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Transatlantic registries for minimally invasive liver surgery: towards harmonization

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A Correction to this article was published on 30 January 2023

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Abstract

Background

Several registries focus on patients undergoing minimally invasive liver surgery (MILS). This study compared transatlantic registries focusing on the variables collected and differences in baseline characteristics, indications, and treatment in patients undergoing MILS. Furthermore, key variables were identified.

Methods

The five registries for liver surgery from North America (ACS-NSQIP), Italy, Norway, the Netherlands, and Europe were compared. A set of key variables were established by consensus expert opinion and compared between the registries. Anonymized data of all MILS procedures were collected (January 2014–December 2019). To summarize differences for all patient characteristics, treatment, and outcome, the relative and absolute largest differences (RLD, ALD) between the smallest and largest outcome per variable among the registries are presented.

Results

In total, 13,571 patients after MILS were included. Both 30- and 90-day mortality after MILS were below 1.1% in all registries. The largest differences in baseline characteristics were seen in ASA grade 3–4 (RLD 3.0, ALD 46.1%) and the presence of liver cirrhosis (RLD 6.4, ALD 21.2%). The largest difference in treatment was the use of neoadjuvant chemotherapy (RLD 4.3, ALD 20.6%). The number of variables collected per registry varied from 28 to 303. From the 46 key variables, 34 were missing in at least one of the registries.

Conclusion

Despite considerable variation in baseline characteristics, indications, and treatment of patients undergoing MILS in the five transatlantic registries, overall mortality after MILS was consistently below 1.1%. The registries should be harmonized to facilitate future collaborative research on MILS for which the identified 46 key variables will be instrumental.

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Change history

Abbreviations

MILS:

Minimally invasive liver surgery

STROBE:

Strengthening the Reporting of Observational Studies in Epidemiology

ACS-NSQIP:

American College of Surgeons National Surgical Quality Improvement Program

IGoMILS:

Italian Group of Minimally Invasive Liver Surgery

NoRGast:

Norwegian Registry for Gastrointestinal Surgery

DHBA:

Dutch Hepato Biliary Audit

E-MILS Registry:

European Registry on Minimally Invasive Liver Surgery

ISGLS:

International study group on liver surgery

SD:

Standard deviation

IQR:

Interquartile range

RLD:

Relative largest differences

ALD:

Absolute largest differences

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Acknowledgements

We would like to acknowledge the following collaborators: Federica Cipriani (Hepatobiliary Surgery Division, San Raffaele Hospital, Milan, Italy), Rafael Diaz-Nieto (Hepatobiliary Surgery Unit, Aintree University Hospital, Liverpool, UK), Jean-Marc Régimbeau (Department of Surgery, Amiens University Hospital, Amiens, France), Mathieu D’Hondt (Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium), Carlos Domingo-Del Pozo (Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain), Miguel Angel Suárez Muñoz (Department of Surgery, Liver Transplantation Unit, Regional University Hospital, Málaga, Spain), Krzysztof Zieniewicz (Department of General, Transplant and Liver Surgery Medical University of Warsaw Poland), Marco Vivarelli (Hepatobiliary and Abdominal Transplantation Surgery, Department of Experimental and Clinical Medicine, Riuniti Hospital, Polytechnic University of Marche, Ancona, Italy), Gregor Stavrou (Department of General, Visceral and Thoracic Surgery, Surgical Oncology, Klinikum Saarbruecken, Winterberg 1, 66199, Saarbrücken, Germany), Dirk J. Grünhagen (Department of Surgical Oncology and Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, the Netherlands), and Marcel den Dulk (Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands).

Author information

Author notes

  1. Nicky van der Heijde, Burak Görgec have Shared first authorship.

  2. Joal D. Beane and Francesca Ratti have Shared second authorship.

  3. Bjørn Edwin, Luca Aldrighetti, Henry A. Pitt, Mohammad Abu Hilal and Marc G. Besselink have Shared senior authorship.

Authors and Affiliations

  1. Department of Surgery, University Hospital Southampton, Southampton, UK

    Nicky van der Heijde, Burak Görgec & Mohammad Abu Hilal

  2. Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

    Nicky van der Heijde, Burak Görgec, Marcel J. van der Poel & Marc G. Besselink

  3. Cancer Center Amsterdam, Amsterdam, The Netherlands

    Nicky van der Heijde, Burak Görgec, Marcel J. van der Poel & Marc G. Besselink

  4. Department of Surgery, Instituto Ospedale Fondazione Poliambulanza, Brescia, Italy

    Burak Görgec, Andrea Benedetti Cacciaguerra & Mohammad Abu Hilal

  5. Department of Surgery, Ohio State University, Columbus, OH, USA

    Joal D. Beane

  6. Department of Surgery, San Raffaele Hospital, Milan, Italy

    Francesca Ratti & Luca Aldrighetti

  7. Department of Surgery, University Hospital Naples, Naples, Italy

    Giulio Belli & Fulvio Calise

  8. Hepatobiliary and Abdominal Transplantation Surgery, Department of Experimental and Clinical Medicine, Riuniti Hospital, Polytechnic University of Marche, Ancona, Italy

    Andrea Benedetti Cacciaguerra

  9. Department of Surgery, Oncology and Gastroenterology, Hepatobiliary Surgery and Liver Transplantation Unit, Padova University Hospital, Padua, Italy

    Umberto Cillo

  10. Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands

    Marieke T. De Boer

  11. Department of Surgery, Temple University Hospital, Philadelphia, PA, USA

    Alexander M. Fagenson

  12. The Intervention Center and Department of HPB Surgery, Oslo University Hospital and Institute for Clinical Medicine, Oslo, Norway

    Åsmund A. Fretland, Kristoffer Lassen & Bjørn Edwin

  13. Department of Surgery, Mount Sinai Medical Center, New York, NY, USA

    Elizabeth M. Gleeson

  14. Dutch Institute for Clinical Auditing, Scientific Bureau, Leiden, The Netherlands

    Michelle R. de Graaff

  15. Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands

    Michelle R. de Graaff

  16. Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands

    Niels F. M. Kok

  17. Department of Surgery, University of Verona, Verona, Italy

    Andrea Ruzzenente

  18. Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Queen Elizabeth University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

    Robert P. Sutcliffe

  19. Department of Surgery, Rutgers Cancer Institute, New Brunswick, NJ, USA

    Henry A. Pitt

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  1. Nicky van der Heijde
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Correspondence to Mohammad Abu Hilal or Marc G. Besselink.

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Nicky van der Heijde, Burak Görgec, Joal D. Beane, Francesca Ratti, Giulio Belli, Andrea Benedetti Cacciaguerra, Fulvio Calise, Umberto Cillo, Marieke T. De Boer, Alexander M. Fagenson, Åsmund A. Fretland, Elizabeth M. Gleeson, Michelle R. de Graaff, Niels F.M. Kok, Kristoffer Lassen, Marcel J. van der Poel, Andrea Ruzzenente, Robert P. Sutcliffe, Bjørn Edwin, Luca Aldrighetti, Henry A. Pitt, Mohammad Abu Hilal, and Marc G. Besselink have no conflicts of interest or financial ties to disclose.

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van der Heijde, N., Görgec, B., Beane, J.D. et al. Transatlantic registries for minimally invasive liver surgery: towards harmonization. Surg Endosc 37, 3580–3592 (2023). https://doi.org/10.1007/s00464-022-09765-y

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