eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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SCImago Journal & Country Rank
1/2024
vol. 19
 
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General surgery
abstract:
Original paper

Is operation time over the benchmark value a risk factor for worse short-term outcomes after laparoscopic liver resection?

Wacław Hołówko
1
,
Paweł Rykowski
1
,
Anya Wyporski
1
,
Wojciech Serednicki
2
,
Jerzy Mielko
3
,
Stanisław Pierściński
4
,
Adam Durczyński
5
,
Aleksander Tarasik
6
,
Tadeusz Wróblewski
1
,
Andrzej Budzyński
7
,
Michał Pędziwiatr
2
,
Michał Grąt
1

  1. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
  2. 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
  3. Department of Surgical Oncology, 1st Military Clinical Hospital, Lublin, Poland
  4. Department of General, Hepatobiliary and Transplant Surgery, Nicolaus Copernicus University Collegium Medicum, Bydgoszcz, Poland
  5. Department of General and Transplant Surgery, Medical University of Lodz, Barlicki Teaching Hospital, Lodz, Poland
  6. Department of Oncological Surgery, Regional Oncological Centre, Bialystok, Poland
  7. Department of General Surgery and Surgical Oncology, Ludwik Rydygier Memorial Hospital, Krakow, Poland
Videosurgery Miniinv 2024; 19 (1): 60–67
Online publish date: 2024/02/14
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Introduction
Laparoscopic liver resection is a challenging surgical procedure that may require prolonged operation time, particularly during the learning curve. Operation time significantly decreases with increasing experience; however, prolonged operation time may significantly increase the risk of postoperative complications.

Aim
To assess whether prolonged operation time over the benchmark value influences short-term postoperative outcomes after laparoscopic liver resection.

Material and methods
A retrospective cohort study based on data from the National Polish Registry of Minimally Invasive Liver Surgery was performed. A total of 197 cases consisting of left lateral sectionectomy (LLS), left hemihepatectomy (LH), and right hemihepatectomy (RH) with established benchmark values for operation time were included. Data about potential confounders for prolonged operation time and worse short-term outcomes were exported.

Results
Most cases (129; 65.5%) were performed during the learning curve, while the largest rate was observed in LLS (57; 78.1%). Median operation time exceeded the benchmark value in LLS (Me = 210 min) and LH (Me = 350 min), while in RH the benchmark value was exceeded in 39 (44.3%) cases. Textbook outcomes were achieved in 138 (70.1%) cases. Univariate analysis (OR = 1.11; 95% CI: 0.61–2.06; p = 0.720) and multivariate analysis (OR = 1.16; 95% CI: 0.50–2.68; p = 0.734) did not reveal a significant impact of prolonged surgery on failing to achieve a textbook outcome.

Conclusions
Prolonging the time of laparoscopic liver resection does not significantly impair postoperative results. There is no reason related to the patients’ safety to avoid prolonging the time of laparoscopic liver resection over the benchmark value.

keywords:

laparoscopic liver resection, learning curve, operation time, short-term outcome, textbook outcome

  
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