, Breda, the Netherlands., Slooter GD; Department of Surgery, Máxima Medical Centre, Veldhoven, the Netherlands., Stommel MWJ; Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands., Swijnenburg RJ; Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.; Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Tanis PJ; Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands., Te Riele WW; Department of Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands., Terkivatan T; Department of Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands., Van den Tol PMP; Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands., Van den Boezem PB; Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands., Van der Hoeven JA; Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands., Vermaas M; Department of Surgery, IJsselland Hospital, Capelle aan den IJssel, the Netherlands., Edwin B; Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway.; The Intervention Centre, Oslo University Hospital - Rikshospitalet, Oslo, Norway.; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Norway., Aldrighetti LA; Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy., Van Dam RM; Department of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands and RWTH Aachen, Germany.; GROW - School for Oncology & Developmental Biology, Maastricht University, Maastricht, The Netherlands.; Department of General and Visceral Surgery, University Hospital Aachen, Aachen, Germany., Abu Hilal M; Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.; Department of Surgery, Fondazione Poliambulanza - Istituto Ospedaliero, Brescia, Italy., Besselink MG; Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	The British journal of surgery [Br J Surg] 2021 Aug 19; Vol. 108 (8), pp. 983-990.
DOI:	10.1093/bjs/znab096
Abstrakt:	Background: Based on excellent outcomes from high-volume centres, laparoscopic liver resection is increasingly being adopted into nationwide practice which typically includes low-medium volume centres. It is unknown how the use and outcome of laparoscopic liver resection compare between high-volume centres and low-medium volume centres. This study aimed to compare use and outcome of laparoscopic liver resection in three leading European high-volume centres and nationwide practice in the Netherlands. Method: An international, retrospective multicentre cohort study including data from three European high-volume centres (Oslo, Southampton and Milan) and all 20 centres in the Netherlands performing laparoscopic liver resection (low-medium volume practice) from January 2011 to December 2016. A high-volume centre is defined as a centre performing >50 laparoscopic liver resections per year. Patients were retrospectively stratified into low, moderate- and high-risk Southampton difficulty score groups. Results: A total of 2425 patients were included (1540 high-volume; 885 low-medium volume). The median annual proportion of laparoscopic liver resection was 42.9 per cent in high-volume centres and 7.2 per cent in low-medium volume centres. Patients in the high-volume centres had a lower conversion rate (7.4 versus 13.1 per cent; P < 0.001) with less intraoperative incidents (9.3 versus 14.6 per cent; P = 0.002) as compared to low-medium volume centres. Whereas postoperative morbidity and mortality rates were similar in the two groups, a lower reintervention rate (5.1 versus 7.2 per cent; P = 0.034) and a shorter postoperative hospital stay (3 versus 5 days; P < 0.001) were observed in the high-volume centres as compared to the low-medium volume centres. In each Southampton difficulty score group, the conversion rate was lower and hospital stay shorter in high-volume centres. The rate of intraoperative incidents did not differ in the low-risk group, whilst in the moderate-risk and high-risk groups this rate was lower in high-volume centres (absolute difference 6.7 and 14.2 per cent; all P < 0.004). Conclusion: High-volume expert centres had a sixfold higher use of laparoscopic liver resection, less conversions, and shorter hospital stay, as compared to a nationwide low-medium volume practice. Stratification into Southampton difficulty score risk groups identified some differences but largely outcomes appeared better for high-volume centres in each risk group. (© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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