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Laparoscopic Versus Open Liver Resection for Benign Tumors and Lesions: A Case Matched Study with Propensity Score Matching.腹腔镜与开腹肝切除术治疗良性肿瘤和病变:一项倾向评分匹配的病例对照研究
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2
Laparoscopic versus open liver resection for hepatocellular carcinoma in elderly patients: a multi-centre propensity score-based analysis.腹腔镜与开腹肝切除术治疗老年肝细胞癌的多中心倾向评分分析。
Surg Endosc. 2020 Feb;34(2):658-666. doi: 10.1007/s00464-019-06812-z. Epub 2019 May 15.
3
Laparoscopic hepatectomy for elderly patients: Major findings based on a systematic review and meta-analysis.老年患者的腹腔镜肝切除术:基于系统评价和荟萃分析的主要发现
Medicine (Baltimore). 2018 Jul;97(30):e11703. doi: 10.1097/MD.0000000000011703.
4
Changing trends and outcomes associated with the adoption of minimally invasive hepatectomy: a contemporary single-institution experience with 400 consecutive resections.微创肝切除术应用相关的变化趋势和结果:单中心 400 例连续切除术的当代经验
Surg Endosc. 2018 Nov;32(11):4658-4665. doi: 10.1007/s00464-018-6310-1. Epub 2018 Jul 2.
5
Laparoscopic extended liver resection: are postoperative outcomes different?腹腔镜扩大肝切除术:术后结果是否不同?
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6
Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data.腹腔镜与开腹肝切除术治疗肝肿瘤的比较:一项基于个体患者数据的系统评价和荟萃分析。
Surgery. 2018 May;163(5):985-995. doi: 10.1016/j.surg.2018.01.020. Epub 2018 Mar 16.
7
Comparison of Single-Port Versus Standard Multiport Left Lateral Liver Sectionectomy.单孔与标准多孔左肝外侧叶切除术的比较
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8
Cost of Major Complications After Liver Resection in the United States: Are High-volume Centers Cost-effective?美国肝切除术后主要并发症的成本:高容量中心是否具有成本效益?
Ann Surg. 2019 Mar;269(3):503-510. doi: 10.1097/SLA.0000000000002627.
9
Hypoalbuminemia and Clinical Outcomes: What is the Mechanism behind the Relationship?低蛋白血症与临床结局:两者关系背后的机制是什么?
Am Surg. 2017 Nov 1;83(11):1220-1227. doi: 10.1177/000313481708301123.
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Operative and short-term oncologic outcomes of laparoscopic versus open liver resection for colorectal liver metastases located in the posterosuperior liver: a propensity score matching analysis.腹腔镜与开腹肝切除术治疗位于后上肝的结直肠癌肝转移的手术和短期肿瘤学结果:倾向评分匹配分析。
Surg Endosc. 2018 Apr;32(4):1776-1786. doi: 10.1007/s00464-017-5861-x. Epub 2017 Sep 15.

手术时间、年龄和血清白蛋白预测腹腔镜肝手术后的手术并发症。

Operative Time, Age, and Serum Albumin Predict Surgical Morbidity After Laparoscopic Liver Surgery.

机构信息

Department of Surgery and Transplantation, 39058University Hospital RWTH Aachen, Germany.

Department of Surgery, 199236Maastricht University Medical Centre (MUMC), Netherlands.

出版信息

Surg Innov. 2021 Dec;28(6):714-722. doi: 10.1177/1553350621991223. Epub 2021 Feb 10.

DOI:10.1177/1553350621991223
PMID:33568020
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8649428/
Abstract

. 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.

摘要

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。