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Diffusion, outcomes and implementation of minimally invasive liver surgery: a snapshot from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry

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A Correction to this article was published on 11 December 2017

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Abstract

The Italian Group of MILS (I Go MILS) prospective registry was established in 2014 with the goals to create a hub for data and projects on a national basis and to promote the diffusion and implementation of MILS programs on a national scale. The primary endpoint of the present study is to give a snapshot of the real diffusion and outcomes of MILS in Italy, while analyzing the role of the registry in the implementation of MILS programs nationwide. The I Go MILS Registry is a prospective and intention-to-treat registry opened to any Italian center performing MILS, without restriction criteria based on number of procedures. The Registry is developed through the eClinical, an electronic platform for the management of clinical trials and is based on 34 clinical variables, regarding indication, intra- and postoperative course. Clinical outcomes and data regarding implementation of MILS activity have been analyzed for the aim of the study. Between November 2014 and June 2017, data from 1678 MILS performed in 48 centers have been collected (mean number of procedures per center 35, range 1–302). 22% of procedures were performed for benign and 78% for malignant disease (HCC constituted the 49.1% and CRLM the 31.2% of malignant tumors). Major liver resections (>3 liver segments), including right and left hepatectomies, trisectionectomies and ALPPS procedures were 10% of the series. Mean blood loss was 200 ± 230 mL Morbidity rate was 20.5% and mortality was 0.3%. 10.4% of cases were converted to open approach. Median length of stay was 5 days. MILS/total resections ratio in 13 experienced centers increased from 14 to 30% after Registry establishment. MILS programs are well established in Italy, with progressive increase both in the number of cases and in the numerosity of centers. The I Go MILS Registry is playing a crucial role in monitoring the development of MILS in the real world on a national basis while giving a significant contribution to the implementation of MILS programs.

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Change history

  • 11 December 2017

    A technical error led to incorrect rendering of the author group in this article. The correct authorship is as follows:

Abbreviations

LR:

Liver resection

I Go MILS:

Italian Group of Minimally Invasive Liver Surgery

MILS:

Minimally invasive liver surgery

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Acknowledgements

(1) The list of the authors of the Italian Group of Minimally Invasive Liver Surgery is given below: Dalla Valle Raffaele, AOU Parma, Parma; Mazzaferro Vincenzo, Istituto Nazionale Tumori, Milano; Jovine Elio, Ospedale Maggiore, Bologna; De Carlis Luciano Gregorio, Ospedale Niguarda Ca’ Granda, Milano; Boggi Ugo, AOU Pisana, Pisa; Gruttadauria Salvatore, ISMETT, Palermo; Di Benedetto Fabrizio, AOU Policlinico di Modena, Modena; Reggiani Paolo, Ospedale Maggiore Policlinico, Milano; Berti Stefano, Ospedale Civile S.Andrea, La Spezia; Ceccarelli Graziano, Ospedale San Donato, Arezzo; Vincenti Leonardo, AOU Consorziale Policlinico, Bari; Belli Giulio, Ospedale SM Loreto Nuovo, Napoli; Torzilli Guido, Istituto Clinico Humanitas, Rozzano; Zamboni Fausto, Ospedale Brotzu, Cagliari; Coratti Andrea, AOU Careggi, Firenze; Mezzatesta Pietro, Casa di Cura La Maddalena, Palermo; Santambrogio Roberto, AO San Paolo, Milano; Navarra Giuseppe, AOU Policlinico G. Martino, Messina; Giuliani Antonio, AO R.N. Cardarelli, Napoli; Pinna Antonio Daniele, Policlinico Sant’Orsola Malpighi, Bologna; Parisi Amilcare, AO Santa Maria di Terni, Terni; Colledan Michele, AO Papa Giovanni XXIII, Bergamo; Slim Abdallah, AO Desio e Vimercate, Vimercate; Antonucci Adelmo, Policlinico di Monza, Monza; Grazi Gian Luca, Istituto Nazionale Tumori Regina Elena, Roma; Frena Antonio, Ospedale Centrale, Bolzano; Sgroi Giovanni, AO Treviglio-Caravaggio, Treviglio; Brolese Alberto, Ospedale S.Chiara, Trento; Morelli Luca, AOU Pisana, Pisa; Floridi Antonio, AO Ospedale Maggiore, Crema; Patriti Alberto, Ospedale San Matteo degli Infermi, Spoleto; Veneroni Luigi, Ospedale Infermi AUSL Romagna, Rimini; Ercolani Giorgio, Ospedale Morgagni Pierantoni, Forlì; Boni Luigi, AOU Fondazione Macchi, Varese; Maida Pietro, Ospedale Villa Betania, Napoli; Griseri Guido, Ospedale San Paolo, Savona; Percivale Andrea, Ospedale Santa Corona, Pietraligure; Filauro Marco, AO Galliera, Genova; Guerriero Silvio, Ospedale San Martino, Belluno; Tisone Giuseppe, Policlinico Tor Vergata, Roma; Romito Raffaele, AOU Maggiore della Carità, Novara; Tedeschi Umberto, AOU Integrata Verona, Verona; Zimmitti Giuseppe, Fondazione Poliambulanza, Brescia. (2) The authors acknowledge CR-Technology and specifically Dr. Giovanni Cucchiara and Dr. Carmen Caruso for their outstanding and valuable support to the project of the I Go MILS group.

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Authors and Affiliations

  1. IRCCS San Raffaele Hospital, Via Olgettina 60, 20132, Milan, Italy

    Luca Aldrighetti & Francesca Ratti

  2. Policlinico Universitario, Padua, Italy

    Umberto Cillo

  3. Ospedale Mauriziano, Turin, Italy

    Alessandro Ferrero

  4. Ospedale San Camillo Forlanini, Rome, Italy

    Giuseppe Maria Ettorre

  5. Ospedale Universitario GB Rossi, Verona, Italy

    Alfredo Guglielmi

  6. Policlinico Gemelli, Rome, Italy

    Felice Giuliante

  7. Ospedale Pinetagrande, Castel Volturno, Italy

    Fulvio Calise

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  1. Luca Aldrighetti
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Consortia

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

  • Raffaele Dalla Valle
  • , Vincenzo Mazzaferro
  • , Elio Jovine
  • , Luciano Gregorio De Carlis
  • , Ugo Boggi
  • , Salvatore Gruttadauria
  • , Fabrizio Di Benedetto
  • , Paolo Reggiani
  • , Stefano Berti
  • , Graziano Ceccarelli
  • , Leonardo Vincenti
  • , Giulio Belli
  • , Guido Torzilli
  • , Fausto Zamboni
  • , Andrea Coratti
  • , Pietro Mezzatesta
  • , Roberto Santambrogio
  • , Giuseppe Navarra
  • , Antonio Giuliani
  • , Antonio Daniele Pinna
  • , Amilcare Parisi
  • , Michele Colledan
  • , Abdallah Slim
  • , Adelmo Antonucci
  • , Gian Luca Grazi
  • , Antonio Frena
  • , Giovanni Sgroi
  • , Alberto Brolese
  • , Luca Morelli
  • , Antonio Floridi
  • , Alberto Patriti
  • , Luigi Veneroni
  • , Giorgio Ercolani
  • , Luigi Boni
  • , Pietro Maida
  • , Guido Griseri
  • , Andrea Percivale
  • , Marco Filauro
  • , Silvio Guerriero
  • , Giuseppe Tisone
  • , Raffaele Romito
  • , Umberto Tedeschi
  •  & Giuseppe Zimmitti

Corresponding author

Correspondence to Luca Aldrighetti.

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Conflict of interest

All listed authors have participated in the study and have approved the final manuscript. There are no personal conflicts of interest or financial disclosure for any of the authors.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Members of the Italian Group of Minimally Invasive Liver Surgery (I Go MILS) are listed in the “Acknowledgements” at the end of the article.

A correction to this article is available online at https://doi.org/10.1007/s13304-017-0500-6.

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Aldrighetti, L., Ratti, F., Cillo, U. et al. Diffusion, outcomes and implementation of minimally invasive liver surgery: a snapshot from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry. Updates Surg 69, 271–283 (2017). https://doi.org/10.1007/s13304-017-0489-x

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