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Impact of Liver Cirrhosis, Severity of Cirrhosis, and Portal Hypertension on the Difficulty and Outcomes of Laparoscopic and Robotic Major Liver Resections for Primary Liver Malignancies

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收录情况： ◇ SCIE

作者：
Cipriani Federica[1] * ; Aldrighetti Luca[1] * ; Ratti Francesca[1] ; Wu Andrew G R[2] ; Kabir Tousif[3] ; Scatton Olivier[4] ; Lim Chetana[4] ; Zhang Wanguang[5] ; Sijberden Jasper[6] ; Aghayan Davit L[7] ; Siow Tiing-Foong[8] ; Dokmak Safi[9] ; Coelho Fabricio Ferreira[10] ; Herman Paulo[10] ; Marino Marco V[11,12] ; Mazzaferro Vincenzo[13] ; Chiow Adrian K H[14] ; Sucandy Iswanto[15] ; Ivanecz Arpad[16] ; Choi Sung-Hoon[17] ; Lee Jae Hoon[18] ; Gastaca Mikel[19] ; Vivarelli Marco[20] ; Giuliante Felice[21] ; Ruzzenente Andrea[22] ; Yong Chee-Chien[23] ; Yin Mengqiu[24] ; Fondevila Constantino[25,26] ; Efanov Mikhail[27] ; Morise Zenichi[28] ; Di Benedetto Fabrizio[29] ; Brustia Raffaele[30] ; Dalla Valle Raffaele[31] ; Boggi Ugo[32] ; Geller David[33] ; Belli Andrea[34] ; Memeo Riccardo[35] ; Gruttadauria Salvatore[36,37] ; Mejia Alejandro[38] ; Park James O[39] ; Rotellar Fernando[40,41] ; Choi Gi-Hong[42] ; Robles-Campos Ricardo[43] ; Wang Xiaoying[44] ; Sutcliffe Robert P[45] ; Pratschke Johann[46] ; Lai Eric C H[47] ; Chong Charing C N[48] ; D'Hondt Mathieu[49] ; Monden Kazuteru[50] ; Lopez-Ben Santiago[51] ; Kingham T Peter[52] ; Ferrero Alessandro[53] ; Ettorre Giuseppe Maria[54] ; Cherqui Daniel[55] ; Liang Xiao[56] ; Soubrane Olivier[57] ; Wakabayashi Go[58] ; Troisi Roberto I[59] ; Cheung Tan-To[60] ; Kato Yutaro[61] ; Sugioka Atsushi[61] ; Han Ho-Seong[62] ; Long Tran Cong Duy[63] ; Liu Qu[64] ; Liu Rong[64] ; Edwin Bjorn[7] ; Fuks David[57] ; Chen Kuo-Hsin[8] ; Abu Hilal Mohammad[6,65] ; Goh Brian K P[66,67] ;
单位： [1]Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy. [2]Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. [3]Department of General Surgery, Sengkang General Hospital, Singapore, Singapore. [4]Department of Digestive, HBP, and Liver Transplantation, Hopital Pitie-Salpetriere, Sorbonne Universite, Paris, France. [5]Hepatic Surgery Center and Hubei Key Laboratory of Hepato-Biliary-Pancreatic Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [6]Department of Surgery, Fondazione Poliambulanza, Brescia, Italy. [7]The Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. [8]Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan. [9]Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, University Paris Cite, Clichy, France. [10]Liver Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil. [11]General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy. [12]General Surgery Department, F. Tappeiner Hospital, Merano, Italy. [13]HPB Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori di Milano and University of Milan, Milan, Italy. [14]Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore, Singapore. [15]Digestive Health Institute, AdventHealth Tampa, Tampa, Florida, USA. [16]Department of Abdominal and General Surgery, University Medical Center Maribor, Maribor, Slovenia. [17]Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea. [18]Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. [19]Hepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Bilbao, Spain. [20]HPB Surgery and Transplantation Unit, United Hospital of Ancona, Department of Experimental and Clinical Medicine Polytechnic, University of Marche, Ancona, Italy. [21]Hepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of the Sacred Heart, Rome, Italy. [22]General and Hepatobiliary Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, GB Rossi Hospital, Verona, Italy. [23]Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. [24]Department of Hepatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China. [25]General and Digestive Surgery, Hospital Clinic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain. [26]General and Digestive Surgery, Hospital Universitario La Paz, IdiPAZ, CIBERehd, Madrid, Spain. [27]Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia. [28]Department of Surgery, Okazaki Medical Center, Fujita Health University School of Medicine, Okazaki, Japan. [29]HPB Surgery and Liver Transplant Unit, University of Modena and Reggio Emilia, Modena, Italy. [30]Department of Digestive and Hepatobiliary and Pancreatic Surgery, AP-HP, Henri-Mondor Hospital, Creteil, France. [31]Hepatobiliary Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy. [32]Division of General and Transplant Surgery, University of Pisa, Pisa, Italy. [33]Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. [34]Division of Hepatopancreatobiliary Surgical Oncology, Department of Abdominal Oncology, National Cancer Center - IRCCS-G. Pascale, Naples, Italy. [35]Unit of Hepato-Pancreatc-Biliary Surgery, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti, Bari, Italy. [36]Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center Italy, Palermo, Italy. [37]Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy. [38]The Liver Institute, Methodist Dallas Medical Center, Dallas, Texas, USA. [39]Department of Surgery, University of Washington Medical Center, Seattle, WA, USA. [40]HPB and Liver Transplant Unit, Department of General Surgery, Clinica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain. [41]Institute of Health Research of Navarra (IdisNA), Pamplona, Spain. [42]Division of Hepatopancreatobiliary Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. [43]Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de la Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain. [44]Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China. [45]Department of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. [46]Department of Surgery, Campus Charite Mitte and Campus Virchow-Klinikum, Charite-Universitatsmedizin, Corporate Member of Freie Universitat Berlin, and Berlin Institute of Health, Berlin, Germany. [47]Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China. [48]Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China. [49]Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium. [50]Department of Surgery, Fukuyama City Hospital, Hiroshima, Japan. [51]Hepatobiliary and Pancreatic Surgery Unit, Department of Surgery, Dr. Josep Trueta Hospital, IdIBGi, Girona, Spain. [52]Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. [53]Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy. [54]Division of General Surgery and Liver Transplantation, S. Camillo Forlanini Hospital, Rome, Italy. [55]Department of Hepatobiliary Surgery, Assistance Publique Hopitaux de Paris, Centre Hepato-Biliaire, Paul-Brousse Hospital, Villejuif, France. [56]Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. [57]Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France. [58]Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Saitama, Japan. [59]Department of Clinical Medicine and Surgery, Division of HPB, Minimally Invasive and Robotic Surgery, Federico II University Hospital Naples, Naples, Italy. [60]Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China. [61]Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan. [62]Department of Surgery, Seoul National University Hospital Bundang, Seoul National University College of Medicine, Seoul, Korea. [63]Department of Hepatopancreatobiliary Surgery, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. [64]Faculty of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China. [65]Department of Surgery, University Hospital Southampton, Southampton, UK. [66]Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore [67]Surgery Academic Clinical Programme, Duke National University of Singapore Medical School, Singapore, Singapore.
出处：
DOI： 10.1245/s10434-023-14376-5
ISSN：

摘要：
Minimally invasive liver resections (MILR) offer potential benefits such as reduced blood loss and morbidity compared with open liver resections. Several studies have suggested that the impact of cirrhosis differs according to the extent and complexity of resection. Our aim was to investigate the impact of cirrhosis on the difficulty and outcomes of MILR, focusing on major hepatectomies.A total of 2534 patients undergoing minimally invasive major hepatectomies (MIMH) for primary malignancies across 58 centers worldwide were retrospectively reviewed. Propensity score (PSM) and coarsened exact matching (CEM) were used to compare patients with and without cirrhosis.A total of 1353 patients (53%) had no cirrhosis, 1065 (42%) had Child-Pugh A and 116 (4%) had Child-Pugh B cirrhosis. Matched comparison between non-cirrhotics vs Child-Pugh A cirrhosis demonstrated comparable blood loss. However, after PSM, postoperative morbidity and length of hospitalization was significantly greater in Child-Pugh A cirrhosis, but these were not statistically significant with CEM. Comparison between Child-Pugh A and Child-Pugh B cirrhosis demonstrated the latter had significantly higher transfusion rates and longer hospitalization after PSM, but not after CEM. Comparison of patients with cirrhosis of all grades with and without portal hypertension demonstrated no significant difference in all major perioperative outcomes after PSM and CEM.The presence and severity of cirrhosis affected the difficulty and impacted the outcomes of MIMH, resulting in higher blood transfusion rates, increased postoperative morbidity, and longer hospitalization in patients with more advanced cirrhosis. As such, future difficulty scoring systems for MIMH should incorporate liver cirrhosis and its severity as variables.© 2023. Society of Surgical Oncology.

基金：
Dr T. P. Kingham was partially supported by the US National Cancer Institute MSKCC Core Grant number P30 CA008747 for this study. Dr M. Yin was partially funded by the Research Project of Zhejiang Provincial Public Welfare Fund project in the Field of Social development (LGF20H160028).
语种：
外文
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2023]版：
大类 | 2 区 医学
小类 | 2 区 外科 3 区 肿瘤学
最新[2025]版：
大类 | 2 区 医学
小类 | 2 区 外科 3 区 肿瘤学
JCR分区：
出版当年[2022]版：
Q1 SURGERY Q2 ONCOLOGY
最新[2023]版：
Q1 SURGERY Q2 ONCOLOGY

影响因子： 最新[2023版] 最新五年平均 出版当年[2022版] 出版当年五年平均 出版前一年[2021版] 出版后一年[2023版]

第一作者：
第一作者单位： [1]Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
共同第一作者：
通讯作者：
通讯机构： [66]Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore [67]Surgery Academic Clinical Programme, Duke National University of Singapore Medical School, Singapore, Singapore.
推荐引用方式(GB/T 7714)：
Cipriani Federica,Aldrighetti Luca,Ratti Francesca,et al.Impact of Liver Cirrhosis, Severity of Cirrhosis, and Portal Hypertension on the Difficulty and Outcomes of Laparoscopic and Robotic Major Liver Resections for Primary Liver Malignancies[J].ANNALS OF SURGICAL ONCOLOGY.2024,31(1):97-114.doi:10.1245/s10434-023-14376-5.
APA：
Cipriani Federica,Aldrighetti Luca,Ratti Francesca,Wu Andrew G R,Kabir Tousif...&Goh Brian K P.(2024).Impact of Liver Cirrhosis, Severity of Cirrhosis, and Portal Hypertension on the Difficulty and Outcomes of Laparoscopic and Robotic Major Liver Resections for Primary Liver Malignancies.ANNALS OF SURGICAL ONCOLOGY,31,(1)
MLA：
Cipriani Federica,et al."Impact of Liver Cirrhosis, Severity of Cirrhosis, and Portal Hypertension on the Difficulty and Outcomes of Laparoscopic and Robotic Major Liver Resections for Primary Liver Malignancies".ANNALS OF SURGICAL ONCOLOGY 31..1(2024):97-114

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