53 results match your criteria: "GB Rossi Hospital[Affiliation]"
Propensity Score-matched Analysis Comparing Robotic Versus Laparoscopic Minor Liver Resections of the Anterolateral Segments: an International Multi-center Study of 10,517 Cases.
Ann Surg
September 2024
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore.
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.
Impact of Cognitive Rehabilitation on Cognitive and Functional Outcomes in Adult Cancer Survivors: A Systematic Review.
Semin Oncol Nurs
October 2024
Duke University Health System, Durham, North Carolina.
Article Synopsis
- This systematic review aimed to evaluate the effectiveness of cognitive rehabilitation on cognitive and functional outcomes in adult cancer survivors, analyzing studies published until June 2023.
- A total of 53 studies were included, showing that cognitive rehabilitation had positive effects on cognitive measures, particularly with strategy-based interventions and combination therapies.
- The findings suggest cognitive rehabilitation can benefit cancer-related cognitive impairment, highlighting the need for nurses to promote awareness and utilization of these interventions among patients and healthcare providers.
Futility of Up-Front Resection for Anatomically Resectable Pancreatic Cancer.
JAMA Surg
October 2024
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy.
Importance: There are currently no clinically relevant criteria to predict a futile up-front pancreatectomy in patients with anatomically resectable pancreatic ductal adenocarcinoma.
Objectives: To develop a futility risk model using a multi-institutional database and provide unified criteria associated with a futility likelihood below a safety threshold of 20%.
Design, Setting, And Participants: This retrospective study took place from January 2010 through December 2021 at 5 high- or very high-volume centers in Italy.
Defining Global Benchmarks for Laparoscopic Right Posterior Sectionectomy/H67: An International Multicenter Study.
Ann Surg
June 2024
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore.
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.
Factors Associated with and Impact of Open Conversion in Laparoscopic and Robotic Minor Liver Resections: An International Multicenter Study of 10,541 Patients.
Ann Surg Oncol
September 2024
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Center Singapore, Singapore, Singapore.
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.
Impact of age, comorbidities and relevant changes on surveillance strategy of intraductal papillary mucinous neoplasms: a competing risk analysis.
Gut
July 2024
Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy
Objective: Cost-effectiveness of surveillance for branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) is debated. We combined different categories of risks of IPMN progression and of IPMN-unrelated mortality to improve surveillance strategies.
Design: Retrospective analysis of 926 presumed BD-IPMNs lacking worrisome features (WFs)/high-risk stigmata (HRS) under surveillance.
Impact of neoadjuvant chemotherapy on short-term outcomes after simple and complex minimally invasive minor hepatectomy for colorectal liver metastases: A propensity-score matched and coarsened exact matched study.
Eur J Surg Oncol
June 2024
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore. Electronic address:
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.
Impact of liver cirrhosis, severity of cirrhosis and portal hypertension on the difficulty of laparoscopic and robotic minor liver resections for primary liver malignancies in the anterolateral segments.
Eur J Surg Oncol
January 2024
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke National University of Singapore Medical School, Singapore. Electronic address:
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
Impact of Liver Cirrhosis, Severity of Cirrhosis, and Portal Hypertension on the Difficulty and Outcomes of Laparoscopic and Robotic Major Liver Resections for Primary Liver Malignancies.
Ann Surg Oncol
January 2024
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore.
Article Synopsis
- Minimally invasive liver resections (MILR) can reduce blood loss and recovery time compared to traditional methods, but the impact of cirrhosis on these procedures is not fully understood.
- A study reviewed data from 2534 patients who underwent minimally invasive major liver surgeries worldwide, focusing on outcomes related to different levels of cirrhosis.
- Results showed that advanced cirrhosis leads to higher blood transfusion rates, more postoperative complications, and longer hospital stays, suggesting that cirrhosis severity should be considered in future assessments of surgical difficulty in MILR.*
Impact of liver cirrhosis and portal hypertension on minimally invasive limited liver resection for primary liver malignancies in the posterosuperior segments: An international multicenter study.
Eur J Surg Oncol
October 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore. Electronic address:
Article Synopsis
- The study investigates how cirrhosis and portal hypertension (PHT) affect the complexity and outcomes of minimally invasive liver surgery in specific liver segments.
- It examines a large patient group, revealing that those with cirrhosis experienced more complications and required more blood transfusions during surgery.
- The findings suggest that the presence of cirrhosis and PHT should be considered when evaluating the difficulties and risks associated with minimally invasive liver resections.
Impact of Tumor Size on the Difficulty of Laparoscopic Major Hepatectomies: An International Multicenter Study.
Ann Surg Oncol
October 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore.
Article Synopsis
- Tumor size (TS) impacts intraoperative outcomes in laparoscopic major hepatectomy (L-MH), with this study aiming to clarify its effects and find optimal TS cutoffs for assessing surgical difficulty.
- The analysis, which included 1396 patients from a larger pool of 3008 undergoing L-MH, identified two critical TS cutoffs at 50 mm and 100 mm that segmented patients into three distinct groups.
- Results showed that larger TS correlated with increased open conversion rates, longer operation times, higher blood loss, and more intraoperative blood transfusions, while postoperative complications remained similar across the groups.
Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments: An International Multicenter Study.
Ann Surg
February 2024
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore.
Article Synopsis
- This study aimed to compare outcomes of robotic limited liver resections (RLLR) and laparoscopic limited liver resections (LLLR) for tumors in the posterosuperior liver segments, noting that previous research had not thoroughly examined the differences in performance and safety between the two approaches.
- An analysis of data from 3510 patients showed that RLLR had significant advantages over LLLR, including a lower rate of open conversions, reduced blood loss, and shorter operative times, even in patients with cirrhosis.
- Despite the improved perioperative outcomes for RLLR, postoperative metrics like readmission, morbidity, and mortality rates were similar between both surgical techniques.
Impact of liver cirrhosis, the severity of cirrhosis, and portal hypertension on the outcomes of minimally invasive left lateral sectionectomies for primary liver malignancies.
Surgery
September 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Duke National University of Singapore Medical School, Singapore. Electronic address:
Background: The impact of cirrhosis and portal hypertension on perioperative outcomes of minimally invasive left lateral sectionectomies remains unclear. We aimed to compare the perioperative outcomes between patients with preserved and compromised liver function (noncirrhotics versus Child-Pugh A) when undergoing minimally invasive left lateral sectionectomies. In addition, we aimed to determine if the extent of cirrhosis (Child-Pugh A versus B) and the presence of portal hypertension had a significant impact on perioperative outcomes.
View Article and Find Full Text PDFImpact of body mass index on perioperative outcomes of laparoscopic major hepatectomies.
Surgery
August 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore. Electronic address:
Background: Data on the effect of body mass index on laparoscopic liver resections are conflicting. We performed this study to investigate the association between body mass index and postoperative outcomes after laparoscopic major hepatectomies.
Methods: This is a retrospective review of 4,348 laparoscopic major hepatectomies at 58 centers between 2005 and 2021, of which 3,383 met the study inclusion criteria.
Risk Factors and Outcomes of Open Conversion During Minimally Invasive Major Hepatectomies: An International Multicenter Study on 3880 Procedures Comparing the Laparoscopic and Robotic Approaches.
Ann Surg Oncol
August 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore.
Article Synopsis
- Despite advancements in minimally invasive liver surgery, open surgeries are still common, and this study examines the factors that lead to conversions from minimally invasive techniques to open surgery during major hepatectomies.
- Data from 3880 surgical cases showed that 10.28% resulted in open conversions, with several risk factors identified, such as male sex, liver cirrhosis, and larger tumor sizes, which are linked to increased conversion risk.
- The study found that those who experienced open conversions had worse outcomes, including longer operation times and higher rates of postoperative complications, although robotic surgery had a lower conversion rate compared to laparoscopic techniques, it still led to significant challenges when conversions did occur.
Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy.
Eur J Surg Oncol
August 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore. Electronic address:
Article Synopsis
- - The study investigates how body mass index (BMI) affects outcomes after laparoscopic left lateral sectionectomy (L-LLS), revealing that higher BMI levels (greater than 27kg/m²) lead to increased blood loss, longer operative times, and more open conversions during surgery.
- - A large sample of 2,183 patients from 59 centers worldwide was analyzed, showing that as BMI increases, so do certain negative surgical outcomes, but patient complications also exhibited a "U" shaped relationship—higher rates were seen in both underweight and obese individuals.
- - The findings suggest that BMI should be considered in evaluating the difficulty of L-LLS procedures and in future assessments of surgical risk and outcomes.
Robotic versus laparoscopic liver resection for huge (≥10 cm) liver tumors: an international multicenter propensity-score matched cohort study of 799 cases.
Hepatobiliary Surg Nutr
April 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore.
Article Synopsis
- Laparoscopic liver resections (LLR) and robotic liver resections (RLR) are effective techniques for treating large liver tumors (≥10 cm), and a multicenter study provides better understanding of their safety and application.
- A retrospective review of 971 patients from 42 centers between 2002-2020 revealed that 100 underwent RLR and 699 underwent LLR, with a focus on comparing perioperative outcomes.
- After matching for patient characteristics, the study found no significant differences in key outcomes between RLR and LLR, indicating both methods can be safely used with excellent results for large tumors.
Robotic versus laparoscopic liver resections for hepatolithiasis: an international multicenter propensity score matched analysis.
Surg Endosc
August 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, National Cancer Centre Singapore and Duke-National University Singapore Medical School, Academia, Level 5, 20 College Road, Singapore, 169856, Singapore.
Article Synopsis
- Minimally invasive liver resection (MILR) helps treat liver diseases and is becoming more common worldwide.
- A study looked at 273 patients who had two types of surgeries, robotic (RLR) and laparoscopic (LLR), to see how they compared for treating liver stones.
- The results showed that RLR had less blood loss and fewer patients needed to switch to traditional open surgery, but both methods were generally safe.
Propensity-score Matched and Coarsened-exact Matched Analysis Comparing Robotic and Laparoscopic Major Hepatectomies: An International Multicenter Study of 4822 Cases.
Ann Surg
December 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore.
Article Synopsis
- The study aimed to compare outcomes of robotic major hepatectomy (R-MH) versus laparoscopic major hepatectomy (L-MH), exploring whether R-MH offers any advantages.
- An analysis of 4822 patient cases across 59 centers revealed that R-MH resulted in significantly less blood loss, fewer applications of the Pringle maneuver, and lower rates of conversion to open surgery.
- Moreover, R-MH showed reduced postoperative morbidity and shorter hospital stays for patients with cirrhosis compared to L-MH, indicating its potential benefits.
Impact of neoadjuvant chemotherapy on the difficulty and outcomes of laparoscopic and robotic major liver resections for colorectal liver metastases: A propensity-score and coarsened exact-matched controlled study.
Eur J Surg Oncol
July 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, National Cancer Centre Singapore and Duke-National University of Singapore Medical School, Singapore. Electronic address:
Article Synopsis
- Minimal invasive liver resections (MLRs) are safer alternatives to traditional open surgery, but the effects of neoadjuvant chemotherapy (NAT) on their difficulty are not well understood.
- This study analyzed data from 1,034 patients across 57 centers who underwent laparoscopic and robotic MLRs for colorectal liver metastases (CRLM), comparing those who received NAT to those who did not using statistical matching methods.
- Results showed no significant differences in perioperative outcomes after matching, although the NAT group experienced slightly higher blood loss but shorter hospital stays, indicating that NAT has minimal impact on the difficulty and overall outcomes of MLRs for CRLM.*
Impact of tumor size on the difficulty of laparoscopic left lateral sectionectomies.
J Hepatobiliary Pancreat Sci
May 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Division of Surgery, Singapore General Hospital, Singapore, Singapore.
Background: Tumor size (TS) represents a critical parameter in the risk assessment of laparoscopic liver resections (LLR). Moreover, TS has been rarely related to the extent of liver resection. The aim of this study was to study the relationship between tumor size and difficulty of laparoscopic left lateral sectionectomy (L-LLS).
View Article and Find Full Text PDFLong-Term Follow-Up after Surgery for Chronic Pancreatitis: A Bicentric Retrospective Experience.
Dig Surg
January 2023
Department of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Vienna, Austria.
Introduction: The impact of surgery on nutritional status, pancreatic function, and symptoms of patients affected by chronic pancreatitis (CP) has not been unequivocally determined. This study aimed to evaluate clinical follow-up after surgery for CP in an Italian-Austrian population.
Materials And Methods: Patients operated for CP at two high-volume centers between 2000 and 2018 were analyzed.
Utility of the Iwate difficulty scoring system for laparoscopic right posterior sectionectomy: do surgical outcomes differ for tumors in segments VI and VII?
Surg Endosc
December 2022
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital & National Cancer Centre Singapore, Level 5, 20 College Road, Academia, Singapore, 169856, Singapore.
Introduction: The Iwate Score (IS) have not been well-validated for specific procedures, especially for right posterior sectionectomy (RPS). In this study, the utility of the IS was determined for laparoscopic (L)RPS and the effect of tumor location on surgical outcomes was investigated.
Methods: Post-hoc analysis of 647 L-RPS performed in 40 international centers of which 596L-RPS cases met the inclusion criteria.
Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study.
Ann Surg
April 2023
Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
Objective: To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR).
Background: There is limited published data to date on the best achievable outcomes after L-LR.
Methods: This is a post hoc analysis of a multicenter database of 11,983 patients undergoing L-LR in 45 international centers in 4 continents between 2015 and 2020.
Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study.
J Hepatobiliary Pancreat Sci
February 2023
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital/National Cancer Centre Singapore and Duke-National University of Singapore Medical School, Singapore City, Singapore.
Background: Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8.
View Article and Find Full Text PDF