Rotellar Fernando, Ciria Ruben, Wakabayashi Go, Suh Kyung-Suk, Cherqui Daniel
HPB and Liver Transplant Unit, Department of General Surgery, Clínica Universidad de Navarra, University of Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
Unit of Hepatobiliary Surgery and Liver Transplantation, University Hospital Reina Sofía, Cordoba, Spain.
Transplantation. 2022 Jan 1;106(1):96-105. doi: 10.1097/TP.0000000000003680.
Having little evidence on the real extent of the minimally invasive donor hepatectomy (MIDH), a world survey was conducted aiming to picture the spread of MIDH and to identify geographical, institutional, and individual differences.
A web-based survey was created with 5 sections (general, institutional, surgeon's experience, technical, and spread and dissemination), comprising up to a total of 47 questions. A thorough search was carried out to identify all possible centers and surgeons performing MIDH.
A global MIDH experience of 2370 cases was collected: 1587 right hepatectomies (RHs; 48.9% pure laparoscopic), 471 left lateral sectionectomies (LLS; 81.1% pure laparoscopic), and 366 left hepatectomies (LHs; 77.6% laparoscopic-assisted). LLS and adult MIDH conversion rates were 5.4% and 3.9%, respectively. Median blood loss was 250 mL (100-600), 100 mL (50-250), and 150 mL (50-500) for RH, LLS, and LH, respectively. Intra- and postoperative transfusion rates were 0.5%, 0%, and 0.3%; and 1.3%, 1.6%, and 0% for RH, LLS, and LH, respectively. Geographically, Asia accounts up to 1730 cases (73% of the global experience, 49.6% pure lap), of which 1374 cases are RH; Europe and Middle East-395 cases-stands out for its experience in left lateral sectionectomy: 289 cases (93% pure lap). Finally, America accounts for 245 cases, using a laparoscopic-assisted technique in 72.6% of the cases (178).
This world survey provides evidence and data on the global spread of MIDH and anticipates how in a near future a large-scale adoption of these techniques may be observed.
由于关于微创供体肝切除术（MIDH）实际应用范围的证据有限，因此开展了一项全球调查，旨在描绘MIDH的推广情况，并确定地理、机构和个体差异。
创建了一个基于网络的调查问卷，分为5个部分（一般情况、机构情况、外科医生经验、技术情况以及推广与传播），总共包含47个问题。进行了全面搜索，以确定所有可能开展MIDH的中心和外科医生。
共收集到2370例全球MIDH手术经验：1587例右肝切除术（RHs；48.9%为纯腹腔镜手术），471例左外叶切除术（LLS；81.1%为纯腹腔镜手术），366例左肝切除术（LHs；77.6%为腹腔镜辅助手术）。LLS和成人MIDH的中转开腹率分别为5.4%和3.9%。RH、LLS和LH的术中及术后输血率分别为0.5%、0%和0.3%；以及1.3%、1.6%和0%。从地理分布来看，亚洲有1730例（占全球经验的73%，49.6%为纯腹腔镜手术），其中1374例为RH；欧洲和中东有395例，其在左外叶切除术方面的经验较为突出：289例（93%为纯腹腔镜手术）。最后，美洲有245例，其中72.6%（178例）采用腹腔镜辅助技术。
这项全球调查提供了关于MIDH全球推广的证据和数据，并预计在不久的将来可能会观察到这些技术的大规模应用。
