Pekolj J, Clariá Sánchez R, Salceda J, Maurette R J, Schelotto P B, Pierini L, Cánepa E, Moro M, Stork G, Resio N, Neffa J, Mc Cormack L, Quiñonez E, Raffin G, Obeide L, Fernández D, Pfaffen G, Salas C, Linzey M, Schmidt G, Ruiz S, Alvarez F, Buffaliza J, Maroni R, Campi O, Bertona C, de Santibañes M, Mazza O, Belotto de Oliveira M, Diniz A L, Enne de Oliveira M, Machado M A, Kalil A N, Pinto R D, Rezende A P, Ramos E J B, Talvane T Oliveira A, Torres O J M, Jarufe Cassis N, Buckel E, Quevedo Torres R, Chapochnick J, Sanhueza Garcia M, Muñoz C, Castro G, Losada H, Vergara Suárez F, Guevara O, Dávila D, Palacios O, Jimenez A, Poggi L, Torres V, Fonseca G M, Kruger J A P, Coelho F F, Russo L, Herman P
HPB Surgery Section, General Surgery Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Hospital Ramón Santamarina, Tandil, Argentina.
World J Surg. 2020 Nov;44(11):3868-3874. doi: 10.1007/s00268-020-05646-4.
Laparoscopic liver resections (LLR) have been increasingly performed in recent years. Most of the available evidence, however, comes from specialized centers in Asia, Europe and USA. Data from South America are limited and based on single-center experiences. To date, no multicenter studies evaluated the results of LLR in South America. The aim of this study was to evaluate the experience and results with LLR in South American centers.
From February to November 2019, a survey about LLR was conducted in 61 hepatobiliary centers in South America, composed by 20 questions concerning demographic characteristics, surgical data, and perioperative results.
Fifty-one (83.6%) centers from seven different countries answered the survey. A total of 2887 LLR were performed, as follows: Argentina (928), Brazil (1326), Chile (322), Colombia (210), Paraguay (9), Peru (75), and Uruguay (8). The first program began in 1997; however, the majority (60.7%) started after 2010. The percentage of LLR over open resections was 28.4% (4.4-84%). Of the total, 76.5% were minor hepatectomies and 23.5% major, including 266 right hepatectomies and 343 left hepatectomies. The conversion rate was 9.7%, overall morbidity 13%, and mortality 0.7%.
This is the largest study assessing the dissemination and results of LLR in South America. It showed an increasing number of centers performing LLR with the promising perioperative results, aligned with other worldwide excellence centers.
近年来，腹腔镜肝切除术（LLR）的开展越来越多。然而，大多数现有证据来自亚洲、欧洲和美国的专业中心。南美洲的数据有限且基于单中心经验。迄今为止，尚无多中心研究评估南美洲LLR的结果。本研究的目的是评估南美洲各中心LLR的经验和结果。
2019年2月至11月，对南美洲61个肝胆中心进行了一项关于LLR的调查，由20个关于人口统计学特征、手术数据和围手术期结果的问题组成。
来自七个不同国家的51个（83.6%）中心回答了调查。共进行了2887例LLR，情况如下：阿根廷（928例）、巴西（1326例）、智利（322例）、哥伦比亚（210例）、巴拉圭（9例）、秘鲁（75例）和乌拉圭（8例）。第一个项目始于1997年；然而，大多数（60.7%）在2010年后开始。LLR在开腹肝切除术中所占比例为28.4%（4.4 - 84%）。其中，76.5%为小范围肝切除术，23.5%为大范围肝切除术，包括266例右肝切除术和343例左肝切除术。中转率为9.7%，总体发病率为13%，死亡率为0.7%。
这是评估南美洲LLR传播情况和结果的最大规模研究。结果显示，开展LLR的中心数量不断增加，围手术期结果良好，与全球其他优秀中心一致。
