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51. Impact of neoadjuvant chemotherapy on the difficulty and outcomes of laparoscopic and robotic major liver resections for colorectal liver metastases: A propensity-score and coarsened exact-matched controlled study

Author: Ghotbi, J., Aghayan, D., Fretland, A., Edwin, B., Syn, N. L., Cipriani, F., Alzoubi, M., Lim, C., Scatton, O., Long, T. C. D., Herman, P., Coelho, F. F., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. -H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Fondevila, C., Efanov, M., Morise, Z., Di Benedetto, F., Brustia, R., Dalla Valle, R., Boggi, U., Geller, D., Belli, A., Memeo, R., Mejia, A., Park, J. O., Rotellar, F., Choi, G. -H., Robles-Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. -N., Chong, C. C. N., D'Hondt, M., Monden, K., Lopez-Ben, S., Kingham, T. P., Ferrero, A., Ettorre, G. M., Levi Sandri, G. B., Pascual, F., Cherqui, D., Liang, X., Mazzotta, A., Wakabayashi, G., Giglio, M., Troisi, R. I., Han, H. -S., Cheung, T. -T., Sugioka, A., Chen, K. -H., Liu, R., Soubrane, O., Fuks, D., Aldrighetti, L., Abu Hilal, M., Goh, B. K. P., Gastaca, M., Meurs, J., De Meyere, C., Lee, K. -F., Ng, K. K., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kato, Y., Kojima, M., Pirola Kruger, J. A., Lopez-Lopez, V., Casellas I Robert, M., Montalti, R., Lee, B., D'Silva, M., Wang, H. -P., Saleh, M., Chen, Z., Yu, S., Vani, S., Ardito, Francesco, Giustizieri, U., Citterio, D., Mocchegiani, F., Colasanti, M., Guzman, Y., Labadie, K. P., Conticchio, M., Dogeas, E., Kauffmann, E. F., Giuffrida, M., Sommacale, D., Laurent, A., Magistri, P., Nghia, P. P., Mishima, K., Valle, B. D., Krenzien, F., Schmelzle, M., Kadam, P., Liu, Q., Lai, E. C. H., Zheng, J., Siow, T. F., Forchino, F., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Ghotbi, J., Aghayan, D., Fretland, A., Edwin, B., Syn, N. L., Cipriani, F., Alzoubi, M., Lim, C., Scatton, O., Long, T. C. D., Herman, P., Coelho, F. F., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. -H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Fondevila, C., Efanov, M., Morise, Z., Di Benedetto, F., Brustia, R., Dalla Valle, R., Boggi, U., Geller, D., Belli, A., Memeo, R., Mejia, A., Park, J. O., Rotellar, F., Choi, G. -H., Robles-Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. -N., Chong, C. C. N., D'Hondt, M., Monden, K., Lopez-Ben, S., Kingham, T. P., Ferrero, A., Ettorre, G. M., Levi Sandri, G. B., Pascual, F., Cherqui, D., Liang, X., Mazzotta, A., Wakabayashi, G., Giglio, M., Troisi, R. I., Han, H. -S., Cheung, T. -T., Sugioka, A., Chen, K. -H., Liu, R., Soubrane, O., Fuks, D., Aldrighetti, L., Abu Hilal, M., Goh, B. K. P., Gastaca, M., Meurs, J., De Meyere, C., Lee, K. -F., Ng, K. K., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kato, Y., Kojima, M., Pirola Kruger, J. A., Lopez-Lopez, V., Casellas I Robert, M., Montalti, R., Lee, B., D'Silva, M., Wang, H. -P., Saleh, M., Chen, Z., Yu, S., Vani, S., Ardito, Francesco, Giustizieri, U., Citterio, D., Mocchegiani, F., Colasanti, M., Guzman, Y., Labadie, K. P., Conticchio, M., Dogeas, E., Kauffmann, E. F., Giuffrida, M., Sommacale, D., Laurent, A., Magistri, P., Nghia, P. P., Mishima, K., Valle, B. D., Krenzien, F., Schmelzle, M., Kadam, P., Liu, Q., Lai, E. C. H., Zheng, J., Siow, T. F., Forchino, F., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)
Abstract: Background: Minimal invasive liver resections are a safe alternative to open surgery. Different scoring systems considering different risks factors have been developed to predict the risks associated with these procedures, especially challenging major liver resections (MLR). However, the impact of neoadjuvant chemotherapy (NAT) on the difficulty of minimally invasive MLRs remains poorly investigated. Methods: Patients who underwent laparoscopic and robotic MLRs for colorectal liver metastases (CRLM) performed across 57 centers between January 2005 to December 2021 were included in this analysis. Patients who did or did not receive NAT were matched based on 1:1 coarsened exact and 1:2 propensity-score matching. Pre- and post-matching comparisons were performed. Results: In total, the data of 5189 patients were reviewed. Of these, 1411 procedures were performed for CRLM, and 1061 cases met the inclusion criteria. After excluding 27 cases with missing data on NAT, 1034 patients (NAT: n = 641; non-NAT: n = 393) were included. Before matching, baseline characteristics were vastly different. Before matching, the morbidity rate was significantly higher in the NAT-group (33.2% vs. 27.2%, p-value = 0.043). No significant differences were seen in perioperative outcomes after the coarsened exact matching. After the propensity-score matching, statistically significant higher blood loss (mean, 300 (SD 128–596) vs. 250 (SD 100–400) ml, p-value = 0.047) but shorter hospital stay (mean, 6 [4-8] vs. 6 [5-9] days, p-value = 0.043) were found in the NAT-group. Conclusion: The current study demonstrated that NAT had minimal impact on the difficulty and outcomes of minimally-invasive MLR for CRLM.
Published: 2023

52. Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study

Author: Goh, B. K. P., Han, H. -S., Chen, K. -H., Chua, D. W., Chan, C. -Y., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., D'Silva, M., Siow, T. F., Kato, Y., Lim, C., Nghia, P. P., Herman, P., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Gastaca, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Chen, Z., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Campos, R. R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Coelho, F. F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Sandri, G. B. L., Saleh, M., Cherqui, D., Scatton, O., Soubrane, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Hilal, M. A., Fuks, D., Edwin, B., Aldrighetti, L., Syn, N., Prieto, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kojima, M., Ghotbi, J., Kruger, J. A. P., Lopez-Lopez, V., Valle, B. D., Casellas I Robert, M., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., Wang, H. -P., Pascual, F., Kadam, P., Tang, C. -N., Yu, S., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Goh, B. K. P., Han, H. -S., Chen, K. -H., Chua, D. W., Chan, C. -Y., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., D'Silva, M., Siow, T. F., Kato, Y., Lim, C., Nghia, P. P., Herman, P., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Gastaca, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Chen, Z., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Campos, R. R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Coelho, F. F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Sandri, G. B. L., Saleh, M., Cherqui, D., Scatton, O., Soubrane, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Hilal, M. A., Fuks, D., Edwin, B., Aldrighetti, L., Syn, N., Prieto, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kojima, M., Ghotbi, J., Kruger, J. A. P., Lopez-Lopez, V., Valle, B. D., Casellas I Robert, M., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., Wang, H. -P., Pascual, F., Kadam, P., Tang, C. -N., Yu, S., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)
Abstract: Objective: To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR). Background: There is limited published data to date on the best achievable outcomes after L-LR. Methods: This is a post hoc analysis of a multicenter database of 11,983 patients undergoing L-LR in 45 international centers in 4 continents between 2015 and 2020. Three specific procedures: left lateral sectionectomy (LLS), left hepatectomy (LH), and right hepatectomy (RH) were selected to represent the 3 difficulty levels of L-LR. Fifteen outcome indicators were selected to establish benchmark cutoffs. Results: There were 3519 L-LR (LLS, LH, RH) of which 1258 L-LR (40.6%) cases performed in 34 benchmark expert centers qualified as low-risk benchmark cases. These included 659 LLS (52.4%), 306 LH (24.3%), and 293 RH (23.3%). The benchmark outcomes established for operation time, open conversion rate, blood loss ≥500 mL, blood transfusion rate, postoperative morbidity, major morbidity, and 90-day mortality after LLS, LH, and RH were 209.5, 302, and 426 minutes; 2.1%, 13.4%, and 13.0%; 3.2%, 20%, and 47.1%; 0%, 7.1%, and 10.5%; 11.1%, 20%, and 50%; 0%, 7.1%, and 20%; and 0%, 0%, and 0%, respectively. Conclusions: This study established the first global benchmark outcomes for L-LR in a large-scale international patient cohort. It provides an up-to-date reference regarding the "best achievable" results for L-LR for which centers adopting L-LR can use as a comparison to enable an objective assessment of performance gaps and learning curves.
Published: 2023

53. Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study

Author: Efanov, M., Salimgereeva, D., Alikhanov, R., Wu, A. G. R., Geller, D., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., Belli, A., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Fondevila, C., Rotellar, F., Choi, G. -H., Robless Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Herman, P., Di Benedetto, F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Levi Sandri, G. B., Cherqui, D., Scatton, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Han, H. -S., Abu Hilal, M., Soubrane, O., Fuks, D., Aldrighetti, L., Edwin, B., Goh, B. K. P., Chan, C. -Y., Syn, N., D'Silva, M., Lee, B., Lim, C., Nghia, P. P., Gastaca, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Lee, L. S., Jang, J. Y., Kojima, M., Kato, Y., Ghotbi, J., Kruger, J. A. P., Coelho, F. F., Lopez-Lopez, V., Valle, B. D., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Wang, H. -P., Pascual, F., Saleh, M., Kadam, P., Tang, C. -N., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Dogeas, E., Magistri, P., Mazzotta, A., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Efanov, M., Salimgereeva, D., Alikhanov, R., Wu, A. G. R., Geller, D., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., Belli, A., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Fondevila, C., Rotellar, F., Choi, G. -H., Robless Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Herman, P., Di Benedetto, F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Levi Sandri, G. B., Cherqui, D., Scatton, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Han, H. -S., Abu Hilal, M., Soubrane, O., Fuks, D., Aldrighetti, L., Edwin, B., Goh, B. K. P., Chan, C. -Y., Syn, N., D'Silva, M., Lee, B., Lim, C., Nghia, P. P., Gastaca, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Lee, L. S., Jang, J. Y., Kojima, M., Kato, Y., Ghotbi, J., Kruger, J. A. P., Coelho, F. F., Lopez-Lopez, V., Valle, B. D., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Wang, H. -P., Pascual, F., Saleh, M., Kadam, P., Tang, C. -N., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Dogeas, E., Magistri, P., Mazzotta, A., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)
Abstract: Background: Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8. Methods: A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8. Results: A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay. Conclusion: Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.
Published: 2023

54. Laparoscopic versus open right posterior sectionectomy: an international, multicenter, propensity score-matched evaluation

Author: Mehmet F Can, Mohammed Abu Hilal, Paolo Magistri, Luca Aldrighetti, Mathieu D'Hondt, Francesca Ratti, Fabrizio Di Benedetto, M. Papoulas, Arpad Ivanecz, Marc G. Besselink, Marco Vivarelli, Andrea Benedetti Cacciaguerra, Krishna Menon, Nicky van der Heijde, van der Heijde, N., Ratti, F., Aldrighetti, L., Benedetti Cacciaguerra, A., Can, M. F., D'Hondt, M., Di Benedetto, F., Ivanecz, A., Magistri, P., Menon, K., Papoulas, M., Vivarelli, M., Besselink, M. G., Abu Hilal, M., Graduate School, Surgery, CCA - Cancer Treatment and Quality of Life, and Amsterdam Gastroenterology Endocrinology Metabolism
Subjects: Laparoscopic surgery, medicine.medical_specialty, Surgical procedure, medicine.medical_treatment, Operative Time, Malignancy, Article, Postoperative Complications, Minimally invasive surgery, Internal medicine, Propensity score matching, medicine, Clinical endpoint, Hepatectomy, Humans, Propensity Score, Liver surgery, Retrospective Studies, business.industry, Liver Neoplasms, Retrospective cohort study, Hepatology, Length of Stay, medicine.disease, Operative outcomes, Surgery, Treatment Outcome, Right posterior, Laparoscopy, business, Abdominal surgery
Abstract: Background Although laparoscopic liver resection has become the standard for minor resections, evidence is lacking for more complex resections such as the right posterior sectionectomy (RPS). We aimed to compare surgical outcomes between laparoscopic (LRPS) and open right posterior sectionectomy (ORPS). Methods An international multicenter retrospective study comparing patients undergoing LRPS or ORPS (January 2007—December 2018) was performed. Patients were matched based on propensity scores in a 1:1 ratio. Primary endpoint was major complication rate defined as Accordion ≥ 3 grade. Secondary endpoints included blood loss, length of hospital stay (LOS) and resection status. A sensitivity analysis was done excluding the first 10 LRPS patients of each center to correct for the learning curve. Additionally, possible risk factors were explored for operative time, blood loss and LOS. Results Overall, 399 patients were included from 9 centers from 6 European countries of which 150 LRPS could be matched to 150 ORPS. LRPS was associated with a shorter operative time [235 (195–285) vs. 247 min (195–315) p = 0.004], less blood loss [260 (188–400) vs. 400 mL (280–550) p = 0.009] and a shorter LOS [5 (4–7) vs. 8 days (6–10), p = 0.002]. Major complication rate [n = 8 (5.3%) vs. n = 9 (6.0%) p = 1.00] and R0 resection rate [144 (96.0%) vs. 141 (94.0%), p = 0.607] did not differ between LRPS and ORPS, respectively. The sensitivity analysis showed similar findings in the previous mentioned outcomes. In multivariable regression analysis blood loss was significantly associated with the open approach, higher ASA classification and malignancy as diagnosis. For LOS this was the open approach and a malignancy. Conclusion This international multicenter propensity score-matched study showed an advantage in favor of LRPS in selected patients as compared to ORPS in terms of operative time, blood loss and LOS without differences in major complications and R0 resection rate.
Published: 2021
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55. Laparoscopic versus open resection of primary colorectal cancers and synchronous liver metastasis: a systematic review and meta-analysis

Author: Stefan Morarasu, Cillian Clancy, Emre Gorgun, Sumeyye Yilmaz, Arpad Ivanecz, Shoji Kawakatsu, Ana Maria Musina, Natalia Velenciuc, Cristian Ene Roata, Gabriel Mihail Dimofte, and Sorinel Lunca
Subjects: Gastroenterology
Abstract: Purpose Combined resection of primary colorectal cancer and associated liver metastases is increasingly common. This study compares peri-operative and oncological outcomes according to surgical approach. Methods The study was registered with PROSPERO. A systematic search was performed for all comparative studies describing outcomes in patients that underwent laparoscopic versus open simultaneous resection of colorectal primary tumours and liver metastases. Data was extracted and analysed using a random effects model via Rev Man 5.3 Results Twenty studies were included with a total of 2168 patients. A laparoscopic approach was performed in 620 patients and an open approach in 872. There was no difference in the groups for BMI (mean difference: 0.04, 95% CI: 0.63–0.70, p = 0.91), number of difficult liver segments (mean difference: 0.64, 95% CI:0.33–1.23, p = 0.18) or major liver resections (mean difference: 0.96, 95% CI: 0.69–1.35, p = 0.83). There were fewer liver lesions per operation in the laparoscopic group (mean difference 0.46, 95% CI: 0.13–0.79, p = 0.007). Laparoscopic surgery was associated with shorter length of stay (p Conclusion Synchronous laparoscopic resection of primary colorectal cancers and liver metastases is a feasible approach in selected patients and does not demonstrate inferior peri-operative or oncological outcomes.
Published: 2023
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56. Factors associated with and impact of open conversion on the outcomes of minimally invasive left lateral sectionectomies: An international multicenter study

Author: Hao Ping Wang, Chee Chien Yong, Andrew G.R. Wu, Daniel Cherqui, Roberto I. Troisi, Federica Cipriani, Davit Aghayan, Marco V. Marino, Andrea Belli, Adrian K.H. Chiow, Iswanto Sucandy, Arpad Ivanecz, Marco Vivarelli, Fabrizio Di Benedetto, Sung-Hoon Choi, Jae Hoon Lee, James O. Park, Mikel Gastaca, Constantino Fondevila, Mikhail Efanov, Fernando Rotellar, Gi-Hong Choi, Ricardo Robles Campos, Xiaoying Wang, Robert P. Sutcliffe, Johann Pratschke, Chung Ngai Tang, Charing C. Chong, Mathieu D’Hondt, Andrea Ruzzenente, Paolo Herman, T. Peter Kingham, Olivier Scatton, Rong Liu, Alessandro Ferrero, Giovanni Battista Levi Sandri, Olivier Soubrane, Alejandro Mejia, Santiago Lopez-Ben, Jasper Sijberden, Kazuteru Monden, Go Wakabayashi, Atsushi Sugioka, Tan-To Cheung, Tran Cong Duy Long, Bjorn Edwin, Ho-Seong Han, David Fuks, Luca Aldrighetti, Mohamed Abu Hilal, Brian K.P. Goh, Chung-Yip Chan, Nicholas Syn, Mikel Prieto, Henri Schotte, Celine De Meyere, Felix Krenzien, Moritz Schmelzle, Kit-Fai Lee, Diana Salimgereeva, Ruslan Alikhanov, Lip Seng Lee, Jae Young Jang, Kevin P. Labadie, Masayuki Kojima, Yutaro Kato, Asmund Avdem Fretland, Jacob Ghotbi, Fabricio Ferreira Coelho, Jaime Arthur Pirola Kruger, Victor Lopez-Lopez, Paolo Magistri, Bernardo Dalla Valle, Margarida Casellas I Robert, Kohei Mishima, Giuseppe Maria Ettorre, Federico Mocchegiani, Prashant Kadam, Franco Pascual, Mansour Saleh, Alessandro Mazzotta, Roberto Montalti, Mariano Giglio, Boram Lee, Mizelle D’Silva, Phan Phuoc Nghia, Chetana Lim, Qu Liu, Eric C. Lai, Wang, Hao Ping, Yong, Chee Chien, Wu, Andrew G R, Cherqui, Daniel, Troisi, Roberto I, Cipriani, Federica, Aghayan, Davit, Marino, Marco V, Belli, Andrea, Chiow, Adrian K H, Sucandy, Iswanto, Ivanecz, Arpad, Vivarelli, Marco, Di Benedetto, Fabrizio, Choi, Sung-Hoon, Lee, Jae Hoon, Park, James O, Gastaca, Mikel, Fondevila, Constantino, Efanov, Mikhail, Rotellar, Fernando, Choi, Gi-Hong, Campos, Ricardo Roble, Wang, Xiaoying, Sutcliffe, Robert P, Pratschke, Johann, Tang, Chung Ngai, Chong, Charing C, D'Hondt, Mathieu, Ruzzenente, Andrea, Herman, Paolo, Kingham, T Peter, Scatton, Olivier, Liu, Rong, Ferrero, Alessandro, Levi Sandri, Giovanni Battista, Soubrane, Olivier, Mejia, Alejandro, Lopez-Ben, Santiago, Sijberden, Jasper, Monden, Kazuteru, Wakabayashi, Go, Sugioka, Atsushi, Cheung, Tan-To, Long, Tran Cong Duy, Edwin, Bjorn, Han, Ho-Seong, Fuks, David, Aldrighetti, Luca, Abu Hilal, Mohamed, Goh, Brian K P, Wang, H. P., Yong, C. C., Wu, A. G. R., Cherqui, D., Troisi, R. I., Cipriani, F., Aghayan, D., Marino, M. V., Belli, A., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Vivarelli, M., Di Benedetto, F., Choi, S. -H., Lee, J. H., Park, J. O., Gastaca, M., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Campos, R. R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. N., Chong, C. C., D'Hondt, M., Ruzzenente, A., Herman, P., Kingham, T. P., Scatton, O., Liu, R., Ferrero, A., Levi Sandri, G. B., Soubrane, O., Mejia, A., Lopez-Ben, S., Sijberden, J., Monden, K., Wakabayashi, G., Sugioka, A., Cheung, T. -T., Long, T. C. D., Edwin, B., Han, H. -S., Fuks, D., Aldrighetti, L., Abu Hilal, M., Goh, B. K. P., Chan, C. -Y., Syn, N., Prieto, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. S., Jang, J. Y., Labadie, K. P., Kojima, M., Kato, Y., Fretland, A. A., Ghotbi, J., Coelho, F. F., Pirola Kruger, J. A., Lopez-Lopez, V., Magistri, P., Valle, B. D., Casellas I Robert, M., Mishima, K., Ettorre, G. M., Mocchegiani, F., Kadam, P., Pascual, F., Saleh, M., Mazzotta, A., Montalti, R., Giglio, M., Lee, B., D'Silva, M., Nghia, P. P., Lim, C., Liu, Q., Lai, E. C., Graduate School, Surgery, and CCA - Cancer Treatment and Quality of Life
Subjects: Male, Operative Time, Length of Stay, Conversion to Open Surgery, Hepatectomy, Humans, Minimally Invasive Surgical Procedures, Postoperative Complications, Retrospective Studies, Treatment Outcome, Hypertension, Portal, Laparoscopy, Neoplasms, Hypertension, Surgery, Portal
Abstract: Background: Despite the rapid advances that minimally invasive liver resection has gained in recent decades, open conversion is still inevitable in some circumstances. In this study, we aimed to determine the risk factors for open conversion after minimally invasive left lateral sectionectomy, and its impact on perioperative outcomes. Methods: This is a post hoc analysis of 2,445 of 2,678 patients who underwent minimally invasive left lateral sectionectomy at 45 international centers between 2004 and 2020. Factors related to open conversion were analyzed via univariate and multivariate analyses. One-to-one propensity score matching was used to analyze outcomes after open conversion versus non-converted cases. Results: The open conversion rate was 69/2,445 (2.8%). On multivariate analyses, male gender (3.6% vs 1.8%, P = .011), presence of clinically significant portal hypertension (6.1% vs 2.6%, P = .009), and larger tumor size (50 mm vs 32 mm, P < .001) were identified as independent factors associated with open conversion. The most common reason for conversion was bleeding in 27/69 (39.1%) of cases. After propensity score matching (65 open conversion vs 65 completed via minimally invasive liver resection), the open conversion group was associated with increased operation time, blood transfusion rate, blood loss, and postoperative stay compared with cases completed via the minimally invasive approach. Conclusion: Male sex, portal hypertension, and larger tumor size were predictive factors of open conversion after minimally invasive left lateral sectionectomy. Open conversion was associated with inferior perioperative outcomes compared with non-converted cases.
Published: 2022

57. Utility of the Iwate difficulty scoring system for laparoscopic right posterior sectionectomy: do surgical outcomes differ for tumors in segments VI and VII?

Author: Choi S. H., Chen K. -H., Syn N. L., Cipriani F., Cheung T. -T., Chiow A. K. H., Choi G. -H., Siow T. -F., Sucandy I., Marino M. V., Gastaca M., Chong C. C., Lee J. H., Ivanecz A., Mazzaferro V., Lopez-Ben S., Fondevila C., Rotellar F., Campos R. R., Efanov M., Kingham T. P., Sutcliffe R. P., Troisi R. I., Pratschke J., Wang X., D'Hondt M., Yong C. C., Levi Sandri G. B., Tang C. N., Ruzzenente A., Cherqui D., Ferrero A., Wakabayashi G., Scatton O., Aghayan D., Edwin B., Coelho F. F., Giuliante F., Liu R., Sijberden J., Abu Hilal M., Sugioka A., Long T. C. D., Fuks D., Aldrighetti L., Han H. -S., Goh B. K. P., Kang I., Jang J. Y., Chan C. -Y., D'Silva M., Schotte H., De Meyere C., Lai E., Krenzien F., Schmelzle M., Kadam P., Montalti R., Giglio M., Liu Q., Lee K. -F., Salimgereeva D., Alikhanov R., Lee L. -S., Prieto M., Lim C., Nghia P. P., Kojima M., Kato Y., Forchino F., Herman P., Kruger J. A. P., Saleh M., Pascual F., Dalla Valle B., Lopez-Lopez V., Casellas-Robert M., Giustizieri U., Citterio D., Mishima K., Fretland A. A., Ghotbi J., Ettorre G. M., Colasanti M., Guzman Y., Ardito F., Vani S., Wang H. -P., Choi, S. H., Chen, K. -H., Syn, N. L., Cipriani, F., Cheung, T. -T., Chiow, A. K. H., Choi, G. -H., Siow, T. -F., Sucandy, I., Marino, M. V., Gastaca, M., Chong, C. C., Lee, J. H., Ivanecz, A., Mazzaferro, V., Lopez-Ben, S., Fondevila, C., Rotellar, F., Campos, R. R., Efanov, M., Kingham, T. P., Sutcliffe, R. P., Troisi, R. I., Pratschke, J., Wang, X., D'Hondt, M., Yong, C. C., Levi Sandri, G. B., Tang, C. N., Ruzzenente, A., Cherqui, D., Ferrero, A., Wakabayashi, G., Scatton, O., Aghayan, D., Edwin, B., Coelho, F. F., Giuliante, F., Liu, R., Sijberden, J., Abu Hilal, M., Sugioka, A., Long, T. C. D., Fuks, D., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Kang, I., Jang, J. Y., Chan, C. -Y., D'Silva, M., Schotte, H., De Meyere, C., Lai, E., Krenzien, F., Schmelzle, M., Kadam, P., Montalti, R., Giglio, M., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Prieto, M., Lim, C., Nghia, P. P., Kojima, M., Kato, Y., Forchino, F., Herman, P., Kruger, J. A. P., Saleh, M., Pascual, F., Dalla Valle, B., Lopez-Lopez, V., Casellas-Robert, M., Giustizieri, U., Citterio, D., Mishima, K., Fretland, A. A., Ghotbi, J., Ettorre, G. M., Colasanti, M., Guzman, Y., Ardito, F., Vani, S., Wang, H. -P., Choi, Sung Hoon, Chen, Kuo-Hsin, Syn, Nicholas L, Cipriani, Federica, Cheung, Tan-To, Chiow, Adrian K H, Choi, Gi-Hong, Siow, Tiing-Foong, Sucandy, Iswanto, Marino, Marco V, Gastaca, Mikel, Chong, Charing C, Lee, Jae Hoon, Ivanecz, Arpad, Mazzaferro, Vincenzo, Lopez-Ben, Santiago, Fondevila, Constantino, Rotellar, Fernando, Campos, Ricardo Roble, Efanov, Mikhail, Kingham, T Peter, Sutcliffe, Robert P, Troisi, Roberto I, Pratschke, Johann, Wang, Xiaoying, D'Hondt, Mathieu, Yong, Chee Chien, Levi Sandri, Giovanni Battista, Tang, Chung Ngai, Ruzzenente, Andrea, Cherqui, Daniel, Ferrero, Alessandro, Wakabayashi, Go, Scatton, Olivier, Aghayan, Davit, Edwin, Bjørn, Coelho, Fabricio Ferreira, Giuliante, Felice, Liu, Rong, Sijberden, Jasper, Abu Hilal, Mohammad, Sugioka, Atsushi, Long, Tran Cong Duy, Fuks, David, Aldrighetti, Luca, Han, Ho-Seong, and Goh, Brian K P
Subjects: Carcinoma, Hepatocellular, Laparoscopic liver, Settore MED/18 - CHIRURGIA GENERALE, Operative Time, Liver Neoplasms, Carcinoma, Hepatocellular, Difficulty score, Length of Stay, Iwate, Laparoscopic hepatectomy, Right posterior sectionectomy, Treatment Outcome, Postoperative Complications, Humans, Hepatectomy, Surgery, Laparoscopy, Retrospective Studies
Abstract: Introduction: The Iwate Score (IS) have not been well-validated for specific procedures, especially for right posterior sectionectomy (RPS). In this study, the utility of the IS was determined for laparoscopic (L)RPS and the effect of tumor location on surgical outcomes was investigated. Methods: Post-hoc analysis of 647 L-RPS performed in 40 international centers of which 596L-RPS cases met the inclusion criteria. Baseline characteristics and perioperative outcomes of patients stratified based on the Iwate score were compared to determine whether a correlation with surgical difficulty existed. A 1:1 Mahalanobis distance matching was utilized to investigate the effect of tumor location on L-RPS outcomes. Results: The patients were stratified into 3 levels of difficulty (31 intermediate, 143 advanced, and 422 expert) based on the IS. When using a stepwise increase of the IS excluding the tumor location score, only Pringle’s maneuver was more frequently used in the higher surgical difficulty level (35.5%, 54.6%, and 65.2%, intermediate, advanced, and expert levels, respectively, Z = 3.34, p = 0.001). Other perioperative results were not associated with a statistical gradation toward higher difficulty level. 80 of 85 patients with a segment VI lesion and 511 patients with a segment VII lesion were matched 1:1. There were no significant differences in the perioperative outcomes of the two groups including open conversion, operating time, blood loss, intraoperative blood transfusion, postoperative stay, major morbidity, and mortality. Conclusion: Among patients undergoing L-RPS, the IS did not significantly correlate with most outcome measures associated with intraoperative difficulty and postoperative outcomes. Similarly, tumor location had no effect on L-RPS outcomes.
Published: 2022

58. Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8

Author: Efanov, M., Salimgereeva, D., Alikhanov, R., A. G. R., Wu, Geller, D., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., Belli, A., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Fondevila, C., Rotellar, F., Choi, G. -H., Robless Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Herman, P., Di Benedetto, F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Levi Sandri, G. B., Cherqui, D., Scatton, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Han, H. -S., Abu Hilal, M., Soubrane, O., Fuks, D., Aldrighetti, L., Edwin, B., Goh, B. K. P., Chan, C. -Y., Syn, N., D'Silva, M., Lee, B., Lim, C., Nghia, P. P., Gastaca, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Lee, L. S., Jang, J. Y., Kojima, M., Kato, Y., Ghotbi, J., Kruger, J. A. P., Coelho, F. F., Lopez-Lopez, V., Valle, B. D., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Wang, H. -P., Pascual, F., Saleh, M., Kadam, P., Tang, C. -N., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Dogeas, E., Magistri, P., Mazzotta, A., Graduate School, Surgery, CCA - Cancer Treatment and Quality of Life, Efanov, M., Salimgereeva, D., Alikhanov, R., Wu, A. G. R., Geller, D., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., Belli, A., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, F., Ruzzenente, A., Yong, C. -C., Fondevila, C., Rotellar, F., Choi, G. -H., Robless Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Herman, P., Di Benedetto, F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Levi Sandri, G. B., Cherqui, D., Scatton, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Han, H. -S., Abu Hilal, M., Soubrane, O., Fuks, D., Aldrighetti, L., Edwin, B., Goh, B. K. P., Chan, C. -Y., Syn, N., D'Silva, M., Lee, B., Lim, C., Nghia, P. P., Gastaca, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Lee, L. S., Jang, J. Y., Kojima, M., Kato, Y., Ghotbi, J., Kruger, J. A. P., Coelho, F. F., Lopez-Lopez, V., Valle, B. D., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Wang, H. -P., Pascual, F., Saleh, M., Kadam, P., Tang, C. -N., Ardito, F., Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Dogeas, E., Magistri, P., Mazzotta, A., Efanov, Mikhail, Salimgereeva, Diana, Alikhanov, Ruslan, Wu, Andrew G R, Geller, David, Cipriani, Federica, Aghayan, Davit L, Fretland, Asmund Avdem, Sijberden, Jasper, Belli, Andrea, Marino, Marco V, Mazzaferro, Vincenzo, Chiow, Adrian K H, Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung Hoon, Lee, Jae Hoon, Prieto, Mikel, Vivarelli, Marco, Giuliante, Felice, Ruzzenente, Andrea, Yong, Chee-Chien, Fondevila, Constantino, Rotellar, Fernando, Choi, Gi-Hong, Robless Campos, Ricardo, Wang, Xiaoying, Sutcliffe, Robert P, Pratschke, Johann, Lai, Eric, Chong, Charing C, D'Hondt, Mathieu, Monden, Kazuteru, Lopez-Ben, Santiago, Herman, Paulo, Di Benedetto, Fabrizio, Kingham, T Peter, Liu, Rong, Long, Tran Cong Duy, Ferrero, Alessandro, Levi Sandri, Giovanni Battista, Cherqui, Daniel, Scatton, Olivier, Wakabayashi, Go, Troisi, Roberto I, Cheung, Tan-To, Sugioka, Atsushi, Han, Ho-Seong, Abu Hilal, Mohammad, Soubrane, Olivier, Fuks, David, Aldrighetti, Luca, Edwin, Bjorn, and Goh, Brian K P
Subjects: hepatectomy, laparoscopy, liver resection, posterosuperior segments, risk score, Hepatology, Settore MED/18 - CHIRURGIA GENERALE, Surgery, posterosuperior segment
Abstract: Background: Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8. Methods: A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8. Results: A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay. Conclusion: Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.
Published: 2022
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59. The external validation of a difficulty scoring system for predicting the risk of intraoperative complications during laparoscopic liver resection

Author: Ivanecz, Arpad, Plahuta, Irena, Magdalenić, Tomislav, Mencinger, Matej, Peruš, Iztok, Potrč, Stojan, and Krebs, Bojan
Published: 2019
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60. Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study

Author: Goh, B. K. P., Han, H. -S., Chen, K. -H., Chua, D. W., Chan, C. -Y., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., D'Silva, M., Siow, T. F., Kato, Y., Lim, C., Nghia, P. P., Herman, P., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Gastaca, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Chen, Z., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Campos, R. R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Coelho, F. F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Sandri, G. B. L., Saleh, M., Cherqui, D., Scatton, O., Soubrane, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Hilal, M. A., Fuks, D., Edwin, B., Aldrighetti, L., Syn, N., Prieto, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kojima, M., Ghotbi, J., Kruger, J. A. P., Lopez-Lopez, V., Valle, B. D., Casellas I Robert, M., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., Wang, H. -P., Pascual, F., Kadam, P., Tang, C. -N., Yu, S., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Goh, Brian K P, Han, Ho-Seong, Chen, Kuo-Hsin, Chua, Darren W, Chan, Chung-Yip, Cipriani, Federica, Aghayan, Davit L, Fretland, Asmund A, Sijberden, Jasper, D'Silva, Mizelle, Siow, Tiing Foong, Kato, Yutaro, Lim, Chetana, Nghia, Phan Phuoc, Herman, Paulo, Marino, Marco V, Mazzaferro, Vincenzo, Chiow, Adrian K H, Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung Hoon, Lee, Jae Hoon, Gastaca, Mikel, Vivarelli, Marco, Giuliante, Felice, Ruzzenente, Andrea, Yong, Chee-Chien, Yin, Mengqui, Chen, Zewei, Fondevila, Constantino, Efanov, Mikhail, Rotellar, Fernando, Choi, Gi-Hong, Campos, Ricardo R, Wang, Xiaoying, Sutcliffe, Robert P, Pratschke, Johann, Lai, Eric, Chong, Charing C, D'Hondt, Mathieu, Monden, Kazuteru, Lopez-Ben, Santiago, Coelho, Fabricio F, Kingham, Thomas Peter, Liu, Rong, Long, Tran Cong Duy, Ferrero, Alessandro, Sandri, Giovanni B Levi, Saleh, Mansour, Cherqui, Daniel, Scatton, Olivier, Soubrane, Olivier, Wakabayashi, Go, Troisi, Roberto I, Cheung, Tan-To, Sugioka, Atsushi, Hilal, Mohammad Abu, Fuks, David, Edwin, Bjørn, and Aldrighetti, Luca
Subjects: benchmark, hepatectomy, quality assessment, Settore MED/18 - CHIRURGIA GENERALE, minimally invasive, Surgery, laparoscopic liver resection, global
Abstract: To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR).There is limited published data to date on the best achievable outcomes after L-LR.This is a post hoc analysis of a multicenter database of 11,983 patients undergoing L-LR in 45 international centers in 4 continents between 2015 and 2020. Three specific procedures: left lateral sectionectomy (LLS), left hepatectomy (LH), and right hepatectomy (RH) were selected to represent the 3 difficulty levels of L-LR. Fifteen outcome indicators were selected to establish benchmark cutoffs.There were 3519 L-LR (LLS, LH, RH) of which 1258 L-LR (40.6%) cases performed in 34 benchmark expert centers qualified as low-risk benchmark cases. These included 659 LLS (52.4%), 306 LH (24.3%), and 293 RH (23.3%). The benchmark outcomes established for operation time, open conversion rate, blood loss ≥500 mL, blood transfusion rate, postoperative morbidity, major morbidity, and 90-day mortality after LLS, LH, and RH were 209.5, 302, and 426 minutes; 2.1%, 13.4%, and 13.0%; 3.2%, 20%, and 47.1%; 0%, 7.1%, and 10.5%; 11.1%, 20%, and 50%; 0%, 7.1%, and 20%; and 0%, 0%, and 0%, respectively.This study established the first global benchmark outcomes for L-LR in a large-scale international patient cohort. It provides an up-to-date reference regarding the "best achievable" results for L-LR for which centers adopting L-LR can use as a comparison to enable an objective assessment of performance gaps and learning curves.
Published: 2022

61. Propensity-score Matched and Coarsened-exact Matched Analysis Comparing Robotic and Laparoscopic Major Hepatectomies: An International Multicenter Study of 4822 Cases.

Author: Qu Liu, Wanguang Zhang, Zhao, Joseph J., Syn, Nicholas L., Cipriani, Federica, Alzoubi, Mohammad, Aghayan, Davit L., Tiing-Foong Siow, Lim, Chetana, Scatton, Olivier, Herman, Paulo, Ferreira Coelho, Fabricio, Marino, Marco V., Mazzaferro, Vincenzo, Chiow, Adrian K. H., Sucandy, Iswanto, Ivanecz, Arpad, Sung-Hoon Choi, Jae Hoon Lee, and Prieto, Mikel
Abstract: Objective: To compare the outcomes between robotic major hepatectomy (R-MH) and laparoscopic major hepatectomy (L-MH). Background: Robotic techniques may overcome the limitations of laparoscopic liver resection. However, it is unknown whether R-MH is superior to L-MH. Methods: This is a post hoc analysis of a multicenter database of patients undergoing R-MH or L-MH at 59 international centers from 2008 to 2021. Data on patient demographics, center experience volume, perioperative outcomes, and tumor characteristics were collected and analyzed. Both 1:1 propensity-score matched (PSM) and coarsened-exact matched (CEM) analyses were performed to minimize selection bias between both groups Results: A total of 4822 cases met the study criteria, of which 892 underwent R-MH and 3930 underwent L-MH. Both 1:1 PSM (841 R-MH vs. 841 L-MH) and CEM (237 R-MH vs. 356 L-MH) were performed. R-MH was associated with significantly less blood loss {PSM:200.0 [interquartile range (IQR):100.0, 450.0] vs 300.0 (IQR:150.0, 500.0) mL; P = 0.012; CEM:170.0 (IQR: 90.0, 400.0) vs 200.0 (IQR:100.0, 400.0) mL; P = 0.006}, lower rates of Pringle maneuver application (PSM: 47.1% vs 63.0%; P < 0.001; CEM: 54.0% vs 65.0%; P = 0.007) and open conversion (PSM: 5.1% vs 11.9%; P < 0.001; CEM: 5.5% vs 10.4%, P = 0.04) compared with L-MH. On subset analysis of 1273 patients with cirrhosis, R-MH was associated with a lower postoperative morbidity rate (PSM: 19.5% vs 29.9%; P = 0.02; CEM 10.4% vs 25.5%; P = 0.02) and shorter postoperative stay [PSM: 6.9 (IQR: 5.0, 9.0) days vs 8.0 (IQR: 6.0 11.3) days; P < 0.001; CEM 7.0 (IQR: 5.0, 9.0) days vs 7.0 (IQR: 6.0, 10.0) days; P = 0.047]. Conclusions: This international multicenter study demonstrated that R-MH was comparable to L-MH in safety and was associated with reduced blood loss, lower rates of Pringle maneuver application, and conversion to open surgery. [ABSTRACT FROM AUTHOR]
Published: 2023
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62. Two-stage Procedures in Resection of Colorectal Liver Metastases — A Single-institution Experience with a Propensity Score Analysis

Author: Turk, Š., primary, Plahuta, I., additional, Magdalenić, T., additional, Mavc, Ž., additional, Španring, T., additional, Laufer, K., additional, Potrč, S., additional, and Ivanecz, A., additional
Published: 2023
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63. Impact of neoadjuvant chemotherapy on the difficulty of laparoscopic and robotic major liver resections for colorectal liver metastases: A propensity-score and coarsened exact-matched controlled study

Author: Ghotbi, Jacob, primary, Aghayan, Davit, additional, Fretland, Åsmund, additional, Edwin, Bjørn, additional, Syn, Nicholas L., additional, Cipriani, Federica, additional, Alzoubi, Mohammed, additional, Lim, Chetana, additional, Scatton, Olivier, additional, Long, Tran Cong duy, additional, Herman, Paulo, additional, Coelho, Fabricio Ferreira, additional, Marino, Marco V., additional, Mazzaferro, Vincenzo, additional, Chiow, Adrian K.H., additional, Sucandy, Iswanto, additional, Ivanecz, Arpad, additional, Choi, Sung-Hoon, additional, Lee, Jae Hoon, additional, Prieto, Mikel, additional, Vivarelli, Marco, additional, Giuliante, Felice, additional, Ruzzenente, Andrea, additional, Yong, Chee-Chien, additional, Yin, Mengqui, additional, Fondevila, Constantino, additional, Efanov, Mikhail, additional, Morise, Zenichi, additional, Di Benedetto, Fabrizio, additional, Brustia, Raffaele, additional, Dalla Valle, Raffaele, additional, Boggi, Ugo, additional, Geller, David, additional, Belli, Andrea, additional, Memeo, Riccardo, additional, Mejia, Alejandro, additional, Park, James O., additional, Rotellar, Fernando, additional, Choi, Gi-Hong, additional, Robles-Campos, Ricardo, additional, Wang, Xiaoying, additional, Sutcliffe, Robert P., additional, Pratschke, Johann, additional, Tang, Chung-Ngai, additional, Chong, Charing C.N., additional, D'Hondt, Mathieu, additional, Monden, Kazuteru, additional, Lopez-Ben, Santiago, additional, Kingham, T. Peter, additional, Ferrero, Alessandro, additional, Ettorre, Giuseppe Maria, additional, Levi Sandri, Giovanni Battista, additional, Pascual, Franco, additional, Cherqui, Daniel, additional, Liang, Xiao, additional, Mazzotta, Alessandro, additional, Wakabayashi, Go, additional, Giglio, Mariano, additional, Troisi, Roberto I., additional, Han, Ho-Seong, additional, Cheung, Tan-To, additional, Sugioka, Atsushi, additional, Chen, Kuo-Hsin, additional, Liu, Rong, additional, Soubrane, Olivier, additional, Fuks, David, additional, Aldrighetti, Luca, additional, Abu Hilal, Mohammad, additional, Goh, Brian K.P., additional, Gastaca, Mikel, additional, Meurs, Juul, additional, De Meyere, Celine, additional, Lee, Kit-Fai, additional, Ng, Kelvin K., additional, Salimgereeva, Diana, additional, Alikhanov, Ruslan, additional, Lee, Lip-Seng, additional, Jang, Jae Young, additional, Kato, Yutaro, additional, Kojima, Masayuki, additional, Pirola Kruger, Jaime Arthur, additional, Lopez-Lopez, Victor, additional, Casellas I Robert, Margarida, additional, Montalti, Roberto, additional, Lee, Boram, additional, D'Silva, Mizelle, additional, Wang, Hao-Ping, additional, Saleh, Mansour, additional, Chen, Zewei, additional, Yu, Shian, additional, Vani, Simone, additional, Ardito, Francesco, additional, Giustizieri, Ugo, additional, Citterio, Davide, additional, Mocchegiani, Federico, additional, Colasanti, Marco, additional, Guzmán, Yoelimar, additional, Labadie, Kevin P., additional, Conticchio, Maria, additional, Dogeas, Epameinondas, additional, Kauffmann, Emanuele F., additional, Giuffrida, Mario, additional, Sommacale, Daniele, additional, Laurent, Alexis, additional, Magistri, Paolo, additional, Nghia, Phan Phuoc, additional, Mishima, Kohei, additional, Valle, Bernardo Dalla, additional, Krenzien, Felix, additional, Schmelzle, Moritz, additional, Kadam, Prashant, additional, Liu, Qu, additional, Lai, Eric C., additional, Zheng, Junhao, additional, Siow, Tiing Foong, additional, and Forchino, Fabio, additional
Published: 2023
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64. Ranking of the Survival Factors in the Prognostic Score Predicting the Survival of Patients Treated with Curative Intent for Colorectal Liver Metastases

Author: Plahuta, I., primary, Mencinger, M., additional, Peruš, I., additional, Turk, Š., additional, Magdalenić, T., additional, Mavc, Ž., additional, Potrč, S., additional, and Ivanecz, A., additional
Published: 2023
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65. Pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head with venous resection

Author: Flis Vojko, Potrc Stojan, Kobilica Nina, and Ivanecz Arpad
Subjects: pancreaticoduodenectomy, pancreatic cancer, vein resection, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract: Recent reports have shown that patients with vascular tumour invasion who undergo concurrent vascular resection can achieve long-term survival rates equivalent to those without vascular involvement requiring pancreaticoduodenectomy alone. There is no consensus about which patients benefit from the portal-superior mesenteric vein resection and there is no consensus about the best surgical technique of vessel reconstruction (resection with or without graft reconstruction). As published series are small the aim of this study was to evaluate our experience in pancreatectomies with en bloc vascular resection and reconstruction of vessels.
Published: 2016
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66. Impact of neoadjuvant chemotherapy on the difficulty and outcomes of laparoscopic and robotic major liver resections for colorectal liver metastases: A propensity-score and coarsened exact-matched controlled study

Author: Jacob Ghotbi, Davit Aghayan, Åsmund Fretland, Bjørn Edwin, Nicholas L. Syn, Federica Cipriani, Mohammed Alzoubi, Chetana Lim, Olivier Scatton, Tran Cong duy Long, Paulo Herman, Fabricio Ferreira Coelho, Marco V. Marino, Vincenzo Mazzaferro, Adrian K.H. Chiow, Iswanto Sucandy, Arpad Ivanecz, Sung-Hoon Choi, Jae Hoon Lee, Mikel Prieto, Marco Vivarelli, Felice Giuliante, Andrea Ruzzenente, Chee-Chien Yong, Mengqiu Yin, Constantino Fondevila, Mikhail Efanov, Zenichi Morise, Fabrizio Di Benedetto, Raffaele Brustia, Raffaele Dalla Valle, Ugo Boggi, David Geller, Andrea Belli, Riccardo Memeo, Alejandro Mejia, James O. Park, Fernando Rotellar, Gi-Hong Choi, Ricardo Robles-Campos, Xiaoying Wang, Robert P. Sutcliffe, Johann Pratschke, Chung-Ngai Tang, Charing C.N. Chong, Mathieu D'Hondt, Kazuteru Monden, Santiago Lopez-Ben, T. Peter Kingham, Alessandro Ferrero, Giuseppe Maria Ettorre, Giovanni Battista Levi Sandri, Franco Pascual, Daniel Cherqui, Xiao Liang, Alessandro Mazzotta, Go Wakabayashi, Mariano Giglio, Roberto I. Troisi, Ho-Seong Han, Tan-To Cheung, Atsushi Sugioka, Kuo-Hsin Chen, Rong Liu, Olivier Soubrane, David Fuks, Luca Aldrighetti, Mohammad Abu Hilal, Brian K.P. Goh, Mikel Gastaca, Juul Meurs, Celine De Meyere, Kit-Fai Lee, Kelvin K. Ng, Diana Salimgereeva, Ruslan Alikhanov, Lip-Seng Lee, Jae Young Jang, Yutaro Kato, Masayuki Kojima, Jaime Arthur Pirola Kruger, Victor Lopez-Lopez, Margarida Casellas I Robert, Roberto Montalti, Boram Lee, Mizelle D'Silva, Hao-Ping Wang, Mansour Saleh, Zewei Chen, Shian Yu, Simone Vani, Francesco Ardito, Ugo Giustizieri, Davide Citterio, Federico Mocchegiani, Marco Colasanti, Yoelimar Guzmán, Kevin P. Labadie, Maria Conticchio, Epameinondas Dogeas, Emanuele F. Kauffmann, Mario Giuffrida, Daniele Sommacale, Alexis Laurent, Paolo Magistri, Phan Phuoc Nghia, Kohei Mishima, Bernardo Dalla Valle, Felix Krenzien, Moritz Schmelzle, Prashant Kadam, Qu Liu, Eric C.H. Lai, Junhao Zheng, Tiing Foong Siow, and Fabio Forchino
Subjects: Robotic liver resections, Oncology, Laparoscopic liver resections, Major resections, Settore MED/18 - CHIRURGIA GENERALE, Surgery, General Medicine, Difficulty, Neoadjuvant chemotherapy
Published: 2023

67. Impact of liver cirrhosis, the severity of cirrhosis, and portal hypertension on the outcomes of minimally invasive left lateral sectionectomies for primary liver malignancies

Author: Coelho, Fabricio Ferreira, Herman, Paulo, Kruger, Jaime A P, Andrew G R, Wu, Chin, Ken-Min, Hasegawa, Kiyoshi, Zhang, Wanguang, Alzoubi, Mohammed, Aghayan, Davit L, Siow, Tiing-Foong, Scatton, Olivier, Kingham, T Peter, Marino, Marco V, Mazzaferro, Vincenzo, Chiow, Adrian K H, Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung Hoon, Lee, Jae Hoon, Gastaca, Mikel, Vivarelli, Marco, Giuliante, Felice, Ruzzenente, Andrea, Yong, Chee-Chien, Dokmak, Safi, Fondevila, Constantino, Efanov, Mikhail, Morise, Zenichi, Di Benedetto, Fabrizio, Brustia, Raffaele, Valle, Raffaele Dalla, Boggi, Ugo, Geller, David, Belli, Andrea, Memeo, Riccardo, Gruttadauria, Salvatore, Mejia, Alejandro, Park, James O, Rotellar, Fernando, Choi, Gi Hong, Robles-Campos, Ricardo, Wang, Xiaoying, Sutcliffe, Robert P, Pratschke, Johann, Lai, Eric C H, Chong, Charing C N, D'Hondt, Mathieu, Monden, Kazuteru, Lopez-Ben, Santiago, Liu, Rong, Ferrero, Alessandro, Ettorre, Giuseppe Maria, Cipriani, Federica, Cherqui, Daniel, Liang, Xiao, Soubrane, Olivier, Wakabayashi, Go, Troisi, Roberto I, Yin, Mengqiu, Cheung, Tan-To, Sugioka, Atsushi, Han, Ho-Seong, Long, Tran Cong Duy, Fuks, David, Abu Hilal, Mohammad, Chen, Kuo-Hsin, Aldrighetti, Luca, Edwin, Bjørn, and Goh, Brian K P
Published: 2023

68. Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy

Author: Zewei Chen, Mengqiu Yin, Junhao Fu, Shian Yu, Nicholas L. Syn, Darren W. Chua, T. Peter Kingham, Wanguang Zhang, Tijs J. Hoogteijling, Davit L. Aghayan, Tiing Foong Siow, Olivier Scatton, Paulo Herman, Marco V. Marino, Vincenzo Mazzaferro, Adrian K.H. Chiow, Iswanto Sucandy, Arpad Ivanecz, Sung Hoon Choi, Jae Hoon Lee, Mikel Prieto, Marco Vivarelli, Felice Giuliante, Andrea Ruzzenente, Chee-Chien Yong, Safi Dokmak, Constantino Fondevila, Mikhail Efanov, Zenichi Morise, Fabrizio Di Benedetto, Raffaele Brustia, Raffaele Dalla Valle, Ugo Boggi, David Geller, Andrea Belli, Riccardo Memeo, Salvatore Gruttadauria, Alejandro Mejia, James O. Park, Fernando Rotellar, Gi-Hong Choi, Ricardo Robles-Campos, Xiaoying Wang, Robert P. Sutcliffe, Johann Pratschke, Eric C.H. Lai, Charing C.N. Chong, Mathieu D'Hondt, Kazuteru Monden, Santiago Lopez-Ben, Qu Liu, Rong Liu, Alessandro Ferrero, Giuseppe Maria Ettorre, Federica Cipriani, Daniel Cherqui, Xiao Liang, Olivier Soubrane, Go Wakabayashi, Roberto I. Troisi, Tan-To Cheung, Yutaro Kato, Atsushi Sugioka, Ho-Seong Han, Tran Cong duy Long, David Fuks, Mohammad Abu Hilal, Luca Aldrighetti, Kuo-Hsin Chen, Bjørn Edwin, Brian K.P. Goh, Mikel Gastaca, Juul Meurs, Celine De Meyere, Kit-Fai Lee, Kelvin K. Ng, Diana Salimgereeva, Ruslan Alikhanov, Lip-Seng Lee, Jae-Young Jang, Masayuki Kojima, Jaime Arthur Pirola Kruger, Fabricio Ferreira Coelho, Victor Lopez-Lopez, Margarida Casellas I Robert, Roberto Montalti, Mariano Giglio, Mizelle D'Silva, Boram Lee, Hao-Ping Wang, Franco Pascual, Mansour Saleh, Simone Vani, Francesco Ardito, Ugo Giustizieri, Davide Citterio, Federico Mocchegiani, Giammauro Berardi, Marco Colasanti, Yoelimar Guzmán, Kevin P. Labadie, Maria Conticchio, Epameinondas Dogeas, Emanuele F. Kauffmann, Mario Giuffrida, Daniele Sommacale, Alexis Laurent, Paolo Magistri, Kohei Mishima, Moritz Schmelzle, Felix Krenzien, Prashant Kadam, Jacob Ghotbi, Åsmund Avdem Fretland, Fabio Forchino, Alessandro Mazzotta, Francois Cauchy, Chetana Lim, Bernardo Dalla Valle, Junhao Zheng, Phan Phuoc Nghia, and Graduate School
Subjects: Minimally-invasive liver, Oncology, Left lateral sectionectomy, Laparoscopic hepatectomy, Laparoscopic liver, Minimally-invasive hepatectomy, Surgery, General Medicine, Body mass index
Abstract: Introduction: Currently, the impact of body mass index (BMI) on the outcomes of laparoscopic liver resections (LLR) is poorly defined. This study attempts to evaluate the impact of BMI on the peri-operative outcomes following laparoscopic left lateral sectionectomy (L-LLS). Methods: A retrospective analysis of 2183 patients who underwent pure L-LLS at 59 international centers between 2004 and 2021 was performed. Associations between BMI and selected peri-operative outcomes were analyzed using restricted cubic splines. Results: A BMI of >27kg/m2 was associated with increased in blood loss (Mean difference (MD) 21 mls, 95% CI 5–36), open conversions (Relative risk (RR) 1.13, 95% CI 1.03–1.25), operative time (MD 11 min, 95% CI 6–16), use of Pringles maneuver (RR 1.15, 95% CI 1.06–1.26) and reductions in length of stay (MD -0.2 days, 95% CI -0.3 to −0.1). The magnitude of these differences increased with each unit increase in BMI. However, there was a “U” shaped association between BMI and morbidity with the highest complication rates observed in underweight and obese patients. Conclusion: Increasing BMI resulted in increasing difficulty of L-LLS. Consideration should be given to its incorporation in future difficulty scoring systems in laparoscopic liver resections.
Published: 2023

69. Impact of body mass index on perioperative outcomes of laparoscopic major hepatectomies

Author: Berardi, Giammauro, Kingham, T Peter, Zhang, Wanguang, Syn, Nicholas L, Koh, Ye-Xin, Jaber, Bashar, Aghayan, Davit L, Siow, Tiing Foong, Lim, Chetana, Scatton, Olivier, Herman, Paulo, Coelho, Fabricio Ferreira, Marino, Marco V, Mazzaferro, Vincenzo, Chiow, Adrian K H, Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung Hoon, Lee, Jae Hoon, Gastaca, Mikel, Vivarelli, Marco, Giuliante, Felice, Dalla Valle, Bernardo, Ruzzenente, Andrea, Yong, Chee-Chien, Chen, Zewei, Yin, Mengqiu, Fondevila, Constantino, Efanov, Mikhail, Morise, Zenichi, Di Benedetto, Fabrizio, Brustia, Raffaele, Dalla Valle, Raffaele, Boggi, Ugo, Geller, David, Belli, Andrea, Memeo, Riccardo, Gruttadauria, Salvatore, Mejia, Alejandro, Park, James O, Rotellar, Fernando, Choi, Gi-Hong, Robles-Campos, Ricardo, Wang, Xiaoying, Sutcliffe, Robert P, Schmelzle, Moritz, Pratschke, Johann, Lai, Eric C H, Chong, Charing C N, Meurs, Juul, D'Hondt, Mathieu, Monden, Kazuteru, Lopez-Ben, Santiago, Liu, Qu, Liu, Rong, Ferrero, Alessandro, Ettorre, Giuseppe Maria, Cipriani, Federica, Pascual, Franco, Cherqui, Daniel, Zheng, Junhao, Liang, Xiao, Soubrane, Olivier, Wakabayashi, Go, Troisi, Roberto I, Cheung, Tan-To, Kato, Yutaro, Sugioka, Atsushi, D'Silva, Mizelle, Han, Ho-Seong, Nghia, Phan Phuoc, Long, Tran Cong Duy, Edwin, Bjørn, Fuks, David, Abu Hilal, Mohammad, Aldrighetti, Luca, Chen, Kuo-Hsin, and Goh, Brian K P
Published: 2023

70. Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: a multicenter propensity score-matched study

Author: Sahakyan, Mushegh A., primary, Aghayan, Davit L., additional, Edwin, Bjørn, additional, Alikhanov, Ruslan, additional, Britskaia, Natalia, additional, Brudvik, Kristoffer Watten, additional, D’Hondt, Mathieu, additional, De Meyere, Celine, additional, Efanov, Mikhail, additional, Fretland, Åsmund A., additional, Hoff, Rune, additional, Ismail, Warsan, additional, Ivanecz, Arpad, additional, Kazaryan, Airazat M., additional, Lassen, Kristoffer, additional, Magdalenić, Tomislav, additional, Parmentier, Isabelle, additional, Røsok, Bård Ingvald, additional, Villanger, Olaug, additional, and Yaqub, Sheraz, additional
Published: 2022
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71. Can we improve the clinical risk score? The prognostic value of p53, Ki-67 and thymidylate synthase in patients undergoing radical resection of colorectal liver metastases

Author: Ivanecz, Arpad, Kavalar, Rajko, Palfy, Miroslav, Pivec, Vid, Sremec, Marko, Horvat, Matjaž, and Potrč, Stojan
Published: 2014
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72. An international multicenter propensity-score matched and coarsened-exact matched analysis comparing robotic versus laparoscopic partial liver resections of the anterolateral segments

Author: Kadam P., Sutcliffe R. P., Scatton O., Sucandy I., Kingham T. P., Liu R., Choi G. H., Syn N. L., Gastaca M., Choi S. -H., Chiow A. K. H., Marino M. V., Efanov M., Lee J. -H., Chong C. C., Tang C. -N., Cheung T. -T., Pratschke J., Wang X., Campos R. R., Ivanecz A., Park J. O., Rotellar F., Fuks D., D'Hondt M., Han H. -S., Troisi R. I., Goh B. K. P., Chan C. -Y., Prieto M., Schotte H., De Meyere C., Lai E., Krenzien F., Schmelzle M., Montalti R., Liu Q., Lee K. -F., Salimgereeva D., Alikhanov R., Lee L. -S., Jang J. Y., Lim C., Labadie K. P., Lopez-Lopez V., Kadam, P., Sutcliffe, R. P., Scatton, O., Sucandy, I., Kingham, T. P., Liu, R., Choi, G. H., Syn, N. L., Gastaca, M., Choi, S. -H., Chiow, A. K. H., Marino, M. V., Efanov, M., Lee, J. -H., Chong, C. C., Tang, C. -N., Cheung, T. -T., Pratschke, J., Wang, X., Campos, R. R., Ivanecz, A., Park, J. O., Rotellar, F., Fuks, D., D'Hondt, M., Han, H. -S., Troisi, R. I., Goh, B. K. P., Chan, C. -Y., Prieto, M., Schotte, H., De Meyere, C., Lai, E., Krenzien, F., Schmelzle, M., Montalti, R., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Lim, C., Labadie, K. P., and Lopez-Lopez, V.
Subjects: Carcinoma, Hepatocellular, robotic liver resection, Hepatology, Liver Neoplasms, anterolateral segment, laparoscopic liver resection, Length of Stay, Postoperative Complications, Robotic Surgical Procedures, Hepatectomy, Humans, Laparoscopy, Surgery, Propensity Score, Retrospective Studies, minimally invasive liver surgery
Abstract: Background: Robotic liver resections (RLR) may have the ability to address some of the drawbacks of laparoscopic liver resections (LLR) but few studies have done a head-to-head comparison of the outcomes after anterolateral segment resections by the two techniques. Methods: A retrospective study was conducted of 3202 patients who underwent minimally invasive LR of the anterolateral liver segments at 26 international centres from 2005 to 2020. Two thousand six hundred and six cases met study criteria of which there were 358 RLR and 1868 LLR cases. Perioperative outcomes were compared between the two groups using a 1:3 Propensity Score Matched (PSM) and 1:1 Coarsened Exact Matched (CEM) analysis. Results: Patients matched after 1:3 PSM (261 RLR vs 783 LLR) and 1:1 CEM (296 RLR vs 296 LLR) revealed no significant differences in length of stay, readmission rates, morbidity, mortality, and involvement of or close oncological margins. RLR surgeries were associated with significantly less blood loss (50 mL vs 100 ml, P
Published: 2022

73. Impact of tumor size on the difficulty of laparoscopic left lateral sectionectomies

Author: Arizza, G., Russolillo, N., Ferrero, A., Syn, N. L., Cipriani, F., Aghayan, D., Marino, M. V., Memeo, R., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Vivarelli, M., Di Benedetto, F., Choi, S. -H., Lee, J. H., Park, J. O., Gastaca, M., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Robles-Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. N., Chong, C. C., D'Hondt, M., Yong, C. C., Ruzzenente, A., Herman, P., Kingham, T. P., Scatton, O., Liu, R., Levi Sandri, G. B., Soubrane, O., Mejia, A., Lopez-Ben, S., Monden, K., Wakabayashi, G., Cherqui, D., Troisi, R. I., Yin, M., Giuliante, Felice, Geller, D., Sugioka, A., Edwin, B., Cheung, T. -T., Long, T. C. D., Hilal, M. A., Fuks, D., Chen, K. -H., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Chan, C. -Y., Prieto, M., Meurs, J., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., K. K., Ng, Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Labadie, K. P., Kato, Y., Kojima, M., Fretland, A. A., Ghotbi, J., Coelho, F. F., Kruger, J. A. P., Lopez-Lopez, V., Magistri, P., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., D'Silva, M., Wang, H. -P., Saleh, M., Pascual, F., Suhool, A., Nghia, P. P., Lim, C., Liu, Q., Kadam, P., Dalla Valle, B., Lai, E. C., Conticchio, M., Giustizieri, U., Citterio, D., Chen, Z., Yu, S., Ardito, Francesco, Vani, S., Dogeas, E., Siow, T. F., Mocchegianni, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Arizza, G., Russolillo, N., Ferrero, A., Syn, N. L., Cipriani, F., Aghayan, D., Marino, M. V., Memeo, R., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Vivarelli, M., Di Benedetto, F., Choi, S. -H., Lee, J. H., Park, J. O., Gastaca, M., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Robles-Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. N., Chong, C. C., D'Hondt, M., Yong, C. C., Ruzzenente, A., Herman, P., Kingham, T. P., Scatton, O., Liu, R., Levi Sandri, G. B., Soubrane, O., Mejia, A., Lopez-Ben, S., Monden, K., Wakabayashi, G., Cherqui, D., Troisi, R. I., Yin, M., Giuliante, F., Geller, D., Sugioka, A., Edwin, B., Cheung, T. -T., Long, T. C. D., Hilal, M. A., Fuks, D., Chen, K. -H., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Chan, C. -Y., Prieto, M., Meurs, J., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Ng, K. K., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Labadie, K. P., Kato, Y., Kojima, M., Fretland, A. A., Ghotbi, J., Coelho, F. F., Kruger, J. A. P., Lopez-Lopez, V., Magistri, P., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., D'Silva, M., Wang, H. -P., Saleh, M., Pascual, F., Suhool, A., Nghia, P. P., Lim, C., Liu, Q., Kadam, P., Dalla Valle, B., Lai, E. C., Conticchio, M., Giustizieri, U., Citterio, D., Chen, Z., Yu, S., Ardito, F., Vani, S., Dogeas, E., Siow, T. F., Mocchegianni, F., Ettorre, G. M., Colasanti, M., and Guzman, Y.
Subjects: difficulty, laparoscopic hepatectomy, laparoscopic liver, left lateral sectionectomy, size, Hepatology, Settore MED/18 - CHIRURGIA GENERALE, Surgery
Abstract: Background: Tumor size (TS) represents a critical parameter in the risk assessment of laparoscopic liver resections (LLR). Moreover, TS has been rarely related to the extent of liver resection. The aim of this study was to study the relationship between tumor size and difficulty of laparoscopic left lateral sectionectomy (L-LLS). Methods: The impact of TS cutoffs was investigated by stratifying tumor size at each 10 mm-interval. The optimal cutoffs were chosen taking into consideration the number of endpoints which show a statistically significant split around the cut-points of interest and the magnitude of relative risk after correction for multiple risk factors. Results: A total of 1910 L-LLS were included. Overall, open conversion and intraoperative blood transfusion were 3.1 and 3.3%, respectively. The major morbidity rate was 2.7% and 90-days mortality 0.6%. Three optimal TS cutoffs were identified: 40-, 70-, and 100-mm. All the selected cutoffs showed a significant discriminative power for the prediction of open conversion, operative time, blood transfusion and need of Pringle maneuver. Moreover, 70- and 100-mm cutoffs were both discriminative for estimated blood loss and major complications. A stepwise increase in rates of open conversion rate (Z = 3.90, P
Published: 2022

74. The learning curve of laparoscopic liver resection utilising a difficulty score

Author: Irena Plahuta, Stojan Potrč, Arpad Ivanecz, Tomislav Magdalenić, Iztok Peruš, Matej Mencinger, and Spela Turk
Subjects: Retrospective review, business.industry, Liver Neoplasms, Liver resections, Single surgeon, Outcome (probability), Resection, Oncology, Blood loss, Learning curve, Statistics, Hepatectomy, Humans, Medicine, Laparoscopy, Radiology, Nuclear Medicine and imaging, business, Learning Curve, Regression curve
Abstract: Background This study aimed to quantitatively evaluate the learning curve of laparoscopic liver resection (LLR) of a single surgeon. Patients and methods A retrospective review of a prospectively maintained database of liver resections was conducted. 171 patients undergoing pure LLRs between April 2008 and April 2021 were analysed. The Halls difficulty score (HDS) for theoretical predictions of intraoperative complications (IOC) during LLR was applied. IOC was defined as blood loss over 775 mL, unintentional damage to the surrounding structures, and conversion to an open approach. Theoretical association between HDS and the predicted probability of IOC was utilised to objectify the shape of the learning curve. Results The obtained learning curve has resulted from thirteen years of surgical effort of a single surgeon. It consists of an absolute and a relative part in the mathematical description of the additive function described by the logarithmic function (absolute complexity) and fifth-degree regression curve (relative complexity). The obtained learning curve determines the functional dependency of the learning outcome versus time and indicates several local extreme values (peaks and valleys) in the learning process until proficiency is achieved. Conclusions This learning curve indicates an ongoing learning process for LLR. The proposed mathematical model can be applied for any surgical procedure with an existing difficulty score and a known theoretically predicted association between the difficulty score and given outcome (for example, IOC).
Published: 2021
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75. Sub‐classification of laparoscopic left hepatectomy based on hierarchic interaction of tumor location and size with perioperative outcomes.

Author: Ruzzenente, Andrea, Valle, Bernardo Dalla, Poletto, Edoardo, Syn, Nicholas L., Kabir, Tousif, Sugioka, Atsushi, Cipriani, Federica, Cherqui, Daniel, Han, Ho‐Seong, Armstrong, Thomas, Long, Tran Cong Duy, Scatton, Olivier, Herman, Paolo, Pratschke, Johann, Aghayan, Davit L., Liu, Rong, Marino, Marco V., Chiow, Adrian K. H., Sucandy, Iswanto, and Ivanecz, Arpad
Abstract: Background: The aim of this multicentric study was to investigate the impact of tumor location and size on the difficulty of Laparoscopic‐Left Hepatectomy (L‐LH). Methods: Patients who underwent L‐LH performed across 46 centers from 2004 to 2020 were analyzed. Of 1236 L‐LH, 770 patients met the study criteria. Baseline clinical and surgical characteristics with a potential impact on LLR were included in a multi‐label conditional interference tree. Tumor size cut‐off was algorithmically determined. Results: Patients were stratified into 3 groups based on tumor location and dimension: 457 in antero‐lateral location (Group 1), 144 in postero‐superior segment (4a) with tumor size ≤40 mm (Group 2), and 169 in postero‐superior segment (4a) with tumor size >40 mm (Group 3). Patients in the Group 3 had higher conversion rate (7.0% vs. 7.6% vs. 13.0%, p‐value.048), longer operating time (median, 240 min vs. 285 min vs. 286 min, p‐value <.001), greater blood loss (median, 150 mL vs. 200 mL vs. 250 mL, p‐value <.001) and higher intraoperative blood transfusion rate (5.7% vs. 5.6% vs. 11.3%, p‐value.039). Pringle's maneuver was also utilized more frequently in Group 3 (66.7%), compared to Group 1 (53.2%) and Group 2 (51.8%) (p =.006). There were no significant differences in postoperative stay, major morbidity, and mortality between the three groups. Conclusion: L‐LH for tumors that are >40 mm in diameter and located in PS Segment 4a are associated with the highest degree of technical difficulty. However, post‐operative outcomes were not different from L‐LH of smaller tumors located in PS segments, or tumors located in the antero‐lateral segments. [ABSTRACT FROM AUTHOR]
Published: 2023
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76. Impact of neoadjuvant chemotherapy on the difficulty and outcomes of laparoscopic and robotic major liver resections for colorectal liver metastases: A propensity-score and coarsened exact-matched controlled study.

Author: Ghotbi, Jacob, Aghayan, Davit, Fretland, Åsmund, Edwin, Bjørn, Syn, Nicholas L., Cipriani, Federica, Alzoubi, Mohammed, Lim, Chetana, Scatton, Olivier, Long, Tran Cong duy, Herman, Paulo, Coelho, Fabricio Ferreira, Marino, Marco V., Mazzaferro, Vincenzo, Chiow, Adrian K.H., Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung-Hoon, Lee, Jae Hoon, and Prieto, Mikel
Subjects: COLORECTAL liver metastasis, LIVER surgery, NEOADJUVANT chemotherapy, LIVER, LAPAROSCOPIC surgery, ROBOTICS
Abstract: Minimal invasive liver resections are a safe alternative to open surgery. Different scoring systems considering different risks factors have been developed to predict the risks associated with these procedures, especially challenging major liver resections (MLR). However, the impact of neoadjuvant chemotherapy (NAT) on the difficulty of minimally invasive MLRs remains poorly investigated. Patients who underwent laparoscopic and robotic MLRs for colorectal liver metastases (CRLM) performed across 57 centers between January 2005 to December 2021 were included in this analysis. Patients who did or did not receive NAT were matched based on 1:1 coarsened exact and 1:2 propensity-score matching. Pre- and post-matching comparisons were performed. In total, the data of 5189 patients were reviewed. Of these, 1411 procedures were performed for CRLM, and 1061 cases met the inclusion criteria. After excluding 27 cases with missing data on NAT, 1034 patients (NAT: n = 641; non-NAT: n = 393) were included. Before matching, baseline characteristics were vastly different. Before matching, the morbidity rate was significantly higher in the NAT-group (33.2% vs. 27.2%, p-value = 0.043). No significant differences were seen in perioperative outcomes after the coarsened exact matching. After the propensity-score matching, statistically significant higher blood loss (mean, 300 (SD 128–596) vs. 250 (SD 100–400) ml, p-value = 0.047) but shorter hospital stay (mean, 6 [ 4-8] vs. 6 [ 5-9] days, p-value = 0.043) were found in the NAT-group. The current study demonstrated that NAT had minimal impact on the difficulty and outcomes of minimally-invasive MLR for CRLM. Abbreviated abstract: The impact of neoadjuvant chemotherapy (NAT) on the difficulty of minimally invasive major liver resections (MLRs) remains poorly investigated. NAT had minimal impact on the difficulty and outcomes of minimally-invasive MLR for colorectal liver metastases. [ABSTRACT FROM AUTHOR]
Published: 2023
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77. Laparoscopic anatomical liver resection after complex blunt liver trauma: a case report

Author: Ivanecz, Arpad, Pivec, Vid, Ilijevec, Bojan, Rudolf, Saša, and Potrč, Stojan
Published: 2018
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78. Laparoscopic liver resection for colorectal metastases – treatment results

Author: Arpad Ivanecz, Vid Pivec, Irena Plahuta, Bojan Krebs, Tomaž Jagrič, and Stojan Potrč
Subjects: laparoscopic liver resection, colorectal liver metastases, morbidity, mortality, survival analysis, Medicine
Abstract: Background: In many referral centers, laparoscopic liver resection (LLR) is a well-established method for the management of colorectal liver metastases (CLM). The aim of this study is to review a single institution experience.Methods: Between April 2008 and September 2016, 58 patients underwent LLR for various benign and malignant liver tumors. The analysis included 12 patients operated on for CLM. The primary outcomes of this prospective non-randomized study included operative procedure and operating time (minutes), estimated blood loss (mL), conversion rate, R0 resections, resection margins (mm), length of hospital stay (days), post-operative morbidity, and mortality. The secondary outcome of the study was survival analysis.Results: Eight patients (67 %) had atypical LLR. The average operating time was 130 minutes (range 60–210 minutes). The mean estimated blood loss was 140 mL (range < 50–600 mL). In one patient LLR was converted to open procedure (conversion rate 8 %). Seven patients (58 %) had one liver metastasis. The mean metastasis size was 3.6 cm (range 1–9 cm). R0 resection was achieved in all cases. The mean resection margin was 6.8 mm (range 2–15 mm). Te mean length of hospital stay was 6 days (range 3–12 days). Morbidity and mortality rates were 0 %. The median follow-up for surviving patients was 13 months. Nine patients are alive with no evidence of disease, two patients are alive with disease and one patient died of disease.Conclusion: LLR is a feasible and safe method for the treatment of CLM and there is no compromise of oncological surgical principles.
Published: 2017

79. Hepatocelični rak - možnost resekcije jeter

Author: Arpad Ivanecz, Marko Sremec, Tomaž Jagrič, and Stojan Potrč
Subjects: jetra, hepatocelični rak, resekcija, kirurški postopki, operativni, zapleti, smrtnost, preživetje, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Resekcija jeter (RJ) je ostala glavna oblika terapije pri solitarnem hepatoceličnem raku (HCC), pri bolnikih z ohranjeno funkcijsko rezervo jeter in v primernem splošnem stanju. Izpopolnjene slikovne preiskave so pripomogle k boljši izbiri bolnikov. Kirurgija jeter je napredovala: uporabne so številne tehnike transekcije jetrnega tkiva; dosegljive so različne naprave, ki omogočajo hitrejše in natančnejše operiranje v brezkrvnem operativnem polju. Izboljšana kirurška tehnika, vzdrževanje nizkega centralnega venskega pritiska in napredek pri negi bolnika po operaciji so omogočili, da se je smrtnost po operaciji jeter v izbranih serijah znižala celo do 0%. Barcelona Clinic Liver Cancer (BCLC) klasifikacija poleg zamejitve bolezni, nudi priporočila tudi glede izbora terapije. Kirurško terapijo omejuje zgolj na bolnike z zgodnjim stadijem raka. Namen tega prispevka je raziskati, ali je v sedanjem času mogoče RJ opraviti s sprejemljivimi kratko- in dolgoročnimi rezultati tudi pri bolnikih s takšnim HCC, pri katerem so prisotni številni in veliki tumorji, ki makroskopsko vdirajo v žile.
Published: 2014

80. Dosežki kirurškega zdravljenja bolnikov z jetrnimi zasevki raka debelega črevesa in danke od 2000 do 2020

Author: Plahuta, Irena, primary, Magdalenić, Tomislav, additional, Turk, Špela, additional, Potrč, Stojan, additional, and Ivanecz, Arpad, additional
Published: 2022
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81. Factors associated with and impact of open conversion on the outcomes of minimally invasive left lateral sectionectomies: An international multicenter study

Author: Wang, Hao Ping, primary, Yong, Chee Chien, additional, Wu, Andrew G.R., additional, Cherqui, Daniel, additional, Troisi, Roberto I., additional, Cipriani, Federica, additional, Aghayan, Davit, additional, Marino, Marco V., additional, Belli, Andrea, additional, Chiow, Adrian K.H., additional, Sucandy, Iswanto, additional, Ivanecz, Arpad, additional, Vivarelli, Marco, additional, Di Benedetto, Fabrizio, additional, Choi, Sung-Hoon, additional, Lee, Jae Hoon, additional, Park, James O., additional, Gastaca, Mikel, additional, Fondevila, Constantino, additional, Efanov, Mikhail, additional, Rotellar, Fernando, additional, Choi, Gi-Hong, additional, Campos, Ricardo Robles, additional, Wang, Xiaoying, additional, Sutcliffe, Robert P., additional, Pratschke, Johann, additional, Tang, Chung Ngai, additional, Chong, Charing C., additional, D’Hondt, Mathieu, additional, Ruzzenente, Andrea, additional, Herman, Paolo, additional, Kingham, T. Peter, additional, Scatton, Olivier, additional, Liu, Rong, additional, Ferrero, Alessandro, additional, Levi Sandri, Giovanni Battista, additional, Soubrane, Olivier, additional, Mejia, Alejandro, additional, Lopez-Ben, Santiago, additional, Sijberden, Jasper, additional, Monden, Kazuteru, additional, Wakabayashi, Go, additional, Sugioka, Atsushi, additional, Cheung, Tan-To, additional, Long, Tran Cong Duy, additional, Edwin, Bjorn, additional, Han, Ho-Seong, additional, Fuks, David, additional, Aldrighetti, Luca, additional, Abu Hilal, Mohamed, additional, Goh, Brian K.P., additional, Chan, Chung-Yip, additional, Syn, Nicholas, additional, Prieto, Mikel, additional, Schotte, Henri, additional, De Meyere, Celine, additional, Krenzien, Felix, additional, Schmelzle, Moritz, additional, Lee, Kit-Fai, additional, Salimgereeva, Diana, additional, Alikhanov, Ruslan, additional, Lee, Lip Seng, additional, Jang, Jae Young, additional, Labadie, Kevin P., additional, Kojima, Masayuki, additional, Kato, Yutaro, additional, Fretland, Asmund Avdem, additional, Ghotbi, Jacob, additional, Coelho, Fabricio Ferreira, additional, Pirola Kruger, Jaime Arthur, additional, Lopez-Lopez, Victor, additional, Magistri, Paolo, additional, Valle, Bernardo Dalla, additional, Casellas I Robert, Margarida, additional, Mishima, Kohei, additional, Ettorre, Giuseppe Maria, additional, Mocchegiani, Federico, additional, Kadam, Prashant, additional, Pascual, Franco, additional, Saleh, Mansour, additional, Mazzotta, Alessandro, additional, Montalti, Roberto, additional, Giglio, Mariano, additional, Lee, Boram, additional, D’Silva, Mizelle, additional, Nghia, Phan Phuoc, additional, Lim, Chetana, additional, Liu, Qu, additional, and Lai, Eric C., additional
Published: 2022
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82. Utility of the Iwate difficulty scoring system for laparoscopic right posterior sectionectomy: do surgical outcomes differ for tumors in segments VI and VII?

Author: Choi, S. H., Chen, K. -H., Syn, N. L., Cipriani, F., Cheung, T. -T., Chiow, A. K. H., Choi, G. -H., Siow, T. -F., Sucandy, I., Marino, M. V., Gastaca, M., Chong, C. C., Lee, J. H., Ivanecz, A., Mazzaferro, V., Lopez-Ben, S., Fondevila, C., Rotellar, F., Campos, R. R., Efanov, M., Kingham, T. P., Sutcliffe, R. P., Troisi, R. I., Pratschke, J., Wang, X., D'Hondt, M., Yong, C. C., Levi Sandri, G. B., Tang, C. N., Ruzzenente, A., Cherqui, D., Ferrero, A., Wakabayashi, G., Scatton, O., Aghayan, D., Edwin, B., Coelho, F. F., Giuliante, Felice, Liu, R., Sijberden, J., Abu Hilal, M., Sugioka, A., Long, T. C. D., Fuks, D., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Kang, I., Jang, J. Y., Chan, C. -Y., D'Silva, M., Schotte, H., De Meyere, C., Lai, E., Krenzien, F., Schmelzle, M., Kadam, P., Montalti, R., Giglio, M., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Prieto, M., Lim, C., Nghia, P. P., Kojima, M., Kato, Y., Forchino, F., Herman, P., Kruger, J. A. P., Saleh, M., Pascual, F., Dalla Valle, B., Lopez-Lopez, V., Casellas-Robert, M., Giustizieri, U., Citterio, D., Mishima, K., Fretland, A. A., Ghotbi, J., Ettorre, G. M., Colasanti, M., Guzman, Y., Ardito, Francesco, Vani, S., Wang, H. -P., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Choi, S. H., Chen, K. -H., Syn, N. L., Cipriani, F., Cheung, T. -T., Chiow, A. K. H., Choi, G. -H., Siow, T. -F., Sucandy, I., Marino, M. V., Gastaca, M., Chong, C. C., Lee, J. H., Ivanecz, A., Mazzaferro, V., Lopez-Ben, S., Fondevila, C., Rotellar, F., Campos, R. R., Efanov, M., Kingham, T. P., Sutcliffe, R. P., Troisi, R. I., Pratschke, J., Wang, X., D'Hondt, M., Yong, C. C., Levi Sandri, G. B., Tang, C. N., Ruzzenente, A., Cherqui, D., Ferrero, A., Wakabayashi, G., Scatton, O., Aghayan, D., Edwin, B., Coelho, F. F., Giuliante, Felice, Liu, R., Sijberden, J., Abu Hilal, M., Sugioka, A., Long, T. C. D., Fuks, D., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Kang, I., Jang, J. Y., Chan, C. -Y., D'Silva, M., Schotte, H., De Meyere, C., Lai, E., Krenzien, F., Schmelzle, M., Kadam, P., Montalti, R., Giglio, M., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Prieto, M., Lim, C., Nghia, P. P., Kojima, M., Kato, Y., Forchino, F., Herman, P., Kruger, J. A. P., Saleh, M., Pascual, F., Dalla Valle, B., Lopez-Lopez, V., Casellas-Robert, M., Giustizieri, U., Citterio, D., Mishima, K., Fretland, A. A., Ghotbi, J., Ettorre, G. M., Colasanti, M., Guzman, Y., Ardito, Francesco, Vani, S., Wang, H. -P., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)
Abstract: Introduction: The Iwate Score (IS) have not been well-validated for specific procedures, especially for right posterior sectionectomy (RPS). In this study, the utility of the IS was determined for laparoscopic (L)RPS and the effect of tumor location on surgical outcomes was investigated. Methods: Post-hoc analysis of 647 L-RPS performed in 40 international centers of which 596L-RPS cases met the inclusion criteria. Baseline characteristics and perioperative outcomes of patients stratified based on the Iwate score were compared to determine whether a correlation with surgical difficulty existed. A 1:1 Mahalanobis distance matching was utilized to investigate the effect of tumor location on L-RPS outcomes. Results: The patients were stratified into 3 levels of difficulty (31 intermediate, 143 advanced, and 422 expert) based on the IS. When using a stepwise increase of the IS excluding the tumor location score, only Pringle’s maneuver was more frequently used in the higher surgical difficulty level (35.5%, 54.6%, and 65.2%, intermediate, advanced, and expert levels, respectively, Z = 3.34, p = 0.001). Other perioperative results were not associated with a statistical gradation toward higher difficulty level. 80 of 85 patients with a segment VI lesion and 511 patients with a segment VII lesion were matched 1:1. There were no significant differences in the perioperative outcomes of the two groups including open conversion, operating time, blood loss, intraoperative blood transfusion, postoperative stay, major morbidity, and mortality. Conclusion: Among patients undergoing L-RPS, the IS did not significantly correlate with most outcome measures associated with intraoperative difficulty and postoperative outcomes. Similarly, tumor location had no effect on L-RPS outcomes.
Published: 2022

83. Ponovne operacije jeter pri recidivu zasevkov raka debelega črevesa in danke

Author: Arpad Ivanecz, Jasmina Golc, Jasna Zakelšek, Marko Sremec, and Stojan Potrč
Subjects: jetra, kolorektalne novotvorbe, rak debelega črevesa, prognoza, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Pri polovici bolnikov z rakom debelega črevesa in danke se lahko pojavijo zasevki v jetrih. Multidisciplinarna obravnava predstavlja temelj uspešnega zdravljenja, resekcija jeter pa je edina potencialno kurativna oblika terapije. Kljub uspešni operaciji pa se lahko jetrni zasevki kasneje ponovijo. Tudi v takšnem primeru je smiselno znova začeti zdravljenje, ki zajema kombinacijo kemoterapije, tarčnih zdravil in načrtovanja ponovnih jetrnih resekcij. Nekateri bolniki živijo brez ponovitve obolenja več let po začetku zdravljenja.
Published: 2013

84. Rezultati kirurškega zdravljenja resektabilnih jetrnih metastaz pri raku debelega črevesa in danke v UKC Maribor

Author: Stojan Potrč, Matjaž Horvat, Tomaž Jagrič, Janja Ocvirk, Bojan Krebs, and Arpad Ivanecz
Subjects: kolorektalne novotvorbe, jetra, metastaze, debelo črevo, rak, resekcije, preživetje, survival, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Izhodišča: Pri bolnikih z jetrnimi metastazami (JM) pri kolorektalnem raku (KRR) le kirurško zdravljenje, sedaj pogosto kombinirano z drugimi načini zdravljenja, nudi možnost dolgotrajnejšega preživetja ali pa celo upanje na ozdravitev. Namen raziskave je prikaz možnosti multimodalnega načina zdravljenja in ocenitev rezultatov takšnega zdravljenja JM pri KRR pri naših bolnikih. Metode: V obdobju od 1. julija 1997 do 31. decembra 2011 je bilo opravljenih 377 jetrnih operacij pri 281 bolnikih z metastazami KRR (178 moški, 103 ženske; povprečna starost 63,3 leta; razpon 27 do 85 let). Rezultati: Od skupno 377 operacij zaradi JM KRR je bila 324-krat opravljena resekcija jeter, od tega pri 28 bolnikih kombinirana z RFA. 235 (79,4 %) je bilo R0 resekcij, 54 (18,2 %) je bilo R1 in 7 (2,4 %) R2 resekcij. Skupno 53 posegi so bile RFA JM. Pri 113 bolnikih so bile JM ugotovljene sinhrono ob ugotovitvi KRR, pri 168 pa je šlo za metahrone JM. 145 bolnikov je imelo unilobarne, 136 pa bilobarne metastaze. Povprečno je bilo 2,9 jetrnih metastaz, povprečna velikost metastaz pa je bila 4,3 cm. Pri 46 bolnikih je bilo obolenje prisotno tudi zunaj jeter. 131 bolnikov je pred jetrno operacijo prejemalo neoadjuvantno kemoterapijo. 16-krat je bila za povečanje preostanka jeter opravljena portalna embolizacija, 10-krat pa ligatura desne veje vene porte. Simultana resekcija jeter je bila narejena pri 41 bolnikih. Pri prvi operaciji je bila opravljena resekcija jeter pri 252 bolnikih. Pri 239 bolnikih je bila narejena samo resekcija jeter, pri 23 bolnikih pa je bila resekcija kombinirana še z radiofrekventno ablacijo JM (RFA). Od 239 resekcij JM brez dodatne RFA je bilo 198 (83 %) resekcij R0, 36 (15 %) R1, 5 (2 %) pa R2 resekcij. Pri 29 bolnikih je bila narejena samo RFA JM (20-krat odprta RFA, 9-krat perkutana RFA). Zaradi ponovitve obolenja smo operirali 73 bolnikov, pri katerih smo opravili 96 posegov (1 do 6 na bolnika). Upoštevajoč vse opravljene operacije (377) je bila skupna pooperacijska obolevnost 25,5 %, 30-dnevna umrljivost pa je bila 1,9 %. Pričakovano 5-letno preživetje pri bolnikih z R0 resekcijo JM in brez zunaj jetrnega obolenja je bilo 38,3 % (mediano preživetje: 43 mesecev). Zaključki: Resekcije jeter so varne (morbiditeta: 25,5 %; 30 mortaliteta: 1,9 pri R0 resekcijah), glede na pričakovano dolgoročno preživetje (5-letno 38,3 %, mediana 43 mesecev) pa trenutno predstavljajo najučinkovitejši način zdravljenja bolnikov z metastazami KRR. Poudarjen je pomen multidisciplinarnega pristopa in multimodalnega zdravljenja bolnikov z metastazami KRR ; slv - slovenski
Published: 2013

85. Impact of tumor size on the difficulty of laparoscopic left lateral sectionectomies.

Author: Aizza, Giada, Russolillo, Nadia, Ferrero, Alessandro, Syn, Nicholas L., Cipriani, Federica, Aghayan, Davit, Marino, Marco V., Memeo, Riccardo, Mazzaferro, Vincenzo, Chiow, Adrian K. H., Sucandy, Iswanto, Ivanecz, Arpad, Vivarelli, Marco, Di Benedetto, Fabrizio, Choi, Sung‐Hoon, Lee, Jae Hoon, Park, James O., Gastaca, Mikel, Fondevila, Constantino, and Efanov, Mikhail
Abstract: Background: Tumor size (TS) represents a critical parameter in the risk assessment of laparoscopic liver resections (LLR). Moreover, TS has been rarely related to the extent of liver resection. The aim of this study was to study the relationship between tumor size and difficulty of laparoscopic left lateral sectionectomy (L‐LLS). Methods: The impact of TS cutoffs was investigated by stratifying tumor size at each 10 mm‐interval. The optimal cutoffs were chosen taking into consideration the number of endpoints which show a statistically significant split around the cut‐points of interest and the magnitude of relative risk after correction for multiple risk factors. Results: A total of 1910 L‐LLS were included. Overall, open conversion and intraoperative blood transfusion were 3.1 and 3.3%, respectively. The major morbidity rate was 2.7% and 90‐days mortality 0.6%. Three optimal TS cutoffs were identified: 40‐, 70‐, and 100‐mm. All the selected cutoffs showed a significant discriminative power for the prediction of open conversion, operative time, blood transfusion and need of Pringle maneuver. Moreover, 70‐ and 100‐mm cutoffs were both discriminative for estimated blood loss and major complications. A stepwise increase in rates of open conversion rate (Z = 3.90, P <.001), operative time (Z = 3.84, P <.001), blood loss (Z = 6.50, P <.001), intraoperative blood transfusion rate (Z = 5.15, P <.001), Pringle maneuver use (Z = 6.48, P <.001), major morbidity(Z = 2.17, P =.030) and 30‐days readmission (Z = 1.99, P =.047) was registered as the size increased. Conclusion: L‐LLS for tumors of increasing size was associated with poorer intraoperative and early postoperative outcomes suggesting increasing difficulty of the procedure. We determined three optimal TS cutoffs (40‐, 70‐ and 100‐mm) to accurately stratify surgical difficulty after L‐LLS. [ABSTRACT FROM AUTHOR]
Published: 2023
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86. Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: a multicenter propensity score-matched study.

Author: Sahakyan, Mushegh A., Aghayan, Davit L., Edwin, Bjørn, Alikhanov, Ruslan, Britskaia, Natalia, Brudvik, Kristoffer Watten, D'Hondt, Mathieu, De Meyere, Celine, Efanov, Mikhail, Fretland, Åsmund A., Hoff, Rune, Ismail, Warsan, Ivanecz, Arpad, Kazaryan, Airazat M., Lassen, Kristoffer, Magdalenić, Tomislav, Parmentier, Isabelle, Røsok, Bård Ingvald, Villanger, Olaug, and Yaqub, Sheraz
Subjects: LYMPHADENECTOMY, LIVER surgery, LAPAROSCOPIC surgery, CHOLANGIOCARCINOMA, PROPENSITY score matching, LIVER, REOPERATION
Abstract: The role of laparoscopy in the treatment of intrahepatic cholangiocarcinoma (ICC) remains unclear. This multicenter study examined the outcomes of laparoscopic liver resection for ICC. Patients with ICC who had undergone laparoscopic or open liver resection between 2012 and 2019 at four European expert centers were included in the study. Laparoscopic and open approaches were compared in terms of surgical and oncological outcomes. Propensity score matching was used for minimizing treatment selection bias and adjusting for confounders (age, ASA grade, tumor size, location, number of tumors and underlying liver disease). Of 136 patients, 50 (36.7%) underwent laparoscopic resection, whereas 86 (63.3%) had open surgery. Median tumor size was larger (73.6 vs 55.1 mm, p = 0.01) and the incidence of bi-lobar tumors was higher (36.6 vs 6%, p < 0.01) in patients undergoing open surgery. After propensity score matching baseline characteristics were comparable although open surgery was associated with a larger fraction of major liver resections (74 vs 38%, p < 0.01), lymphadenectomy (60 vs 20%, p < 0.01) and longer operative time (294 vs 209 min, p < 0.01). Tumor characteristics were similar. Laparoscopic resection resulted in less complications (30 vs 52%, p = 0.025), fewer reoperations (4 vs 16%, p = 0.046) and shorter hospital stay (5 vs 8 days, p < 0.01). No differences were found in terms of recurrence, recurrence-free and overall survival. Laparoscopic resection seems to be associated with improved short-term and with similar long-term outcomes compared with open surgery in patients with ICC. However, possible selection criteria for laparoscopic surgery are yet to be defined. [ABSTRACT FROM AUTHOR]
Published: 2023
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87. Electrochemotherapy – An effective method for treatment of tumors with combination of chemotherapeutic agent and electric field

Author: Tina Stepišnik, Tomaž Jarm, Aleš Grošelj, Ibrahim Edhemović, Mihajlo Djokić, Arpad Ivanecz, Blaž Trotovšek, Erik Brecelj, Stojan Potrč, Maja Čemažar, Nebojša Glumac, Tjaša Pečnik, Biserka Veberič, Eldar Gadžijev, Primož Strojan, Marko Snoj, Damijan Miklavčič, and Gregor Serša
Subjects: electrochemotherapy, electroporation, chemotherapeutic agent, tumor, cancer treatment, Medicine
Abstract: Electrochemotherapy is a local treatment for skin tumors and also deep seated tumors and metastases. Electrochemotherapy is based on enhanced cytotoxic effectiveness of bleomycin or cisplatin by electroporation, which increases drug delivery into cells in tumors. Electrochemotherapy is an ablative technique of high effectiveness with over 80% objective responses of electrochemotherapy treated tumors. Its advantage is the simplicity of the procedure that can be utilized in treatment of different tumor histiotypes. Currently it is predominantly used in palliative intent when the other treatment options have been exhausted. For the translation of electrochemotherapy into the clinics also the technological development that is now focusing into the treatment of deep-seated tumors was important. In Slovenia we are at the forefront in the treatment of liver tumors and head and neck tumors, while the others are developing electrochemotherapy for treatment of bone and brain metastases as well as endoluminal tumors.
Published: 2016

88. Evaluation of the Iwate Model for Predicting the Difficulty of Laparoscopic Liver Resection: Does Tumor Size Matter?

Author: Iztok Peruš, Irena Plahuta, Arpad Ivanecz, Tomislav Magdalenić, Bojan Ilijevec, Stojan Potrč, and Matej Mencinger
Subjects: medicine.medical_specialty, Tumor size, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Gastroenterology, 030230 surgery, Liver resections, Surgery, Resection, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, Risk curves, Hepatectomy, business, Laparoscopy
Abstract: This study aimed to externally validate the Iwate scoring model and its prognostic value for predicting the risks of intra- and postoperative complications of laparoscopic liver resection. Consecutive patients who underwent pure laparoscopic liver resection between 2008 and 2019 at a single tertiary center were included. The Iwate scores were calculated according to the original proposition (four difficulty levels based on six indices). Intra- and postoperative complications were compared across difficulty levels. Fitting the obtained data to the cumulative density function of the Weibull distribution and a linear function provided the mean risk curves for intra- and postoperative complications, respectively. The difficulty levels of 142 laparoscopic liver resections were scored as low, intermediate, advanced, and expert level in 41 (28.9%), 53 (37.3%), 32 (22.5%), and 16 (11.3%) patients, respectively. Intraoperative complications were detected in 26 (18.3%) patients and its rates (2.4%, 7.5%, 34.3%, and 62.5%) increased gradually with statistically significant values among difficulty levels (P ˂ 0.001). Major postoperative complications occurred in 21 (14.8%) patients and its rates (4.8%, 5.6%, 28.1%, 43.7%; P ˂ 0.001) showed the same trend as for intraoperative complications. Then, the mean risk curves of both complications were obtained. Due to outliers, a new threshold for a tumor size index was proposed at 38 mm. The repeated analysis showed improved results. The Iwate scoring model predicts the probability of complications across difficulty levels. Our proposed tumor size threshold (38 mm) improves the quality of the prediction. The model is upgraded by a probability of complications for every difficulty score.
Published: 2020
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89. Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: a multicenter propensity score-matched study

Author: Mushegh A. Sahakyan, Davit L. Aghayan, Bjørn Edwin, Ruslan Alikhanov, Natalia Britskaia, Kristoffer Watten Brudvik, Mathieu D’Hondt, Celine De Meyere, Mikhail Efanov, Åsmund A. Fretland, Rune Hoff, Warsan Ismail, Arpad Ivanecz, Airazat M. Kazaryan, Kristoffer Lassen, Tomislav Magdalenić, Isabelle Parmentier, Bård Ingvald Røsok, Olaug Villanger, and Sheraz Yaqub
Subjects: Gastroenterology
Abstract: The role of laparoscopy in the treatment of intrahepatic cholangiocarcinoma (ICC) remains unclear. This multicenter study examined the outcomes of laparoscopic liver resection for ICC. Patients with ICC who had undergone laparoscopic or open liver resection between 2012 and 2019 at four European expert centers were included in the study. Laparoscopic and open approaches were compared in terms of surgical and oncological outcomes. Propensity score matching was used for minimizing treatment selection bias and adjusting for confounders (age, ASA grade, tumor size, location, number of tumors and underlying liver disease). Of 136 patients, 50 (36.7%) underwent laparoscopic resection, whereas 86 (63.3%) had open surgery. Median tumor size was larger (73.6 vs 55.1 mm, p = 0.01) and the incidence of bi-lobar tumors was higher (36.6 vs 6%, p < 0.01) in patients undergoing open surgery. After propensity score matching baseline characteristics were comparable although open surgery was associated with a larger fraction of major liver resections (74 vs 38%, p < 0.01), lymphadenectomy (60 vs 20%, p < 0.01) and longer operative time (294 vs 209 min, p < 0.01). Tumor characteristics were similar. Laparoscopic resection resulted in less complications (30 vs 52%, p = 0.025), fewer reoperations (4 vs 16%, p = 0.046) and shorter hospital stay (5 vs 8 days, p < 0.01). No differences were found in terms of recurrence, recurrence-free and overall survival. Laparoscopic resection seems to be associated with improved short-term and with similar long-term outcomes compared with open surgery in patients with ICC. However, possible selection criteria for laparoscopic surgery are yet to be defined.
Published: 2022
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90. Heterogeneity of management practices surrounding operable gallbladder cancer – results of the OMEGA-S international HPB surgical survey

Author: Anita Balakrishnan, Asif Jah, Mickael Lesurtel, Bodil Andersson, Paul Gibbs, Simon J.F. Harper, Emmanuel L. Huguet, Vasilis Kosmoliaptsis, Siong S. Liau, Raaj K. Praseedom, Jose M. Ramia, Alejandro Branes, Javier Lendoire, Shishir Maithel, Alejandro Serrablo, T. Abe, M. Achalandabaso, M. Adham, A. Ahmet, B. Al-Sarireh, M. Albiol Quer, F. Alconchel, M. Alsammani, A. Alseidi, A. Anand, A. Anselmo, P. Antonakis, E. Arabadzhieva, X. de Aretxabala, S. Aroori, S. Ashley, F. Ausania, A. Banerjee, M. Barabino, A. Bartlett, F. Bartsch, A. Belli, J. Beristain-Hernandez, F. Berrevoet, A.B.H. Bhatti, R. Bhojwani, B. Bjornsson, T. Blaz, M. Byrne, M.P. Calvo, J. Castellanos, M.J. Castro, D. Cavallucci, D. Chang, G. Christodoulis, O. Ciacio, P.A. Clavien, A. Coker, M. Conde-Rodriguez, F.E. D'Amico, M. D'Hondt, F. Daams, B.V.M. Dasari, M. De Bellis, V.E. de Meijer, K. Dede, G. Deiro, F.J.B. Delgado, G. Desai, A. Di Gioia, M. Di Martino, M. Dixon, P. Dorovinis, T. Dumitrascu, T. Ebata, M.S. Eilard, J. Erdmann, M. Erkan, S. Famularo, E. Felli, M. Fergadi, G.B. Fernandez, A. Fox, S. Galodha, D. Galun, S. Ganandha, R.J.R. Garcia, G. Gemenetzis, F. Giannone, L. Gil, E. Giorgakis, F. Giovinazzo, M. Giuffrida, T. Giuliani, F. Giuliante, I. Gkekas, M. Goel, B.K. Goh, A. Gomes, T. Gruenberger, O. Guevara, A. Gulla, A. Gupta, R. Gupta, A.R. Hakeem, H.K.S. Hamid, S. Heinrich, S. Helton, R. Hernandez-Alejandro, A. Heumann, R. Higuchi, D. Hughes, B.C. Inarejos, A. Ivanecz, Y. Iwao, S. Iype, I. Jaen, M.J. Jie, R. Jones, K. Kacirek, R. Kalayarasan, A. Kaldarov, L. Kaman, H. Kanhere, V.K. Kapoor, P. Karanicolas, A. Karayiannakis, A. Kausar, Z.A. Khan, D.-S. Kim, J. Klose, B. Knowles, P.S. Koh, P. Kolodziejczyk, A.L. Komorowski, J.K. Koong, I. Kozyrin, A. Krishna, P. Kron, N. Kumar, S. van Laarhoven, P.J. Lakhey, J. Lanari, A. Laurenzi, V.M. Leow, Y. Limbu, Y.-B. Liu, S. Lob, E. Lolis, V. Lopez-Lopez, R.C. Lozano, L. Lundgren, N. Machairas, D. Magouliotis, A. Mahamid, D. Malde, A. Malek, H. Malik, G. Malleo, M.V. Marino, S.C. Mayo, M. Mazzola, R. Memeo, K. Menon, R. Menzulin, R. Mohan, H. Morgul, D. Moris, F. Mulita, E.M. Muttillo, C. Nahm, M. Nandasena, P.R. Nashidengo, A. Nickkholgh, A. Nikov, C. Noel, D. O'Reilly, T. O'Rourke, M. Ohtsuka, J.A.O. Omoshoro-Jones, S. Pandanaboyana, N. Pararas, R. Patel, S. Patkar, J.S. Peng, A. Perfecto, J. Perinel, K. Perivoliotis, T. Perra, M.T. Phan, G. Piccolo, A. Porcu, F. Primavesi, J. Primrose, E. Pueyo-Periz, D. Radenkovic, A. Rammohan, A. Rowcroft, J. Sakata, E. Saladino, C.A. Schena, A. Scholer, C. Schwarz, P. Serrano, M. Silva, K. Soreide, E. Sparrelid, S. Stattner, C. Sturesson, T. Sugiura, M. Sumo, R. Sutcliffe, C. Teh, J.Y. Teo, K. Tepetes, P.B. Thapa, A. Thepbunchonchai, J.B.P. Torres, O.J.M. Torres, G. Torzili, C. Tovikkai, A. Troncoso, G. Tsoulfas, A. Tuzuher, G. Tzimas, G.I. Umar, L. Urbani, T. Vanagas, null Varga, V. Velayutham, L. Vigano, T. Wakai, Z. Yang, V. Yip, D. Zacharoulis, E.A. Zakharov, G. Zimmitti, Surgery, CCA - Cancer Treatment and quality of life, and Amsterdam Gastroenterology Endocrinology Metabolism
Subjects: Surgeons, Common Bile Duct, Hepatology, Surveys and Questionnaires, Gastroenterology, Humans, Hepatectomy, Gallbladder Neoplasms
Abstract: Background: Gallbladder cancer (GBC) is an aggressive, uncommon malignancy, with variation in operative approaches adopted across centres and few large-scale studies to guide practice. We aimed to identify the extent of heterogeneity in GBC internationally to better inform the need for future multicentre studies. Methods: A 34-question online survey was disseminated to members of the European-African Hepatopancreatobiliary Association (EAHPBA), American Hepatopancreatobiliary Association (AHPBA) and Asia–Pacific Hepatopancreatobiliary Association (A-PHPBA) regarding practices around diagnostic workup, operative approach, utilization of neoadjuvant and adjuvant therapies and surveillance strategies. Results: Two hundred and three surgeons responded from 51 countries. High liver resection volume units (>50 resections/year) organised HPB multidisciplinary team discussion of GBCs more commonly than those with low volumes (p < 0.0001). Management practices exhibited areas of heterogeneity, particularly around operative extent. Contrary to consensus guidelines, anatomical liver resections were favoured over non-anatomical resections for T3 tumours and above, lymphadenectomy extent was lower than recommended, and a minority of respondents still routinely excised the common bile duct or port sites. Conclusion: Our findings suggest some similarities in the management of GBC internationally, but also specific areas of practice which differed from published guidelines. Transcontinental collaborative studies on GBC are necessary to establish evidence-based practice to minimise variation and optimise outcomes.
Published: 2022
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91. The Learning Curve of Laparoscopic Liver Resection Utilising the Southampton Difficulty Score

Author: Ivanecz, A., primary, Plahuta, I., additional, Mencinger, M., additional, Peruš, I., additional, Turk, Š., additional, Magdalenić, T., additional, and Potrč, S., additional
Published: 2022
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92. Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study

Author: Yama Issa, Hjalmar C. van Santvoort, Paul Fockens, Marc G. Besselink, Thomas L. Bollen, Marco J. Bruno, Marja A. Boermeester, Frank G. Moody, Claude Bertrand, Colin Johnson, Aude van Lander, Ross Carter, John B. Conneely, Frederik Berrevoet, Donzília Sousa Silva, Zong-Fang Li, Philippe Lévy, Kofi Oppong, Timothy B. Gardner, C. Mel Wilcox, Jeremy French, Michael Steer, Edward L. Bradley, Peter Layer, Bertrand Napoleon, Jorge Antonio Mosquera, D.J. Gouma, Roland Andersson, Antonio Manzelli, J.M. Klaase, Massimo Falconi, Enrique de-Madaria, Riccardo Casadei, Giuseppe Malleo, Raffaele Pezzilli, Ewa Malecka-Panas, Matthias Lohr, Julia Mayerle, Erik A.J. Rauws, Martin L. Freeman, Affirul Chairil Ariffin, Bhavin Vasavada, Paul Bo-San Lai, Jose Luis Beristain-Hernandez, Álvarez Juan, Haralds Plaudis, Dionisios Vrochides, Vincenzo Neri, Vimalraj Velayutham, Aleksey Andrianov, Joan Figueras, Kjetil Soreide, Aliaksei Shcherba, Mahir Gachabayov, Roger G. Keith, Georgios Tsoulfas, Michael Anthony Fink, Stefano Crippa, Mehrdad Nikfarjam, Dibyajyoti Bora, Rajendra Desai, Marcello Donati, Jan Jin Bong, Emma Martínez Moneo, Gareth Morris-Stiff, Ahmet Coker, Alexandre Prado de Resende, Suryabhan Sakhahari Bhalerao, Sadiq S. Sikora, Dezső Kelemen, László Czakó, Hariharan Ramesh, Oleg Rummo, Aliaksei Fedaruk, Alexey Hlinnik, Madhusudhan Chinthakindi, Traian Dumitrascu, Vyacheslav Egorov, Vincent Bettschart, Michele Molinari, E. Aldana D. Guillermo, Susan L. Orloff, Daniel Vasilev Kostov, Laurent Sulpice, Brett Knowles, Yasutoshi Kimura, Gabriele Marangoni, Rajeev Joshi, Tibor Gyökeres, null Bedin, V. Vladimir, Arpad Ivanecz, Adelmo Antonucci, Jones A.O. Omoshoro-Jones, Richard Nakache, Marco Del Chiaro, Marianne Johnstone, Tomoaki Saito, Gianpaolo Balzano, Serge Chooklin, Piero Boraschi, Walter Park, Pedro Nuno Valente Reis Pereira, Nico Pagano, Pavlos Lykoudis, Lars Ivo Partecke, Aliaksandr Siatkouski, Rosa Jorba Martín, Yasunari Kawabata, Luís Carvalho Lourenço, Carlos Marra-Lopez, Jun Kyu Lee, Nils Habbe, Robert C. Verdonk, Yliya Rabotyagova, Rupjyoti Talukdar, Luca Frulloni, Shamil Galeev, Zoltán Berger, Takeo Yasuda, Thilo Hackert, Ziyovuddin Saatov, Dimitri Aristotle Raptis, Jaume Boadas, Francesco Vitali, Livia Archibugi, Miroslav Ryska, Balazs Tihanyi, Vikesh K. Singh, Atsushi Masamune, Paul Yeaton, Kerrington D. Smith, Shrey Modi, Laura Cosen-Binker, Savio George Barreto, Eugenio Morandi, Sergio Valeri, Cintia Yoko Morioka, Luis F. Lara, Yoshifumi Takeyama, Frank G. Gress, Young-Dong Yu, Ezio Gaia, Sorin Traian Barbu, Ali Tüzün İnce, Akkraporn Deeprasertvit, Yu-Ting Chang, Stephen Olusola Abiola, Sabite Kacar, Peter Muscarella, Henri Braat, Samuel Han, Ali A. Aghdassi, Jean-Louis Frossard, Jill P. Smith, M.P. Schwartz, H.M. van Dullemen, N.G. Venneman, B.W.M. Spanier, Sjoerd Kuiken, Erwin van Geenen, Greg Beilman, Georgios Papachristou, Oscar Chapa Azuela, P. van der Schaar, Nevin Oruc, Marie-Paule Anten, William H. Nealon, Jesús García-Cano, Manol Jovani, Ziad Melki, Mustafa Mohammed Ahmed Ibrahim, M.U. Awajdarip, Mohammad Azam, K.G. Sabu, Igor Ermolaev, Shiran Shetty, Belei Oana, Juris Pokrotnieks, Malgorzata Lazuchiewicz-Kot, Riadh Bouali, Marek Winiarski, Marcus Schmitt, Mihai Rimbas, Alexander Meining, Bories Erwan, Peter N. Meier, Rainer Schoefl, Ahmed Youssef Altonbary, Igor Marsteller, Ingo Wallstabe, Skerdi Prifti, Arnaud Lemmers, M. Horvath, Ajay Kumar, Joseph J. Palermo, Issa, Y., van Santvoort, H. C., Fockens, P., Besselink, M. G., Bollen, T. L., Bruno, M. J., Boermeester, M. A., Moody, F. G., Bertrand, C., Johnson, C., van Lander, A., Carter, R., Conneely, J. B., Berrevoet, F., Sousa Silva, D., Li, Z. -F., Levy, P., Oppong, K., Gardner, T. B., Wilcox, C. M., French, J., Steer, M., Bradley, E. L., Layer, P., Napoleon, B., Mosquera, J. A., Gouma, D. J., Andersson, R., Manzelli, A., Klaase, J. M., Falconi, M., de-Madaria, E., Casadei, R., Malleo, G., Pezzilli, R., Malecka-Panas, E., Lohr, M., Mayerle, J., Rauws, E. A. J., Freeman, M. L., Ariffin, A. C., Vasavada, B., Lai, P. B. -S., Beristain-Hernandez, J. L., Juan, A., Plaudis, H., Vrochides, D., Neri, V., Velayutham, V., Andrianov, A., Figueras, J., Soreide, K., Shcherba, A., Gachabayov, M., Keith, R. G., Tsoulfas, G., Fink, M. A., Crippa, S., Nikfarjam, M., Bora, D., Desai, R., Donati, M., Bong, J. J., Martinez Moneo, E., Morris-Stiff, G., Coker, A., de Resende, A. P., Bhalerao, S. S., Sikora, S. S., Kelemen, D., Czako, L., Ramesh, H., Rummo, O., Fedaruk, A., Hlinnik, A., Chinthakindi, M., Dumitrascu, T., Egorov, V., Bettschart, V., Molinari, M., Guillermo, E. A. D., Orloff, S. L., Kostov, D. V., Sulpice, L., Knowles, B., Kimura, Y., Marangoni, G., Joshi, R., Gyokeres, T., Bedin, Vladimir, V., Ivanecz, A., Antonucci, A., Omoshoro-Jones, J. A. O., Nakache, R., Del Chiaro, M., Johnstone, M., Saito, T., Balzano, G., Chooklin, S., Boraschi, P., Park, W., Pereira, P. N. V. R., Pagano, N., Lykoudis, P., Partecke, L. I., Siatkouski, A., Martin, R. J., Kawabata, Y., Lourenco, L. C., Marra-Lopez, C., Lee, J. K., Habbe, N., Verdonk, R. C., Rabotyagova, Y., Talukdar, R., Frulloni, L., Galeev, S., Berger, Z., Yasuda, T., Hackert, T., Saatov, Z., Raptis, D. A., Boadas, J., Vitali, F., Archibugi, L., Ryska, M., Tihanyi, B., Singh, V. K., Masamune, A., Yeaton, P., Smith, K. D., Modi, S., Cosen-Binker, L., Barreto, S. G., Morandi, E., Valeri, S., Morioka, C. Y., Lara, L. F., Takeyama, Y., Gress, F. G., Yu, Y. -D., Gaia, E., Barbu, S. T., Ince, A. T., Deeprasertvit, A., Chang, Y. -T., Abiola, S. O., Kacar, S., Muscarella, P., Braat, H., Han, S., Aghdassi, A. A., Frossard, J. -L., Smith, J. P., Schwartz, M. P., van Dullemen, H. M., Venneman, N. G., Spanier, B. W. M., Kuiken, S., van Geenen, E., Beilman, G., Papachristou, G., Chapa Azuela, O., van der Schaar, P., Oruc, N., Anten, M. -P., Nealon, W. H., Garcia-Cano, J., Jovani, M., Melki, Z., Ibrahim, M. M. A., Awajdarip, M. U., Azam, M., Sabu, K. G., Ermolaev, I., Shetty, S., Oana, B., Pokrotnieks, J., Lazuchiewicz-Kot, M., Bouali, R., Winiarski, M., Schmitt, M., Rimbas, M., Meining, A., Erwan, B., Meier, P. N., Schoefl, R., Altonbary, A. Y., Marsteller, I., Wallstabe, I., Prifti, S., Lemmers, A., Horvath, M., Kumar, A., Palermo, J. J., Surgery, Amsterdam institute for Infection and Immunity, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, Cancer Center Amsterdam, APH - Methodology, AII - Infectious diseases, Issa, Yama, van Santvoort, Hjalmar C., Fockens, Paul, Besselink, Marc G., Bollen, Thomas L., Bruno, Marco J., Boermeester, Marja A., Moody, Frank G., Bertrand, Claude, Johnson, Colin, van Lander, Aude, Carter, Ro, Conneely, John B., Berrevoet, Frederik, Sousa Silva, Donzãlia, Zong-Fang, Li, Lã©vy, Philippe, Oppong, Kofi, Gardner, Timothy B., Wilcox, C. Mel, French, Jeremy, Steer, Michael, Bradley, Edward L., Layer, Peter, Napoleon, Bertrand, Mosquera, Jorge Antonio, Andersson, Roland, Manzelli, Antonio, Falconi, Massimo, de-Madaria, Enrique, Casadei, Riccardo, Malleo, Giuseppe, Pezzilli, Raffaele, Malecka-Panas, Ewa, Lohr, Matthia, Mayerle, Julia, Rauws, Erik A. J., Freeman, Martin L., Ariffin, Affirul Chairil, Vasavada, Bhavin, Lai, Paul Bo-San, Beristain-Hernandez, Jose Lui, Juan, Ã lvarez, Plaudis, Harald, Vrochides, Dionisio, Neri, Vincenzo, Velayutham, Vimalraj, Andrianov, Aleksey, Figueras, Joan, Soreide, Kjetil, Shcherba, Aliaksei, Gachabayov, Mahir, Keith, Roger G., Tsoulfas, Georgio, Fink, Michael Anthony, Crippa, Stefano, Nikfarjam, Mehrdad, Bora, Dibyajyoti, Desai, Rajendra, Donati, Marcello, Bong, Jan Jin, MartÃnez Moneo, Emma, Morris-Stiff, Gareth, Coker, Ahmet, de Resende, Alexandre Prado, Bhalerao, Suryabhan Sakhahari, Sikora, Sadiq S., Kelemen, Dezså, Czakã³, Lã¡szlã³, Ramesh, Hariharan, Rummo, Oleg, Fedaruk, Aliaksei, Hlinnik, Alexey, Chinthakindi, Madhusudhan, Dumitrascu, Traian, Egorov, Vyacheslav, Bettschart, Vincent, Molinari, Michele, Guillermo, E. Aldana D., Orloff, Susan L., Kostov, Daniel Vasilev, Sulpice, Laurent, Knowles, Brett, Kimura, Yasutoshi, Marangoni, Gabriele, Joshi, Rajeev, Gyã¶keres, Tibor, Bedin, Null, Ivanecz, Arpad, Antonucci, Adelmo, Omoshoro-Jones, Jones A. O., Nakache, Richard, Del Chiaro, Marco, Johnstone, Marianne, Saito, Tomoaki, Balzano, Gianpaolo, Chooklin, Serge, Boraschi, Piero, Park, Walter, Pereira, Pedro Nuno Valente Rei, Pagano, Nico, Lykoudis, Pavlo, Partecke, Lars Ivo, Siatkouski, Aliaksandr, Martãn, Rosa Jorba, Kawabata, Yasunari, Lourenã§o, LuÃs Carvalho, Marra-Lopez, Carlo, Lee, Jun Kyu, Habbe, Nil, Verdonk, Robert C., Rabotyagova, Yliya, Talukdar, Rupjyoti, Frulloni, Luca, Galeev, Shamil, Berger, Zoltã¡n, Yasuda, Takeo, Hackert, Thilo, Saatov, Ziyovuddin, Raptis, Dimitri Aristotle, Boadas, Jaume, Vitali, Francesco, Archibugi, Livia, Ryska, Miroslav, Tihanyi, Balaz, Singh, Vikesh K., Masamune, Atsushi, Yeaton, Paul, Smith, Kerrington D., Modi, Shrey, Cosen-Binker, Laura, Barreto, Savio George, Morandi, Eugenio, Valeri, Sergio, Morioka, Cintia Yoko, Lara, Luis F., Takeyama, Yoshifumi, Gress, Frank G., Young-Dong, Yu, Gaia, Ezio, Barbu, Sorin Traian, Ä°nce, Ali TÃ¼zÃ¼n, Deeprasertvit, Akkraporn, Chang, Yu-Ting, Abiola, Stephen Olusola, Kacar, Sabite, Muscarella, Peter, Braat, Henri, Han, Samuel, Aghdassi, Ali A., Frossard, Jean-Loui, Smith, Jill P., Kuiken, Sjoerd, van Geenen, Erwin, Beilman, Greg, Papachristou, Georgio, Chapa Azuela, Oscar, Oruc, Nevin, Anten, Marie-Paule, Nealon, William H., GarcÃa-Cano, Jesãº, Jovani, Manol, Melki, Ziad, Ibrahim, Mustafa Mohammed Ahmed, Azam, Mohammad, Ermolaev, Igor, Shetty, Shiran, Oana, Belei, Pokrotnieks, Juri, Lazuchiewicz-Kot, Malgorzata, Bouali, Riadh, Winiarski, Marek, Schmitt, Marcu, Rimbas, Mihai, Meining, Alexander, Erwan, Borie, Meier, Peter N., Schoefl, Rainer, Altonbary, Ahmed Youssef, Marsteller, Igor, Wallstabe, Ingo, Prifti, Skerdi, Lemmers, Arnaud, Kumar, Ajay, Palermo, Joseph J., and Gastroenterology & Hepatology
Subjects: Endoscopic ultrasound, medicine.medical_treatment, Islets of Langerhans Transplantation, Practice Patterns, Diagnosis, treatment, chronic pancreatitis, survey, Bioinformatics, 0302 clinical medicine, Risk Factors, Lithotripsy, Diagnosis, 03.02. Klinikai orvostan, Endoscopy, Digestive System, Chronic, Practice Patterns, Physicians', Tomography, Digestive System Surgical Procedures, treatment, medicine.diagnostic_test, Gastroenterology, Magnetic Resonance Imaging, X-Ray Computed, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Predictive value of tests, Pancreatectomy, 030211 gastroenterology & hepatology, Autologous, medicine.medical_specialty, Clinical Decision-Making, Transplantation, Autologous, Decision Support Techniques, chronic pancreatitis, 03 medical and health sciences, Predictive Value of Tests, Pancreatitis, Chronic, medicine, Humans, survey, Pancreatic duct, Transplantation, Physicians', Hepatology, business.industry, General surgery, Gastroenterologists, Endoscopy, Magnetic resonance imaging, medicine.disease, Pancreatitis, Health Care Surveys, Tomography, X-Ray Computed, business, Digestive System
Abstract: Background The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. Methods An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG. Results A total of 288 pancreatologists, 56% surgeons and 44% gastroenterologists, from at least 47 countries, participated in the survey. About half (48%) of the specialists used a classification tool for the diagnosis of CP, including the Mayo Clinic (28%), Mannheim (25%), or Buchler (25%) tools. Overall, CT was the preferred imaging modality for evaluation of an enlarged pancreatic head (59%), pseudocyst (55%), calcifications (75%), and peripancreatic fat infiltration (68%). MRI was preferred for assessment of main pancreatic duct (MPD) abnormalities (60%). Total pancreatectomy with auto-islet transplantation was the preferred treatment in patients with parenchymal calcifications without MPD abnormalities and in patients with refractory pain despite maximal medical, endoscopic, and surgical treatment. In patients with an enlarged pancreatic head, 58% preferred initial surgery (PPPD) versus 42% initial endoscopy. In patients with a dilated MPD and intraductal stones 56% preferred initial endoscopic ± ESWL treatment and 29% preferred initial surgical treatment. Conclusion Worldwide, clinical decision-making in CP is largely based on local expertise, beliefs and disbeliefs. Further development of evidence-based guidelines based on well designed (randomized) studies is strongly encouraged.
Published: 2017
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93. Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity‐score matched study.

Author: Efanov, Mikhail, Salimgereeva, Diana, Alikhanov, Ruslan, Wu, Andrew G. R., Geller, David, Cipriani, Federica, Aghayan, Davit L., Fretland, Asmund Avdem, Sijberden, Jasper, Belli, Andrea, Marino, Marco V., Mazzaferro, Vincenzo, Chiow, Adrian K. H., Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung Hoon, Lee, Jae Hoon, Prieto, Mikel, Vivarelli, Marco, and Giuliante, Felice
Abstract: Background: Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma‐sparing resection of the liver segments 7 and 8. Methods: A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8. Results: A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay. Conclusion: Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7. [ABSTRACT FROM AUTHOR]
Published: 2023
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94. Liver resection and ablation for squamous cell carcinoma liver metastases

Author: Engstrand, J, Abreu De Carvalho, LF, Aghayan, D, Balakrishnan, A, Belli, A, Björnsson, B, Dasari, BVM, Detry, O, Di Martino, M, Edwin, B, Erdmann, J, Fristedt, R, Fusai, G, Gimenez-Maurel, T, Hemmingsson, O, Hidalgo Salinas, C, Isaksson, B, Ivanecz, A, Izzo, F, Knoefel, WT, Kron, P, Lehwald-Tywuschik, N, Lesurtel, M, Lodge, JPA, Machairas, N, Marino, MV, Martin, V, Paterson, A, Rystedt, J, Sandström, P, Serrablo, A, Siriwardena, AK, Taflin, H, Van Gulik, TM, Yaqub, S, Özden, I, Ramia, JM, Sturesson, C, E-AHPBA Scientific And Research Committee, Engstrand, J [0000-0003-1123-7022], Aghayan, D [0000-0001-7051-3512], Belli, A [0000-0002-6252-573X], Detry, O [0000-0002-9436-6673], Di Martino, M [0000-0001-6510-7210], Hemmingsson, O [0000-0003-1732-168X], Lesurtel, M [0000-0003-2397-4599], Lodge, JPA [0000-0001-8771-4214], Machairas, N [0000-0003-3239-3905], Marino, MV [0000-0002-0466-4467], Rystedt, J [0000-0002-8865-9963], Yaqub, S [0000-0002-5696-2319], Ramia, JM [0000-0001-7734-9479], Sturesson, C [0000-0003-3451-2840], and Apollo - University of Cambridge Repository
Subjects: RISK, Liver Neoplasms, HEPATIC RESECTION, General Medicine, CANCER, Cohort Studies, NEUROENDOCRINE, Medicine and Health Sciences, SURVIVAL, Carcinoma, Squamous Cell, Humans, HEAD, Neoplasm Recurrence, Local, Retrospective Studies
Abstract: Funder: Region Stockholm, Funder: Region Stockholm (clinical postdoctoral appointment), BACKGROUND: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). METHOD: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. RESULTS: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). CONCLUSION: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.
Published: 2021
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95. The Learning Curve of Laparoscopic Liver Resection Utilising the Southampton Difficulty Score

Author: A. Ivanecz, I. Plahuta, M. Mencinger, I. Peruš, Š. Turk, T. Magdalenić, and S. Potrč
Subjects: Hepatology, Gastroenterology
Published: 2022
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96. Correction to: Outcomes After Distal Pancreatectomy with Celiac Axis Resection for Pancreatic Cancer: A Pan-European Retrospective Cohort Study

Author: Klompmaker, Sjors, van Hilst, Jony, Gerritsen, Sarah L., Adham, Mustapha, Teresa Albiol Quer, M., Bassi, Claudio, Berrevoet, Frederik, Boggi, Ugo, Busch, Olivier R., Cesaretti, Manuela, Dalla Valle, Raffaele, Darnis, Benjamin, De Pastena, Matteo, Del Chiaro, Marco, Grützmann, Robert, Diener, Markus K., Dumitrascu, Traian, Friess, Helmut, Ivanecz, Arpad, Karayiannakis, Anastasios, Fusai, Giuseppe K., Labori, Knut J., Lombardo, Carlo, López-Ben, Santiago, Mabrut, Jean-Yves, Niesen, Willem, Pardo, Fernando, Perinel, Julie, Popescu, Irinel, Roeyen, Geert, Sauvanet, Alain, Prasad, Raj, Sturesson, Christian, Lesurtel, Mickael, Kleeff, Jorg, Salvia, Roberto, Besselink, Marc G., and the E-AHPBA DP-CAR study group
Published: 2018
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97. Factors affecting the morbidity and mortality of diverting stoma closure: retrospective cohort analysis of twelve-year period

Author: Bojan Krebs, Matjaz Horvat, Arpad Ivanecz, and Stojan Potrč
Subjects: Adult, Male, medicine.medical_specialty, Time Factors, R895-920, morbidity, Anastomosis, digestive system, 03 medical and health sciences, Medical physics. Medical radiology. Nuclear medicine, 0302 clinical medicine, Ileus, Postoperative Complications, Stoma (medicine), Colostomy, medicine, Humans, Surgical Wound Infection, risk factors, Radiology, Nuclear Medicine and imaging, Closure (psychology), Aged, Retrospective Studies, Aged, 80 and over, business.industry, Ileostomy, Rectal Neoplasms, Mortality rate, Age Factors, Retrospective cohort study, Abdominal Wound Closure Techniques, Middle Aged, low anterior resection, surgical stoma closure, Wound infection, mortality, digestive system diseases, Surgery, Diverting stoma, surgical procedures, operative, Oncology, 030220 oncology & carcinogenesis, Rectal cancer surgery, 030211 gastroenterology & hepatology, Female, business, Research Article
Abstract: Background Diverting stoma is often performed in rectal cancer surgery for reducing the consequences of possible anastomotic failure. Closing of stoma follows in most cases after a few months. The aim of our study was to evaluate morbidity and mortality after diverting stoma closure and to identify risk factors for complications of this procedure. Patients and methods At our department, we have performed a retrospective cohort analysis of data for 260 patients with diverting stoma closure from 2003 to 2015. Age, stoma type, patient’s preoperative ASA score, surgical technique and time to stoma closure were investigated as factors which could influence the complication rate. Results 218 patients were eligible for investigation. Postoperative complications developed in 54 patients (24.8%). Most common complications were postoperative ileus (10%) and wound infection (5%). Four patients died (1.8%). There was no effect on complication rate regarding type of stoma, closing technique, patient’s ASA status and patient age. The only factor influencing the complication rate was the time to stoma closure. We found that patients which had the stoma closed prior to 8 months after primary surgery had lower overall complication rate (p Conclusions To reduce overall complication rate, our data suggest a shorter period than 8 months after primary surgery before closure of diverting stoma. As diverting stoma closure is not a simple operation, all strategies should be taken to reduce significant morbidity and mortality rate.
Published: 2019

98. Abandonment of surveillance, followed by emergency surgery for a second spontaneous rupture of hepatocellular carcinoma: A case report and review of the literature

Author: Arpad Ivanecz, Irena Plahuta, Mihael Jelenko, and Stojan Potrč
Subjects: Spontaneous rupture, medicine.medical_specialty, lcsh:Medicine, Case Report, Case Reports, 030204 cardiovascular system & hematology, Chronic liver disease, metabolic syndrome, 03 medical and health sciences, 0302 clinical medicine, Emergency surgery, Nonalcoholic fatty liver disease, medicine, neoplasms, lcsh:R5-920, business.industry, lcsh:R, General Medicine, hepatocellular carcinoma, medicine.disease, bleeding, emergency liver resection, digestive system diseases, Surgery, spontaneous rupture, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Abandonment (emotional), surveillance, Metabolic syndrome, lcsh:Medicine (General), Complication, business
Abstract: Key Clinical Message Hepatocellular carcinoma (HCC) develops in the presence of chronic liver disease, and nonalcoholic fatty liver disease is becoming a frequent cause of HCC in developed regions. Spontaneous rupture of HCC (rHCC) is a potentially life‐threatening complication of a tumor. The patient's compliance with surveillance after liver resection is vital for the prevention of rHCC.
Published: 2019

99. Evaluation of focused sentinel lymph node RT-qPCR screening for micrometastases with the use of the Maruyama computer program

Author: Jagric, T., Potrc, S., Ivanecz, A., Horvat, M., Plankl, M., and Mars, T.
Published: 2013
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100. Liver resection and ablation for squamous cell carcinoma liver metastases

Author: Engstrand, J. de Carvalho, L. F. Abreu Aghayan, D. and Balakrishnan, A. Belli, A. Bjornsson, B. Dasari, B. V. M. and Detry, O. Di Martino, M. Edwin, B. Erdmann, J. and Fristedt, R. Fusai, G. Gimenez-Maurel, T. Hemmingsson, O. and Salinas, C. Hidalgo Isaksson, B. Ivanecz, A. Izzo, F. and Knoefel, W. T. Kron, P. Lehwald-Tywuschik, N. Lesurtel, M. Lodge, J. P. A. Machairas, N. Marino, M. V. Martin, V. Paterson, A. Rystedt, J. Sandstrom, P. Serrablo, A. and Siriwardena, A. K. Taflin, H. Van Gulik, T. M. Yaqub, S. and Ozden, I. Ramia, J. M. Sturesson, C. E AHPBA Sci Res Comm
Abstract: Background: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). Method: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. Results: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). Conclusion: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.
Published: 2021

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