Implementation and outcome of minor and major minimally invasive liver surgery in the Netherlands

被引:37
作者
van der Poel, Marcel J. [1 ]
Fichtinger, Robert S. [2 ,3 ]
Bemelmans, Marc [2 ,3 ]
Bosscha, Koop [4 ]
Braat, Andries E. [5 ]
de Boer, Marieke T. [6 ]
Dejong, Cornelis H. C. [2 ,3 ]
Doornebosch, Pascal G. [7 ]
Draaisma, Werner A. [4 ,8 ]
Gerhards, Michael F. [9 ]
Gobardhan, Paul D. [10 ]
Gorgec, Burak [1 ]
Hagendoorn, Jeroen [11 ]
Kazemier, Geert [12 ]
Klaase, Joost [6 ,13 ]
Leclercq, Wouter K. G. [14 ]
Liem, Mike S. [13 ]
Lips, Daan J. [4 ,13 ]
Marsman, Hendrik A. [9 ]
Mieog, J. Sven D. [5 ]
Molenaar, Quintus I. [11 ]
Nieuwenhuijs, Vincent B. [15 ]
Nota, Carolijn L. [11 ]
Patijn, Gijs A. [15 ]
Rijken, Arjen M. [10 ]
Slooter, Gerrit D. [14 ]
Stommel, Martijn W. J. [16 ]
Swijnenburg, Rutger-Jan [1 ,5 ]
Tanis, Pieter J. [1 ]
te Riele, Wouter W. [17 ]
Terkivatan, Turkan [18 ]
van den Tol, Petrousjka M. [12 ]
van den Boezem, Peter B. [15 ,16 ]
van der Hoeven, Joost A. [19 ]
Vermaas, Maarten [7 ]
Abu Hilal, Moh'd [20 ]
van Dam, Ronald M. [2 ,3 ]
Besselink, Marc G. [1 ]
Zonderhuis, Babs [21 ]
Rinkes, Inne B. [22 ]
Hoff, Christiaan [23 ]
Oosterling, Steven [24 ]
机构
[1] Univ Amsterdam, Dept Surg, Canc Ctr Amsterdam, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands
[2] Maastricht Univ, Med Ctr, Dept Surg, Maastricht, Netherlands
[3] Rhein Westfal TH Aachen, Aachen, Germany
[4] Jeroen Bosch Hosp, Dept Surg, Shertogenbosch, Netherlands
[5] Leiden Univ, Med Ctr, Dept Surg, Leiden, Netherlands
[6] Univ Med Ctr Groningen, Dept Surg, Groningen, Netherlands
[7] IJsselland Hosp, Dept Surg, Capelle Aan Den Ijssel, Netherlands
[8] Meander Med Ctr, Dept Surg, Amersfoort, Netherlands
[9] OLVG, Dept Surg, Amsterdam, Netherlands
[10] Amphia Hosp, Dept Surg, Breda, Netherlands
[11] Univ Med Ctr Utrecht, Dept Surg, Utrecht, Netherlands
[12] Vrije Univ Amsterdam, Amsterdam UMC, Canc Ctr Amsterdam, Dept Surg, Amsterdam, Netherlands
[13] Med Spectrum Twente, Dept Surg, Enschede, Netherlands
[14] Maxima Med Ctr, Dept Surg, Veldhoven, Netherlands
[15] Isala, Dept Surg, Zwolle, Netherlands
[16] Radboud Univ Nijmegen, Med Ctr, Dept Surg, Nijmegen, Netherlands
[17] St Antonius Hosp, Dept Surg, Nieuwegein, Netherlands
[18] Erasmus MC, Dept Surg, Rotterdam, Netherlands
[19] Albert Schweitzer Hosp, Dept Surg, Dordrecht, Netherlands
[20] Univ Hosp Southampton NHS Fdn Trust, Dept Surg, Southampton, Hants, England
[21] Amsterdam UMC, Locat VUmc, Amsterdam, Netherlands
[22] Univ Med Ctr Utrecht, Utrecht, Netherlands
[23] Med Ctr Leeuwarden, Leeuwarden, Netherlands
[24] Kennemer Hosp, Haarlem, Netherlands
关键词
LEARNING-CURVE; RESECTION; RECOMMENDATIONS; EXPERIENCE; PROGRAM; SYSTEM; MODEL;
D O I
10.1016/j.hpb.2019.05.002
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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. 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. 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). 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.
引用
收藏
页码:1734 / 1743
页数:10
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