Prediction of surgical outcomes of laparoscopic liver resections for hepatocellular carcinoma by defining surgical difficulty View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-05-19

AUTHORS

Mohan Periyasamy, Jai Young Cho, Soyeon Ahn, Ho-Seong Han, Yoo-Seok Yoon, YoungRok Choi, Jae Seong Jang, Seong Uk Kwon, Sungho Kim, Jang Kyu Choi, Hanisah Guro

ABSTRACT

BackgroundSeveral classification systems for assessing the surgical difficulty of laparoscopic liver resection (LLR) have been proposed. We evaluated three current classification systems, including traditional Major/Minor Classification, Complexity Classification, and the Difficulty Scoring System for predicting the surgical outcomes after LLR.MethodsWe reviewed the clinical data of 301 patients who underwent LLR for hepatocellular carcinoma between March 1, 2004 and June 30, 2015. We compared the intraoperative, pathologic, and postoperative outcomes according to the three classifications. We also compared the prognostic value of the three classifications using receiver operating characteristic (ROC) curves.ResultsThe Major/Minor Classification, Complexity Classification, and the Difficulty Scoring System efficiently differentiated surgical difficulty in terms of blood loss (P = 0.001, P = 0.009, and P < 0.001, respectively) and operation time (all P < 0.001). Regarding intraoperative outcomes, the Difficulty Scoring System and Complexity Classification successfully differentiated the transfusion rate (P = 0.001 and P < 0.001, respectively). However, only the Complexity Classification adequately predicted severe postoperative complications (P = 0.032), the severity of complications (P < 0.001), and the length of hospital stay (P = 0.005). In ROC curve analysis, the Complexity Classification (area under the curve [AUC] = 0.611) outperformed the Major/Minor Classification (AUC = 0.544) and the Difficulty Scoring System (AUC = 0.530) for predicting severe postoperative complications. None of the classification systems predicted recurrence or patient survival.ConclusionThe Complexity Classification was superior to the other methods for assessing surgical difficulty and predicting complications after LLR for hepatocellular carcinoma. More... »

PAGES

5209-5218

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-017-5589-7

DOI

http://dx.doi.org/10.1007/s00464-017-5589-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1085448054

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28526962


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28 schema:description BackgroundSeveral classification systems for assessing the surgical difficulty of laparoscopic liver resection (LLR) have been proposed. We evaluated three current classification systems, including traditional Major/Minor Classification, Complexity Classification, and the Difficulty Scoring System for predicting the surgical outcomes after LLR.MethodsWe reviewed the clinical data of 301 patients who underwent LLR for hepatocellular carcinoma between March 1, 2004 and June 30, 2015. We compared the intraoperative, pathologic, and postoperative outcomes according to the three classifications. We also compared the prognostic value of the three classifications using receiver operating characteristic (ROC) curves.ResultsThe Major/Minor Classification, Complexity Classification, and the Difficulty Scoring System efficiently differentiated surgical difficulty in terms of blood loss (P = 0.001, P = 0.009, and P < 0.001, respectively) and operation time (all P < 0.001). Regarding intraoperative outcomes, the Difficulty Scoring System and Complexity Classification successfully differentiated the transfusion rate (P = 0.001 and P < 0.001, respectively). However, only the Complexity Classification adequately predicted severe postoperative complications (P = 0.032), the severity of complications (P < 0.001), and the length of hospital stay (P = 0.005). In ROC curve analysis, the Complexity Classification (area under the curve [AUC] = 0.611) outperformed the Major/Minor Classification (AUC = 0.544) and the Difficulty Scoring System (AUC = 0.530) for predicting severe postoperative complications. None of the classification systems predicted recurrence or patient survival.ConclusionThe Complexity Classification was superior to the other methods for assessing surgical difficulty and predicting complications after LLR for hepatocellular carcinoma.
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35 schema:keywords BackgroundSeveral classification systems
36 ConclusionThe Complexity Classification
37 Difficulty Scoring System
38 Major/Minor Classification
39 MethodsWe
40 ROC curve analysis
41 ResultsThe Major/Minor Classification
42 analysis
43 blood loss
44 carcinoma
45 characteristic curve
46 classification
47 classification system
48 clinical data
49 complexity classification
50 complications
51 current classification system
52 curve analysis
53 curves
54 data
55 difficulties
56 hepatocellular carcinoma
57 hospital stay
58 intraoperative outcomes
59 laparoscopic liver resection
60 length
61 liver resection
62 loss
63 method
64 minor classification
65 operation time
66 outcomes
67 patient survival
68 patients
69 postoperative complications
70 postoperative outcomes
71 prediction
72 prognostic value
73 rate
74 receiver
75 recurrence
76 resection
77 scoring system
78 severe postoperative complications
79 severity
80 severity of complications
81 stay
82 surgical difficulty
83 surgical outcomes
84 survival
85 system
86 terms
87 time
88 traditional Major/Minor Classification
89 transfusion rate
90 values
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