Textbook outcome of laparoscopic hepatectomy in the context of precision surgery: A single center experience

Zejiang Xu; Yaqing Lv; Hao Zou; Yuanfang Jia; Wenhao Du; Jinbin Lu; Yang Liu; Zemin Shao; Hao Zhang; Chuandong Sun; Chengzhan Zhu

doi:10.1016/j.dld.2024.04.016

Textbook outcome of laparoscopic hepatectomy in the context of precision surgery: A single center experience

Dig Liver Dis. 2024 May 8:S1590-8658(24)00719-9. doi: 10.1016/j.dld.2024.04.016. Online ahead of print.

Authors

Zejiang Xu¹, Yaqing Lv², Hao Zou¹, Yuanfang Jia³, Wenhao Du¹, Jinbin Lu⁴, Yang Liu¹, Zemin Shao¹, Hao Zhang¹, Chuandong Sun⁵, Chengzhan Zhu⁶

Affiliations

¹ Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, PR China.
² Department of Wound Care Clinic, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, PR China.
³ Department of Anesthesia, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, PR China.
⁴ Department of General Surgery, Laixi City People's Hospital, No.16 Yantai Road, Laixi, Qingdao, PR China.
⁵ Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, PR China. Electronic address: zhuchengz@qduhospital.cn.
⁶ Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266003, PR China; Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266003, PR China. Electronic address: zhuchengz@qduhospital.cn.

PMID: 38724344
DOI: 10.1016/j.dld.2024.04.016

Abstract

Objective: Laparoscopic hepatectomy (LH) has become a common surgery for the treatment of liver tumor. To evaluate the surgical quality of laparoscopic hepatectomy under the context of precision surgery with Textbook outcome (TO), a comprehensive and holistic assessment approach.

Methods: A total of 1056 patients who underwent laparoscopic hepatectomy from May 2016 and December 2022 were enrolled in the study. All the patients were performed hepatectomy. The rate of TO and factors associated with achieving TO were examined.

Results: Among the 1056 patients, 75 % patients achieved TO. The main reason limited patients achieving textbook outcomes was prolonged length of hospital stay (LOS). The univariate analysis indicated that age>65, ASA classification ≥3, liver cirrhosis, tumor size > 3 cm, tumor number ≥2, type of primary cancer, and IWATE DSS were significantly associated with non-achievement of TO. The multivariate analysis indicated that the ASA classification ≥3 and advanced difficulty level in IWATE DSS independent factors associated with achieving TO. Reaching TO can significantly prolong the postoperative recurrence time and overall survival time of hepatocellular carcinoma patients.

Conclusion: In the context of precision surgery, 75 % patients undergoing laparoscopic hepatectomy achieved a TO. Patients who achieved TO had significantly improved survival.

Keywords: Hepatocellular carcinoma; Laparoscopic hepatectomy; Liver cancer; Precision surgery; Textbook outcome.