Kristoffer Lassen1,2,3, Linn Såve Nymo4,5, Frank Olsen6, Kristoffer Watten Brudvik7, Åsmund Avdem Fretland7,8,9, Kjetil Søreide10,11,12. 1. Department of HPB Surgery, Oslo University Hospital at Rikshospitalet, Sognsvannsveien 20, 0372, Oslo, Norway. krlass@ous-hf.no. 2. Department of Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway. krlass@ous-hf.no. 3. Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway. krlass@ous-hf.no. 4. Department of Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway. 5. Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway. 6. Centre for Clinical Documentation and Evaluation (SKDE), Northern Norway Regional Health Authority, Bodo, Norway. 7. Department of HPB Surgery, Oslo University Hospital at Rikshospitalet, Sognsvannsveien 20, 0372, Oslo, Norway. 8. The Intervention Centre, Oslo University Hospital, Oslo, Norway. 9. Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 10. Clinical Surgery, Royal Infirmary of Edinburgh and University of Edinburgh, Edinburgh, UK. 11. Department of Clinical Medicine, University of Bergen, Bergen, Norway. 12. Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
Abstract
BACKGROUND: Improved outcome after liver resections have been reported in several series, but outcomes from national cohorts are scarce. Our aim was to evaluate nationwide practice and short-term outcomes after liver surgery in a universal healthcare system. METHODS: A complete 5-year cohort of all liver resections from the Norwegian Patient Registry (NPR). Short-term outcomes were aggregated length of stay (a-LoS), reoperation and 90-day mortality. RESULTS: Of 2118 liver resections, 605 (28.6%) were major, median age was 65 years and 1184 (55%) were male. Most common indication was metastatic disease (n = 1554; 73.4%) and primary malignancy (n = 328; 15.3%). Laparoscopy was performed in 513 (33.9%) of minor and 37 (6.1%) of major liver resections and increased over time to 39.1% of minor resections in 2016. Median a-LoS was 12 days for major resections, 8 days for open minor and 3 days for laparoscopic minor resections. Reoperation was reported for 159 (7.4%) and 90-day mortality for 44 (2.1%). Primary malignancy, male gender, elderly patients and major resections were associated with poorer outcome. CONCLUSIONS: In a national cohort, laparoscopy is used for a substantial proportion of minor resections and was associated with reduced a-LoS. Risk factors for reoperation and mortality were male gender, increased age and major resection for primary malignancy.
BACKGROUND: Improved outcome after liver resections have been reported in several series, but outcomes from national cohorts are scarce. Our aim was to evaluate nationwide practice and short-term outcomes after liver surgery in a universal healthcare system. METHODS: A complete 5-year cohort of all liver resections from the Norwegian Patient Registry (NPR). Short-term outcomes were aggregated length of stay (a-LoS), reoperation and 90-day mortality. RESULTS: Of 2118 liver resections, 605 (28.6%) were major, median age was 65 years and 1184 (55%) were male. Most common indication was metastatic disease (n = 1554; 73.4%) and primary malignancy (n = 328; 15.3%). Laparoscopy was performed in 513 (33.9%) of minor and 37 (6.1%) of major liver resections and increased over time to 39.1% of minor resections in 2016. Median a-LoS was 12 days for major resections, 8 days for open minor and 3 days for laparoscopic minor resections. Reoperation was reported for 159 (7.4%) and 90-day mortality for 44 (2.1%). Primary malignancy, male gender, elderly patients and major resections were associated with poorer outcome. CONCLUSIONS: In a national cohort, laparoscopy is used for a substantial proportion of minor resections and was associated with reduced a-LoS. Risk factors for reoperation and mortality were male gender, increased age and major resection for primary malignancy.
Entities:
Keywords:
Laparoscopic; Liver resection; National cohort; Short-term outcomes
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: Lancet Date: 2007-10-20 Impact factor: 79.321
Authors: Arthur J Richardson; Tony C Y Pang; Emma Johnston; Michael J Hollands; Vincent W T Lam; Henry C C Pleass Journal: J Gastrointest Surg Date: 2013-09-04 Impact factor: 3.452
Authors: Giovanni Ramacciato; Francesco D'Angelo; Rossella Baldini; Niccolò Petrucciani; Laura Antolino; Paolo Aurello; Giuseppe Nigri; Riccardo Bellagamba; Francesca Pezzoli; Albert Balesh; Alessandro Cucchetti; Matteo Cescon; Massimo Del Gaudio; Matteo Ravaioli; Antonio Daniele Pinna Journal: Am Surg Date: 2012-04 Impact factor: 0.688
Authors: Jessica P Simons; Sing Chau Ng; Joshua S Hill; Shimul A Shah; Zheng Zhou; Jennifer F Tseng Journal: Cancer Date: 2010-04-01 Impact factor: 6.860
Authors: Robbert J de Haas; Dennis A Wicherts; Paola Andreani; Gérard Pascal; Faouzi Saliba; Philippe Ichai; René Adam; Denis Castaing; Daniel Azoulay Journal: Ann Surg Date: 2011-06 Impact factor: 12.969
Authors: Hude Quan; Vijaya Sundararajan; Patricia Halfon; Andrew Fong; Bernard Burnand; Jean-Christophe Luthi; L Duncan Saunders; Cynthia A Beck; Thomas E Feasby; William A Ghali Journal: Med Care Date: 2005-11 Impact factor: 2.983
Authors: Paul D Colavita; Victor B Tsirline; Igor Belyansky; Ryan Z Swan; Amanda L Walters; Amy E Lincourt; David A Iannitti; B Todd Heniford Journal: J Gastrointest Surg Date: 2014-01-16 Impact factor: 3.452
Authors: Jessica P Simons; Sing Chau Ng; Joshua S Hill; Shimul A Shah; Andreea Bodnari; Zheng Zhou; Jennifer F Tseng Journal: J Surg Res Date: 2009-05-03 Impact factor: 2.192
Authors: Rebecca A Schroeder; Carlos E Marroquin; Barbara Phillips Bute; Shukri Khuri; William G Henderson; Paul C Kuo Journal: Ann Surg Date: 2006-03 Impact factor: 12.969
Authors: S Bennett; K Søreide; S Gholami; P Pessaux; C Teh; E Segelov; H Kennecke; H Prenen; S Myrehaug; D Callegaro; J Hallet Journal: Curr Oncol Date: 2020-10-01 Impact factor: 3.677
Authors: Eva Braunwarth; Benedikt Rumpf; Florian Primavesi; David Pereyra; Margarethe Hochleitner; Georg Göbel; Silvia Gasteiger; Philipp Gehwolf; Dietmar Öfner; Patrick Starlinger; Stefan Stättner Journal: PLoS One Date: 2020-12-14 Impact factor: 3.240
Authors: P B Olthof; A K E Elfrink; E Marra; E J T Belt; P B van den Boezem; K Bosscha; E C J Consten; M den Dulk; P D Gobardhan; J Hagendoorn; T N T van Heek; J N M IJzermans; J M Klaase; K F D Kuhlmann; W K G Leclercq; M S L Liem; E R Manusama; H A Marsman; J S D Mieog; S J Oosterling; G A Patijn; W Te Riele; R-J Swijnenburg; H Torrenga; P van Duijvendijk; M Vermaas; N F M Kok; D J Grünhagen Journal: Br J Surg Date: 2020-03-24 Impact factor: 6.939