Liver Cancer, Liver Metastases, Obesity
Conditions
Keywords
overweight, fatty liver, open liver resection, laparoscopic liver resection, minimally invasive liver resection
Brief summary
Despite the worldwide increase of both obesity and use of minimally invasive liver surgery(MILS), evidence regarding the safety and eventual benefits of MILS in obese patients is scarce. The aim of this study is therefore to compare the outcomes of non-obese and obese patients(BMI 18.5-29.9 and BMI≥30, respectively) undergoing MILS and OLS, and to assess trends in MILS use among obese patients. In this retrospective cohort study, patients operated at 20 hospitals in eight countries(2009-2019) will be included and the characteristics and outcomes of non-obese and obese patients will be compared. Thereafter, the outcomes of MILS and OLS were compared in both groups after propensity-score matching(PSM). Changes in the adoption of MILS during the study period will be investigated.
Interventions
PROCEDUREMinimally invasive liver resection
A liver resection performed by minimally invasive (keyhole) surgery
Sponsors
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
The Queen Elizabeth Hospital
Umberto I Mauriziano Hospital, Turin, Italy
Oslo University Hospital and Institute of Medicine, University of Oslo, Oslo, Norway
Padua University Hospital, Padua, Italy
IRCCS San Raffaele
University Hospital of Girona Dr. Josep Trueta
Clinica Universidad de Navarra, Pamplona, Spain
Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France
Groeninge Hospital, Kortrijk, Belgium
University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Riuniti Hospital, Polytechnic University of Marche, Ancona, Italy
University of Verona, Verona, Italy
Virginia Mason Medical Center, Seattle, USA
University of California San Francisco, California, USA
Moscow Clinical Research Centre, Moscow, Russia
Università Cattolica del Sacro Cuore-IRCCS, Rome, Italy
Antoine Béclère Hospital, Paris, France
IRCCS Azienda Ospedaliero-Universitaria di Bologna
University of Modena and Reggio Emilia
Fondazione Poliambulanza Istituto Ospedaliero
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged 18 years and older * Patients that have undergone an elective minimally invasive or open liver resection
Exclusion criteria
* Patients that have undergone a hand-assisted or robotic procedure * Patients with a BMI lower than 18.5
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Major complications | 30 days postoperatively | Severe complications (Clavien-Dindo grade 3a or higher) related to the surgical procedure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of hospital stay | 30 days postoperatively | The length of hospital stay for the surgical procedure |
| R0 resection margin | 30 days postoperatively | Proportion of patients in whom a microscopically radical resection of both the primary colorectal carcinoma and the liver metastases was performed. Proportion of patients in whom a microscopically radical resection was performed |
| Intraoperative blood loss | During the surgical procedure | Intraoperative blood loss in milliliters |
| Operative time | During the surgical procedure | Operative time in minutes |
| Conversion to open surgery | During the surgical procedure | Intra-operative conversion to an open or hand-assisted procedure in the minimally invasive group |
| Respiratory complications | 30 days postoperatively | All respiratory complications |
| Overall complications | 30 days postoperatively | Overall complications related to the surgical procedure |
| Post-hepatectomy liver failure | 30 days postoperatively | Occurrence of post-hepatectomy liver failure (ISGLS definition and classification) |
| Bile leak | 30 days postoperatively | Occurrence of bile leak (ISGLS definition and classification) |
| Ascites | 30 days postoperatively | Occurrence of ascites |
| Mortality | 90 days postoperatively | Postoperative mortality |
| Red blood cell transfusion | During the surgical procedure | Intraoperative red blood cell transfusion |
| Wound-related complications | 30 days postoperatively | All wound-related complications |
Countries
Italy
Outcome results
None listed