Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, 20 College Road, Level 5 Academia, 169856, Singapore; Duke NUS Medical School, Singapore.
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, 20 College Road, Level 5 Academia, 169856, Singapore.
Am J Surg. 2019 Nov;218(5):967-971. doi: 10.1016/j.amjsurg.2019.03.012. Epub 2019 Mar 15.
Preoperative prediction of the difficulty of surgery would be useful for surgeons embarking on MIDP. A novel difficulty scoring system(DSS) was recently developed in Japan but has not been externally validated. This study aims to externally validate the DSS determine its association with important clinical outcome parameters.
Retrospective review of 90 patients who underwent MIDP from 2006 to 2018. The patients were stratified into 3 groups (low, intermediate and high difficulty) according to the DSS with some minor modifications.
Difficulty of MIDP was classified as low in 45(50%), intermediate in 32(35.5%) and high in 13(14.4%). Comparison between the baseline characteristics across the 3 difficulty groups demonstrated a significant difference in the frequency of malignant tumors, larger tumor size, frequency of extended pancreatectomies and use of robotic assistance. There was statistically significant increase in operation time, blood loss and blood transfusion rate across the 3 groups from low to high difficulty.
The DSS correlated significantly with operation time, blood loss and blood transfusion rate. These findings support the validity of the system.
对于接受 MIDP 的外科医生来说，术前预测手术难度将非常有用。日本最近开发了一种新的困难评分系统（DSS），但尚未经过外部验证。本研究旨在对 DSS 进行外部验证，并确定其与重要临床结果参数的相关性。
回顾性分析了 2006 年至 2018 年间接受 MIDP 的 90 例患者。根据 DSS 将患者分为 3 组（低、中、高难度），并进行了一些小的修改。
MIDP 的难度分类为低难度 45 例（50%）、中难度 32 例（35.5%）和高难度 13 例（14.4%）。对 3 组之间的基线特征进行比较，结果显示在恶性肿瘤发生率、肿瘤大小、扩大胰切除术的频率以及机器人辅助手术的使用方面存在显著差异。随着难度从低到高，手术时间、出血量和输血率均有统计学意义的增加。
DSS 与手术时间、出血量和输血率显著相关。这些发现支持该系统的有效性。
