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.
Study Type
OBSERVATIONAL
Enrollment
9,963
A liver resection performed by minimally invasive (keyhole) surgery
Fondazione Poliambulanza Istituto Ospedaliero
Brescia, Italy
Major complications
Severe complications (Clavien-Dindo grade 3a or higher) related to the surgical procedure
Time frame: 30 days postoperatively
Overall complications
Overall complications related to the surgical procedure
Time frame: 30 days postoperatively
Length of hospital stay
The length of hospital stay for the surgical procedure
Time frame: 30 days postoperatively
R0 resection margin
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
Time frame: 30 days postoperatively
Intraoperative blood loss
Intraoperative blood loss in milliliters
Time frame: During the surgical procedure
Operative time
Operative time in minutes
Time frame: During the surgical procedure
Conversion to open surgery
Intra-operative conversion to an open or hand-assisted procedure in the minimally invasive group
Time frame: During the surgical procedure
Respiratory complications
All respiratory complications
Time frame: 30 days postoperatively
Wound-related complications
All wound-related complications
Time frame: 30 days postoperatively
Post-hepatectomy liver failure
Occurrence of post-hepatectomy liver failure (ISGLS definition and classification)
Time frame: 30 days postoperatively
Bile leak
Occurrence of bile leak (ISGLS definition and classification)
Time frame: 30 days postoperatively
Ascites
Occurrence of ascites
Time frame: 30 days postoperatively
Mortality
Postoperative mortality
Time frame: 90 days postoperatively
Red blood cell transfusion
Intraoperative red blood cell transfusion
Time frame: During the surgical procedure
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