Publications by authors named "Bjorn Edwin"
Objectives: Total tumor volume (TTV) is associated with overall and recurrence-free survival in patients with colorectal cancer liver metastases (CRLM). However, the labor-intensive nature of such manual assessments has hampered the clinical adoption of TTV as an imaging biomarker. This study aimed to develop and externally evaluate a CRLM auto-segmentation model on CT scans, to facilitate the clinical adoption of TTV.
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- The study investigates how the length of time taken during liver surgeries affects the likelihood of postoperative complications in patients undergoing different types of liver resections.
- A total of 5,424 patients were analyzed from multiple centers between 2000 and 2022, focusing on procedures like right hemihepatectomy, technically major resection, and left lateral sectionectomy.
- Results show that patients in the longest operative time group had a significantly higher risk of complications, particularly in various surgical approaches like open, laparoscopic, and robotic surgeries.
Article Synopsis
- A study was conducted to compare robotic minor liver resections (RMLR) with laparoscopic minor liver resections (LMLR) in patients undergoing surgery on the anterolateral liver segments.
- The analysis included over 10,000 patients and employed propensity score matching to balance the groups for accuracy in comparisons.
- Results indicated RMLR had benefits like less blood loss, lower major morbidity, and shorter hospital stays than LMLR, although the difference in 30-day readmission rates suggested RMLR may have some drawbacks.
Background: It is well known that laparoscopic liver surgery can offer advantages over open liver surgery in selected patients. However, what type of procedures can benefit most from a laparoscopic approach has been investigated poorly thus far. The aim of this study is thus to define the extent of advantages of laparoscopic over open liver surgery for lesions in the anterolateral (AL) and posterosuperior (PS) segments.
View Article and Find Full Text PDFBackground: Laparoscopic liver surgery is increasingly used for more challenging procedures. The aim of this study was to assess the feasibility and oncological safety of laparoscopic right hepatectomy for colorectal liver metastases after portal vein embolization.
Methods: This was an international retrospective multicentre study of patients with colorectal liver metastases who underwent open or laparoscopic right and extended right hepatectomy after portal vein embolization between 2004 and 2020.
Objective: Routinely collected electronic health records using artificial intelligence (AI)-based systems bring out enormous benefits for patients, healthcare centers, and its industries. Artificial intelligence models can be used to structure a wide variety of unstructured data.
Methods: We present a semi-automatic workflow for medical dataset management, including data structuring, research extraction, AI-ground truth creation, and updates.
Introduction: Laparoscopic liver surgery has advanced significantly, offering benefits, such as reduced intraoperative complications and quicker recovery. However, complex laparoscopic hepatectomy (CLH) is technically demanding, requiring skilled surgeons. This study aims to share technical aspects, insightful tips, and outcomes of CLH at our center, focusing on the safety and learning curve.
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- The study aimed to create global benchmark outcome indicators for laparoscopic right posterior sectionectomies (L-RPS/H67) to improve surgical standards.
- It analyzed data from 854 patients across 57 centers globally, establishing key performance benchmarks for low-risk cases based on specific outcome indicators.
- The findings set standard benchmarks for metrics like operation time and complication rates, serving as a reference for surgical auditing and improvement.
Article Synopsis
- The study investigates the risk factors and outcomes related to open conversion during minimally invasive liver resections (MILR), especially in minor hepatectomies, highlighting its association with inferior results.
- Analysis was conducted on data from over 10,500 patients who underwent laparoscopic or robotic liver resections from 2004 to 2020, identifying key independent predictors for open conversion.
- Results show that patients who required open conversion experienced longer recovery times, increased blood loss, higher complications, and elevated 90-day mortality rates compared to those who had successful minimally invasive surgeries.
Background: Distal pancreatectomy (DP) is performed for lesions in the body and tail of the pancreas. The morbidity profile is considerable, mainly due to clinically relevant postoperative pancreatic fistula (CR-POPF). This study aims to investigate potential differences in CR-POPF related to transection site.
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- The study aimed to compare the outcomes of laparoscopic and open major liver resection (hemihepatectomy) primarily for cancer patients, focusing on functional recovery time and other health-related factors.
- In a multicenter trial, 332 patients underwent surgery, with laparoscopic surgeries resulting in faster functional recovery (4 days vs. 5 days) and higher quality of life scores compared to open surgeries.
- The laparoscopic approach also led to a shorter time to start adjuvant systemic therapy for cancer patients, without negatively affecting resection margin status or overall cancer outcomes.
Article Synopsis
- Minimally invasive liver surgery has become more common over the last 30 years, especially for treating colorectal liver metastases, but the effects of neoadjuvant chemotherapy on surgical outcomes are not well understood.
- A study analyzed a large database of nearly 5,000 patients who underwent minimally invasive liver surgeries to compare outcomes between those who received neoadjuvant chemotherapy and those who did not.
- The results showed that neoadjuvant chemotherapy did not significantly affect the short-term surgical outcomes in patients undergoing these liver procedures.
Article Synopsis
- International guidelines suggest that monitoring minimally invasive pancreatic surgery (MIPS) is important, but there is a lack of data, particularly on minimally invasive distal pancreatectomy (MIDP).
- This study analyzed data from 1672 patients in 83 European centers to compare robot-assisted distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP), focusing on intraoperative events, major morbidity, and mortality.
- Findings showed RDP had fewer intraoperative complications but longer surgery times compared to LDP; both procedures had low mortality rates, with LDP still being the more common approach despite the rising use of RDP.
Background: Ensuring safe adoption of AI tools in healthcare hinges on access to sufficient data for training, testing and validation. Synthetic data has been suggested in response to privacy concerns and regulatory requirements and can be created by training a generator on real data to produce a dataset with similar statistical properties. Competing metrics with differing taxonomies for quality evaluation have been proposed, resulting in a complex landscape.
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- A study was conducted to compare the perioperative outcomes of robotic liver surgery (RLS) and laparoscopic liver surgery (LLS) across various healthcare settings from 2009 to 2021.
- The results showed that RLS had better outcomes in terms of "textbook outcomes," lower blood loss, fewer complications, and shorter operative times compared to LLS after matching patient groups for bias.
- Despite the higher costs generally associated with robotic surgery, this study suggests that RLS may offer specific clinical advantages over LLS in minimally invasive liver procedures.
Hybrid optical-vision tracking in laparoscopy: accuracy of navigation and ultrasound reconstruction.
Minim Invasive Ther Allied Technol
June 2024
Introduction: The use of laparoscopic and robotic liver surgery is increasing. However, it presents challenges such as limited field of view and organ deformations. Surgeons rely on laparoscopic ultrasound (LUS) for guidance, but mentally correlating ultrasound images with pre-operative volumes can be difficult.
View Article and Find Full Text PDFObjectives: The aim of this international multicentric study is to characterize postoperative hyperamylasemia (POH) after distal pancreatectomy (DP), with particular focus on its relationship with postoperative pancreatic fistula (POPF) occurrence and severity.
Background: The clinical relevance of POH after DP and its relationship with the occurrence and severity of POPF have not been explored yet.
Methods: All patients undergoing DP for any indication between 2015 and 2021 at three European referral Centers for pancreatic surgery were retrospectively analyzed.
Article Synopsis
- There is a lack of international studies on the outcomes of minimally invasive pancreatoduodenectomy (MIPD), prompting the establishment of the European Registry for Minimally Invasive Pancreatic Surgery (E-MIPS) to monitor these procedures in Europe.
- An analysis of 1,336 patients from 45 centers across 14 European countries indicated significant outcomes, including a major morbidity rate of 41.2% and a 30-day/in-hospital mortality rate of 4.5%.
- Findings revealed that robot-assisted MIPD (R-MIPD) is becoming more popular than laparoscopic MIPD (L-MIPD), with better outcomes in terms of major morbidity and lower rates of complications when performed
Background: Guidelines are inconclusive on whether contrast-enhanced MRI using gadoxetic acid and diffusion-weighted imaging should be added routinely to CT in the investigation of patients with colorectal liver metastases who are scheduled for curative liver resection or thermal ablation, or both. Although contrast-enhanced MRI is reportedly superior than contrast-enhanced CT in the detection and characterisation of colorectal liver metastases, its effect on clinical patient management is unknown. We aimed to assess the clinical effect of an additional liver contrast-enhanced MRI on local treatment plan in patients with colorectal liver metastases amenable to local treatment, based on contrast-enhanced CT.
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- The study examines the effects of increasing laparoscopic liver surgery on patients with solid benign liver lesions (BLL) across multiple medical centers globally.
- It analyzes patient outcomes over three time periods (2008-2019), noting a stable percentage of surgeries for benign conditions but an increase in laparoscopic procedures and a decrease in hospital stay length.
- Despite no significant change in overall surgical success rates (TOLS), there was a notable improvement in a more stringent success measure (TOLS+) over time, indicating better perioperative outcomes for these patients.
Article Synopsis
- This study assessed how liver cirrhosis (LC) influences the challenges of minimally invasive liver resection (MILR), specifically for minor surgeries involving primary liver tumors in anterolateral segments.
- Conducted from 2004 to 2021 across 60 centers, the research involved 3,675 patients, with varying degrees of cirrhosis classified as Child A and Child B.
- Results indicated that patients with Child A cirrhosis faced higher risks of complications, such as increased blood loss and rates of open conversion, while those with Child B cirrhosis had longer hospital stays and more significant morbidity; overall, the severity of LC complicates the surgical process, highlighting the need for better difficulty
Background/aims: Clinically relevant postoperative pancreatic fistula (CR-POPF) after distal pancreatectomy (DP) occurs in 20%-40% of patients and remains a leading cause of morbidity and increased healthcare cost in this patient group. Recently, several studies suggested decreased risk of CR-POPF with the use of peri-firing compression (PFC) technique. The aim of this report was to conduct a systematic review to get an overview of the current knowledge on the use of PFC in DP.
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