Department of Surgery and Transplantation, 39058University Hospital RWTH Aachen, Germany.
Department of Surgery, 199236Maastricht University Medical Centre (MUMC), Netherlands.
Surg Innov. 2021 Dec;28(6):714-722. doi: 10.1177/1553350621991223. Epub 2021 Feb 10.
. Laparoscopic liver resection (LLR) has emerged as a considerable alternative to conventional liver surgery. However, the increasing complexity of liver resection raises the incidence of postoperative complications. The aim of this study was to identify risk factors for postoperative morbidity in a monocentric cohort of patients undergoing LLR. . All consecutive patients who underwent LLR between 2015 and 2019 at our institution were analyzed for associations between complications with demographics and clinical and operative characteristics by multivariable logistic regression analyses. . Our cohort comprised 156 patients who underwent LLR with a mean age of 60.0 ± 14.4 years. General complications and major perioperative morbidity were observed in 19.9% and 9.6% of the patients, respectively. Multivariable analysis identified age>65 years (HR = 2.56; = .028) and operation time>180 minutes (HR = 4.44; = .001) as significant predictors of general complications (Clavien ≥1), while albumin<4.3 g/dl (HR = 3.66; = .033) and also operative time (HR = 23.72; = .003) were identified as predictors of major postoperative morbidity (Clavien ≥3). . Surgical morbidity is based on patient- (age and preoperative albumin) and procedure-related (operative time) characteristics. Careful patient selection is key to improve postoperative outcomes after LLR.
腹腔镜肝切除术(LLR)已成为传统肝手术的重要替代方法。然而,肝切除术的复杂性不断增加,导致术后并发症的发生率增加。本研究旨在确定接受 LLR 的单中心患者队列中术后发病率的危险因素。
分析了 2015 年至 2019 年期间在我院接受 LLR 的所有连续患者,通过多变量逻辑回归分析,将并发症与人口统计学、临床和手术特征之间的关联进行了关联。
我们的队列包括 156 名接受 LLR 的患者,平均年龄为 60.0±14.4 岁。一般并发症和主要围手术期发病率分别为 19.9%和 9.6%。多变量分析确定年龄>65 岁(HR=2.56;=0.028)和手术时间>180 分钟(HR=4.44;=0.001)是一般并发症(Clavien≥1)的显著预测因素,而白蛋白<4.3g/dl(HR=3.66;=0.033)和手术时间(HR=23.72;=0.003)也被确定为主要术后发病率(Clavien≥3)的预测因素。
手术发病率基于患者(年龄和术前白蛋白)和手术相关(手术时间)特征。仔细选择患者是改善 LLR 后术后结果的关键。