Multicentre evaluation of case volume in minimally invasive hepatectomy

L. Viganò; M. Cimino; L. Aldrighetti; A. Ferrero; U. Cillo; A. Guglielmi; G. M. Ettorre; F. Giuliante; R. Dalla Valle; V. Mazzaferro; E. Jovine; L. De Carlis; F. Calise; G. Torzilli; F. Ratti; E. Gringeri; N. Russolillo; G. B. Levi Sandri; F. Ardito; U. Boggi; S. Gruttadauria; F. Di Benedetto; G. E. Rossi; S. Berti; G. Ceccarelli; L. Vincenti; G. Belli; F. Zamboni; A. Coratti; P. Mezzatesta; R. Santambrogio; G. Navarra; A. Giuliani; A. D. Pinna; A. Parisi; M. Colledan; A. Slim; A. Antonucci; G. L. Grazi; A. Frena; G. Sgroi; A. Brolese; L. Morelli; A. Floridi; A. Patriti; L. Veneroni; L. Boni; P. Maida; G. Griseri; R. Romito; On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO MILS)

doi:10.1002/bjs.11369

Multicentre evaluation of case volume in minimally invasive hepatectomy

L. Viganò, M. Cimino, L. Aldrighetti, A. Ferrero, U. Cillo, A. Guglielmi, G. M. Ettorre, F. Giuliante, R. Dalla Valle, V. Mazzaferro, E. Jovine, L. De Carlis, F. Calise, G. Torzilli, F. Ratti, E. Gringeri, N. Russolillo, G. B. Levi Sandri, F. Ardito, U. BoggiS. Gruttadauria, F. Di Benedetto, G. E. Rossi, S. Berti, G. Ceccarelli, L. Vincenti, G. Belli, F. Zamboni, A. Coratti, P. Mezzatesta, R. Santambrogio, G. Navarra, A. Giuliani, A. D. Pinna, A. Parisi, M. Colledan, A. Slim, A. Antonucci, G. L. Grazi, A. Frena, G. Sgroi, A. Brolese, L. Morelli, A. Floridi, A. Patriti, L. Veneroni, L. Boni, P. Maida, G. Griseri, R. Romito, On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO MILS)

Research output: Contribution to journal › Article › peer-review

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 language	English
Journal	Ann. Surg.
DOIs	https://doi.org/10.1002/bjs.11369
Publication status	Published - Mar 2020

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Viganò, L., Cimino, M., Aldrighetti, L., Ferrero, A., Cillo, U., Guglielmi, A., Ettorre, G. M., Giuliante, F., Dalla Valle, R., Mazzaferro, V., Jovine, E., De Carlis, L., Calise, F., Torzilli, G., Ratti, F., Gringeri, E., Russolillo, N., Levi Sandri, G. B., Ardito, F., ... MILS), O. B. O. T. I. G. O. M. I. L. S. I. GO. (2020). Multicentre evaluation of case volume in minimally invasive hepatectomy. Ann. Surg.. https://doi.org/10.1002/bjs.11369

Multicentre evaluation of case volume in minimally invasive hepatectomy. / Viganò, L.; Cimino, M.; Aldrighetti, L.; Ferrero, A.; Cillo, U.; Guglielmi, A.; Ettorre, G. M.; Giuliante, F.; Dalla Valle, R.; Mazzaferro, V.; Jovine, E.; De Carlis, L.; Calise, F.; Torzilli, G.; Ratti, F.; Gringeri, E.; Russolillo, N.; Levi Sandri, G. B.; Ardito, F.; Boggi, U.; Gruttadauria, S.; Di Benedetto, F.; Rossi, G. E.; Berti, S.; Ceccarelli, G.; Vincenti, L.; Belli, G.; Zamboni, F.; Coratti, A.; Mezzatesta, P.; Santambrogio, R.; Navarra, G.; Giuliani, A.; Pinna, A. D.; Parisi, A.; Colledan, M.; Slim, A.; Antonucci, A.; Grazi, G. L.; Frena, A.; Sgroi, G.; Brolese, A.; Morelli, L.; Floridi, A.; Patriti, A.; Veneroni, L.; Boni, L.; Maida, P.; Griseri, G.; Romito, R.; MILS), On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO.

In: Ann. Surg., 03.2020.

Research output: Contribution to journal › Article › peer-review

Viganò, L , Cimino, M , Aldrighetti, L, Ferrero, A, Cillo, U, Guglielmi, A, Ettorre, GM, Giuliante, F, Dalla Valle, R, Mazzaferro, V , Jovine, E, De Carlis, L, Calise, F, Torzilli, G , Ratti, F, Gringeri, E, Russolillo, N, Levi Sandri, GB, Ardito, F, Boggi, U, Gruttadauria, S, Di Benedetto, F, Rossi, GE, Berti, S, Ceccarelli, G, Vincenti, L, Belli, G, Zamboni, F, Coratti, A, Mezzatesta, P, Santambrogio, R, Navarra, G, Giuliani, A, Pinna, AD, Parisi, A, Colledan, M, Slim, A, Antonucci, A , Grazi, GL, Frena, A, Sgroi, G, Brolese, A, Morelli, L, Floridi, A, Patriti, A, Veneroni, L, Boni, L, Maida, P, Griseri, G, Romito, R & MILS), OBOTIGOMILSIGO 2020, 'Multicentre evaluation of case volume in minimally invasive hepatectomy', Ann. Surg.. https://doi.org/10.1002/bjs.11369

Viganò, L. ; Cimino, M. ; Aldrighetti, L. ; Ferrero, A. ; Cillo, U. ; Guglielmi, A. ; Ettorre, G. M. ; Giuliante, F. ; Dalla Valle, R. ; Mazzaferro, V. ; Jovine, E. ; De Carlis, L. ; Calise, F. ; Torzilli, G. ; Ratti, F. ; Gringeri, E. ; Russolillo, N. ; Levi Sandri, G. B. ; Ardito, F. ; Boggi, U. ; Gruttadauria, S. ; Di Benedetto, F. ; Rossi, G. E. ; Berti, S. ; Ceccarelli, G. ; Vincenti, L. ; Belli, G. ; Zamboni, F. ; Coratti, A. ; Mezzatesta, P. ; Santambrogio, R. ; Navarra, G. ; Giuliani, A. ; Pinna, A. D. ; Parisi, A. ; Colledan, M. ; Slim, A. ; Antonucci, A. ; Grazi, G. L. ; Frena, A. ; Sgroi, G. ; Brolese, A. ; Morelli, L. ; Floridi, A. ; Patriti, A. ; Veneroni, L. ; Boni, L. ; Maida, P. ; Griseri, G. ; Romito, R. ; MILS), On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO. / Multicentre evaluation of case volume in minimally invasive hepatectomy. In: Ann. Surg. 2020.

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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 = "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 and MILS), {On behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO}",

year = "2020",

month = mar,

doi = "10.1002/bjs.11369",

language = "English",

journal = "Ann. Surg.",

issn = "1528-1140",

publisher = "NLM (Medline)",

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TY - JOUR

T1 - Multicentre evaluation of case volume in minimally invasive hepatectomy

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.

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

PY - 2020/3

Y1 - 2020/3

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.

U2 - 10.1002/bjs.11369

DO - 10.1002/bjs.11369

M3 - Article

JO - Ann. Surg.

JF - Ann. Surg.

SN - 1528-1140

ER -