Publications by authors named "Rotellar F"
Background: Several scores have been developed to stratify the risk of graft loss in controlled donation after circulatory death (cDCD). However, their performance is unsatisfactory in the Spanish population, where most cDCD livers are recovered using normothermic regional perfusion (NRP). Consequently, we explored the role of different machine learning-based classifiers as predictive models for graft survival.
View Article and Find Full Text PDFBackground And Aims: Liver transplant (LT) for transplant oncology (TO) indications is being slowly adopted worldwide and has been recommended to be incorporated cautiously due to concerns about mid-long-term survival and its impact on the waiting list.
Approach And Results: We conducted 4 systematic reviews of all series on TO indications (intrahepatic cholangiocarcinoma and perihilar cholangiocarcinoma [phCC]) and liver metastases from neuroendocrine tumors (NETs) and colorectal cancer (CRLM) and compared them using patient-level meta-analyses to data obtained from the United Network for Organ Sharing (UNOS) database considering conventional daily-practice indications. Secondary analyses were done for specific selection criteria (Mayo-like protocols for phCC, SECA-2 for CRLM, and Milan criteria for NET).
Pure laparoscopic living-donor right hepatectomy (PLDRH) has emerged as a significant advancement in liver transplantation, offering reduced donor morbidity and improved recovery times. However, PLDRH is still performed in only a limited number of centers. This retrospective study reports on the outcomes of 215 living donors who underwent PLDRH at Asan Medical Center in Seoul, Korea between November 2014 and December 2021.
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- The use of percutaneous cholecystostomy (PC) for treating acute cholecystitis (AC) has increased due to an aging population and supportive guidelines, prompting a need for clearer management protocols.
- An international consensus was developed through a two-round Delphi survey with 27 questions, and participants aimed for a minimum 70% agreement on the management of PCs.
- Out of these, six key recommendations were established, including the timing of PC implementation and the need for cholangiography before PC removal, highlighting the necessity for comprehensive guidelines on PC management in AC patients.
Article Synopsis
- 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.
Background: Neoadjuvant treatment has shown promising results in patients with borderline resectable pancreatic ductal adenocarcinoma. The potential benefits of neoadjuvant treatment on long-term overall survival in patients with resectable pancreatic ductal adenocarcinoma have not yet been established. The aim of this study was to compare long-term overall survival of patients with resectable pancreatic ductal adenocarcinoma based on whether they received neoadjuvant treatment or underwent upfront surgery.
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- Breast cancer is prevalent among women, with 20-30% of patients developing metastases, primarily affecting the liver. Patients with liver metastases have a wide range of survival rates, influenced by various factors.
- This study aimed to assess the long-term survival and disease-free outcomes for patients who had surgery for liver metastases stemming from breast cancer.
- Results indicated that surgery can enhance long-term survival, with specific patient characteristics (like health status, hormone receptor positivity, and prior treatments) linked to improved outcomes.
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 PDFIntroduction: Although several studies report that the robotic approach is more costly than laparoscopy, the cost-effectiveness of robotic distal pancreatectomy (RDP) over laparoscopic distal pancreatectomy (LDP) is still an issue. This study evaluates the cost-effectiveness of the RDP and LDP approaches across several Spanish centres.
Methods: This study is an observational, multicenter, national prospective study (ROBOCOSTES).
Background: 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.
Article Synopsis
- Metabolic syndrome (MS) is linked to hepatocellular carcinoma (HCC), prompting a study on the long-term outcomes of liver resections in MS patients.
- Data from 813 patients over 20 years showed a median overall survival of 81.4 months, with a recurrence rate of 48.3%, often peaking at 6 and 24 months post-surgery.
- The study concluded that while patients have favorable long-term outcomes, the timing and nature of recurrences—linked to tumor features and cirrhosis—play a crucial role in survival, highlighting the need for careful post-operative monitoring.
Article Synopsis
- 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 aimed to establish a common language regarding extreme liver surgery to facilitate better comparison of surgical outcomes across different centers.
- A Delphi methodology was used, gathering opinions from 38 expert surgeons, who largely agreed on key definitions related to total vascular occlusion and surgical approaches, achieving consensus on various topics.
- Ultimately, 75% agreed on a definition for extreme liver surgery, highlighting the importance of a unified approach in managing patients with complex liver diseases.
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.
Article Synopsis
- * Conducted between June 2019 and August 2020, the retrospective analysis involved 40 hospitals, with insights derived from over 2,200 liver surgeries, including 1350 for colorectal metastases, of which 150 utilized the liver-first strategy.
- * Findings revealed no significant differences in surgical outcomes between hospitals performing fewer than 50 versus those performing 50 or more liver surgeries per year, prompting further research into optimal candidate selection for this treatment approach.
Background And Aims: Liver regeneration is essential for the preservation of homeostasis and survival. Bile acids (BAs)-mediated signaling is necessary for liver regeneration, but BAs levels need to be carefully controlled to avoid hepatotoxicity. We studied the early response of the BAs-fibroblast growth factor 19 (FGF19) axis in healthy individuals undergoing hepatectomy for living donor liver transplant.
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- 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.
Introduction: Involvement of the inferior vena cava (IVC) and hepatic veins has been considered a relative contraindication to hepatic resection for primary and metastatic liver tumors. However, patients affected by tumors extending to the IVC have limited therapeutic options and suffer worsening of quality of life due to IVC compression.
Methods: Cases of primary and metastatic liver tumors with vena cava infiltration from 10 international centers were collected (7 European, 1 US, 2 Brazilian, 1 Indian) were collected.
Background: The effect of radiologic splenic vessels involvement (RSVI) on the survival of patients with pancreatic adenocarcinoma (PAC) located in the body and tail of the pancreas is controversial, and its influence on postoperative morbidity after distal pancreatectomy (DP) is unknown. This study aimed to determine the influence of RSVI on postoperative complications, overall survival (OS), and disease-free survival (DFS) in patients undergoing DP for PAC.
Methods: A multicenter retrospective study of DP was conducted at 7 hepatopancreatobiliary units between January 2008 and December 2018.