Lionel Rebibo1, Pauline Leourier1, Rachid Badaoui2, Fabien Le Roux1, Emmanuel Lorne2,3, Jean-Marc Regimbeau4,5,6. 1. Department of Digestive Surgery, Amiens University Hospital, Avenue René Laennec, 80054, Amiens Cedex 01, France. 2. Department of Anaesthesiology, Amiens University Hospital, Avenue René Laennec, 80054, Amiens Cedex 01, France. 3. SSPC (Simplification des Soins des Patients Complexes) - Clinical Research Unit, University of Picardie Jules Verne, 80054, Amiens Cedex 01, France. 4. Department of Digestive Surgery, Amiens University Hospital, Avenue René Laennec, 80054, Amiens Cedex 01, France. regimbeau.jean-marc@chu-amiens.fr. 5. SSPC (Simplification des Soins des Patients Complexes) - Clinical Research Unit, University of Picardie Jules Verne, 80054, Amiens Cedex 01, France. regimbeau.jean-marc@chu-amiens.fr. 6. Service de chirurgie digestive, Hôpital Sud, CHU d'Amiens, Avenue René Laennec, 80054, Amiens Cedex 01, France. regimbeau.jean-marc@chu-amiens.fr.
Abstract
BACKGROUND: Day-case surgery (DCS) has become increasingly popular over recent years, as has laparoscopic liver resection (LLR) for the treatment of benign or malignant liver tumours. The purpose of this prospective study was to demonstrate the feasibility of minor LLR as DCS. METHODS: Prospective, intention-to-treat, non-randomised study of patients undergoing minor LLR between July 2015 and December 2017. Exclusion criteria were resection by laparotomy, major LLR, difficult locations for minor LLR, history of major abdominal surgery, hepatobiliary procedures without liver parenchyma resection, cirrhosis with Child > A and/or portal hypertension, significant medical history and exclusion criteria for DCS. The primary endpoint was the unplanned overnight admission rate. Secondary endpoints were the reason for exclusion, complication data, criteria for DCS evaluation, satisfaction and compliance with the protocol. RESULTS: One hundred sixty-seven patients underwent liver resection during the study period. LLR was performed in 92 patients (55%), as DCS in 23 patients (25%). Reasons for minor LLR were liver metastasis (n = 9), hepatic adenoma (n = 5), hepatocellular carcinoma (n = 4), ciliated hepatic foregut cyst (n = 2) and other benign tumours (n = 3). All day-case minor LLR, except two patients, consisted of single wedge resection, while one patient underwent left lateral sectionectomy. There were four unplanned overnight admissions (17.4%), one unscheduled consultation (4.3%), two hospital readmissions (8.6%) and no major complications/mortality. Compliance with the protocol was 69.5%. Satisfaction rate was 91%. CONCLUSION: In selected patients, day-case minor LLR is feasible with acceptable complication and readmission rates. Day-case minor LLR can therefore be legitimately proposed in selected patients.
BACKGROUND: Day-case surgery (DCS) has become increasingly popular over recent years, as has laparoscopic liver resection (LLR) for the treatment of benign or malignant liver tumours. The purpose of this prospective study was to demonstrate the feasibility of minor LLR as DCS. METHODS: Prospective, intention-to-treat, non-randomised study of patients undergoing minor LLR between July 2015 and December 2017. Exclusion criteria were resection by laparotomy, major LLR, difficult locations for minor LLR, history of major abdominal surgery, hepatobiliary procedures without liver parenchyma resection, cirrhosis with Child > A and/or portal hypertension, significant medical history and exclusion criteria for DCS. The primary endpoint was the unplanned overnight admission rate. Secondary endpoints were the reason for exclusion, complication data, criteria for DCS evaluation, satisfaction and compliance with the protocol. RESULTS: One hundred sixty-seven patients underwent liver resection during the study period. LLR was performed in 92 patients (55%), as DCS in 23 patients (25%). Reasons for minor LLR were liver metastasis (n = 9), hepatic adenoma (n = 5), hepatocellular carcinoma (n = 4), ciliated hepatic foregut cyst (n = 2) and other benign tumours (n = 3). All day-case minor LLR, except two patients, consisted of single wedge resection, while one patient underwent left lateral sectionectomy. There were four unplanned overnight admissions (17.4%), one unscheduled consultation (4.3%), two hospital readmissions (8.6%) and no major complications/mortality. Compliance with the protocol was 69.5%. Satisfaction rate was 91%. CONCLUSION: In selected patients, day-case minor LLR is feasible with acceptable complication and readmission rates. Day-case minor LLR can therefore be legitimately proposed in selected patients.
Entities:
Keywords:
Ambulatory surgery; Day-case surgery; Laparoscopic liver resection; Outpatient surgery
Authors: M A J van den Broek; R M van Dam; G J P van Breukelen; M H Bemelmans; E Oussoultzoglou; P Pessaux; C H C Dejong; N Freemantle; S W M Olde Damink Journal: Br J Surg Date: 2011-05-06 Impact factor: 6.939
Authors: K Kraft; C Mariette; A Sauvanet; J-M Balon; R Douard; S Fabre; A Guidat; N Huten; H Johanet; A Laurent; F Muscari; P Pessaux; J-P Piermé; G Piessen; M Raucoules-Aimé; A Rault; C Vons Journal: J Visc Surg Date: 2011-02 Impact factor: 2.043
Authors: E M Wong-Lun-Hing; R M van Dam; G J P van Breukelen; P J Tanis; F Ratti; R van Hillegersberg; G D Slooter; J H W de Wilt; M S L Liem; M T de Boer; J M Klaase; U P Neumann; L A Aldrighetti; C H C Dejong Journal: Br J Surg Date: 2017-01-31 Impact factor: 6.939
Authors: Nicola de'Angelis; Benjamin Menahem; Philippe Compagnon; Jean Claude Merle; Francesco Brunetti; Alain Luciani; Daniel Cherqui; Alexis Laurent Journal: Surg Endosc Date: 2017-04-04 Impact factor: 4.584
Authors: Nicolas H Dreifuss; Julia Xie; Francisco Schlottmann; Antonio Cubisino; Carolina Baz; Carolina Vanetta; Alberto Mangano; Francesco M Bianco; Antonio Gangemi; Mario A Masrur Journal: Obes Surg Date: 2022-01-20 Impact factor: 3.479