Abstract

Background: Surgical outcomes may be associated with hospital volume and the influence of volume on minimally invasive liver surgery (MILS) is not known. Methods: Patients entered into the prospective registry of the Italian Group of MILS from 2014 to 2018 were considered. Only centres with an accrual period of at least 12 months and stable MILS activity during the enrolment period were included. Case volume was defined by the mean number of minimally invasive liver resections performed per month (MILS/month). Results: A total of 2225 MILS operations were undertaken by 46 centres; nine centres performed more than two MILS/month (1376 patients) and 37 centres carried out two or fewer MILS/month (849 patients). The proportion of resections of anterolateral segments decreased with case volume, whereas that of major hepatectomies increased. Left lateral sectionectomies and resections of anterolateral segments had similar outcome in the two groups. Resections of posterosuperior segments and major hepatectomies had higher overall and severe morbidity rates in centres performing two or fewer MILS/month than in those undertaking a larger number (posterosuperior segments resections: overall morbidity 30·4 versus 18·7 per cent respectively, and severe morbidity 9·9 versus 4·0 per cent; left hepatectomy: 46 versus 22 per cent, and 19 versus 5 per cent; right hepatectomy: 42 versus 34 per cent, and 25 versus 15 per cent). Conclusion: A volume–outcome association existed for minimally invasive hepatectomy. Complex and major resections may be best managed in high-volume centres.

Original languageEnglish
JournalBritish Journal of Surgery
DOIs
Publication statusAccepted/In press - Jan 1 2019

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Hepatectomy
Minimally Invasive Surgical Procedures
Liver
Morbidity
Registries

ASJC Scopus subject areas

  • Surgery

Cite this

On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO MILS) (Accepted/In press). Multicentre evaluation of case volume in minimally invasive hepatectomy. British Journal of Surgery. https://doi.org/10.1002/bjs.11369

Multicentre evaluation of case volume in minimally invasive hepatectomy. / On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO MILS).

In: British Journal of Surgery, 01.01.2019.

Research output: Contribution to journalArticle

On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO MILS) 2019, 'Multicentre evaluation of case volume in minimally invasive hepatectomy', British Journal of Surgery. https://doi.org/10.1002/bjs.11369
On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO MILS). Multicentre evaluation of case volume in minimally invasive hepatectomy. British Journal of Surgery. 2019 Jan 1. https://doi.org/10.1002/bjs.11369
On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO MILS). / Multicentre evaluation of case volume in minimally invasive hepatectomy. In: British Journal of Surgery. 2019.
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title = "Multicentre evaluation of case volume in minimally invasive hepatectomy",
abstract = "Background: Surgical outcomes may be associated with hospital volume and the influence of volume on minimally invasive liver surgery (MILS) is not known. Methods: Patients entered into the prospective registry of the Italian Group of MILS from 2014 to 2018 were considered. Only centres with an accrual period of at least 12 months and stable MILS activity during the enrolment period were included. Case volume was defined by the mean number of minimally invasive liver resections performed per month (MILS/month). Results: A total of 2225 MILS operations were undertaken by 46 centres; nine centres performed more than two MILS/month (1376 patients) and 37 centres carried out two or fewer MILS/month (849 patients). The proportion of resections of anterolateral segments decreased with case volume, whereas that of major hepatectomies increased. Left lateral sectionectomies and resections of anterolateral segments had similar outcome in the two groups. Resections of posterosuperior segments and major hepatectomies had higher overall and severe morbidity rates in centres performing two or fewer MILS/month than in those undertaking a larger number (posterosuperior segments resections: overall morbidity 30·4 versus 18·7 per cent respectively, and severe morbidity 9·9 versus 4·0 per cent; left hepatectomy: 46 versus 22 per cent, and 19 versus 5 per cent; right hepatectomy: 42 versus 34 per cent, and 25 versus 15 per cent). Conclusion: A volume–outcome association existed for minimally invasive hepatectomy. Complex and major resections may be best managed in high-volume centres.",
author = "{On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO MILS)} and L. Vigan{\`o} and M. Cimino and L. Aldrighetti and A. Ferrero and U. Cillo and A. Guglielmi and Ettorre, {G. M.} and F. Giuliante and {Dalla Valle}, R. and V. Mazzaferro and E. Jovine and {De Carlis}, L. and F. Calise and G. Torzilli and F. Ratti and E. Gringeri and N. Russolillo and {Levi Sandri}, {G. B.} and F. Ardito and U. Boggi and S. Gruttadauria and {Di Benedetto}, F. and Rossi, {G. E.} and S. Berti and G. Ceccarelli and L. Vincenti and G. Belli and F. Zamboni and A. Coratti and P. Mezzatesta and R. Santambrogio and G. Navarra and A. Giuliani and Pinna, {A. D.} and A. Parisi and M. Colledan and A. Slim and A. Antonucci and Grazi, {G. L.} and A. Frena and G. Sgroi and A. Brolese and L. Morelli and A. Floridi and A. Patriti and L. Veneroni and L. Boni and P. Maida and G. Griseri and R. Romito",
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T1 - Multicentre evaluation of case volume in minimally invasive hepatectomy

AU - On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO MILS)

AU - Viganò, L.

AU - Cimino, M.

AU - Aldrighetti, L.

AU - Ferrero, A.

AU - Cillo, U.

AU - Guglielmi, A.

AU - Ettorre, G. M.

AU - Giuliante, F.

AU - Dalla Valle, R.

AU - Mazzaferro, V.

AU - Jovine, E.

AU - De Carlis, L.

AU - Calise, F.

AU - Torzilli, G.

AU - Ratti, F.

AU - Gringeri, E.

AU - Russolillo, N.

AU - Levi Sandri, G. B.

AU - Ardito, F.

AU - Boggi, U.

AU - Gruttadauria, S.

AU - Di Benedetto, F.

AU - Rossi, G. E.

AU - Berti, S.

AU - Ceccarelli, G.

AU - Vincenti, L.

AU - Belli, G.

AU - Zamboni, F.

AU - Coratti, A.

AU - Mezzatesta, P.

AU - Santambrogio, R.

AU - Navarra, G.

AU - Giuliani, A.

AU - Pinna, A. D.

AU - Parisi, A.

AU - Colledan, M.

AU - Slim, A.

AU - Antonucci, A.

AU - Grazi, G. L.

AU - Frena, A.

AU - Sgroi, G.

AU - Brolese, A.

AU - Morelli, L.

AU - Floridi, A.

AU - Patriti, A.

AU - Veneroni, L.

AU - Boni, L.

AU - Maida, P.

AU - Griseri, G.

AU - Romito, R.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Surgical outcomes may be associated with hospital volume and the influence of volume on minimally invasive liver surgery (MILS) is not known. Methods: Patients entered into the prospective registry of the Italian Group of MILS from 2014 to 2018 were considered. Only centres with an accrual period of at least 12 months and stable MILS activity during the enrolment period were included. Case volume was defined by the mean number of minimally invasive liver resections performed per month (MILS/month). Results: A total of 2225 MILS operations were undertaken by 46 centres; nine centres performed more than two MILS/month (1376 patients) and 37 centres carried out two or fewer MILS/month (849 patients). The proportion of resections of anterolateral segments decreased with case volume, whereas that of major hepatectomies increased. Left lateral sectionectomies and resections of anterolateral segments had similar outcome in the two groups. Resections of posterosuperior segments and major hepatectomies had higher overall and severe morbidity rates in centres performing two or fewer MILS/month than in those undertaking a larger number (posterosuperior segments resections: overall morbidity 30·4 versus 18·7 per cent respectively, and severe morbidity 9·9 versus 4·0 per cent; left hepatectomy: 46 versus 22 per cent, and 19 versus 5 per cent; right hepatectomy: 42 versus 34 per cent, and 25 versus 15 per cent). Conclusion: A volume–outcome association existed for minimally invasive hepatectomy. Complex and major resections may be best managed in high-volume centres.

AB - Background: Surgical outcomes may be associated with hospital volume and the influence of volume on minimally invasive liver surgery (MILS) is not known. Methods: Patients entered into the prospective registry of the Italian Group of MILS from 2014 to 2018 were considered. Only centres with an accrual period of at least 12 months and stable MILS activity during the enrolment period were included. Case volume was defined by the mean number of minimally invasive liver resections performed per month (MILS/month). Results: A total of 2225 MILS operations were undertaken by 46 centres; nine centres performed more than two MILS/month (1376 patients) and 37 centres carried out two or fewer MILS/month (849 patients). The proportion of resections of anterolateral segments decreased with case volume, whereas that of major hepatectomies increased. Left lateral sectionectomies and resections of anterolateral segments had similar outcome in the two groups. Resections of posterosuperior segments and major hepatectomies had higher overall and severe morbidity rates in centres performing two or fewer MILS/month than in those undertaking a larger number (posterosuperior segments resections: overall morbidity 30·4 versus 18·7 per cent respectively, and severe morbidity 9·9 versus 4·0 per cent; left hepatectomy: 46 versus 22 per cent, and 19 versus 5 per cent; right hepatectomy: 42 versus 34 per cent, and 25 versus 15 per cent). Conclusion: A volume–outcome association existed for minimally invasive hepatectomy. Complex and major resections may be best managed in high-volume centres.

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U2 - 10.1002/bjs.11369

DO - 10.1002/bjs.11369

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JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

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