Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers
Herein, we aimed to establish benchmark values – based on a composite indicator of healthcare quality – for the performance of laparoscopic left lateral sectionectomy (LLLS) and laparoscopic right hepatectomy (LRH) using data from expert centers. Data from a nationwide multicenter survey including a...
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| Veröffentlicht in: | Journal of hepatology 2020-11, Vol.73 (5), p.1100-1108 |
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| creator | Hobeika, Christian Fuks, David Cauchy, François Goumard, Claire Gayet, Brice Laurent, Alexis Soubrane, Olivier Salamé, Ephrem Cherqui, Daniel Regimbeau, Jean-Marc Mabrut, Jean-Yves Scatton, Olivier Vibert, Eric Nomi, T. Oudafal, N. Kawai, T. Komatsu, S. Okumura, S. Petrucciani, N. Laurent, A. Bucur, P. Barbier, L. Trechot, B. Nunèz, J. Tedeschi, M. Allard, M.-A. Golse, N. Ciacio, O. Pittau, G. Sa Cunha, A. Adam, R. Laurent, C. Chiche, L. Leourier, P. Rebibo, L. Regimbeau, J.-M. Ferre, L. Souche, F.R. Chauvat, J. Fabre, J.-M. Jehaes, F. Mohkam, K. Lesurtel, M. Ducerf, C. Mabrut, J.-Y. Hor, T. Paye, F. Balladur, P. Suc, B. Muscari, F. Millet, G. El Amrani, M. Ratajczak, C. Lecolle, K. Boleslawski, E. Truant, S. Pruvot, F.-R. Kianmanesh, A.-R. Codjia, T. Schwarz, L. Girard, E. Abba, J. Letoublon, C. Chirica, M. Carmelo, A. VanBrugghe, C. Cherkaoui, Z. Unterteiner, X. Memeo, R. Pessaux, P. Buc, E. Lermite, E. Barbieux, J. Bougard, M. Marchese, U. Ewald, J. Turini, O. Thobie, A. Menahem, B. Mulliri, A. Lubrano, J. Zemour, J. Fagot, H. Passot, G. Gregoire, E. Hardwigsen, J. le Treut, Y.-P. Patrice, D. |
| description | Herein, we aimed to establish benchmark values – based on a composite indicator of healthcare quality – for the performance of laparoscopic left lateral sectionectomy (LLLS) and laparoscopic right hepatectomy (LRH) using data from expert centers.
Data from a nationwide multicenter survey including all patients undergoing LLLS and LRH between 2000 and 2017 were analyzed. Textbook outcome (TO) completion was considered in patients fulfilling all 6 of the following characteristics: negative margins, no transfusion, no complication, no prolonged hospital stay, no readmission and no mortality. For each procedure, a cut-off laparoscopic liver resection (LLR) volume by center was associated with TO on multivariable analysis. These cut-offs defined the expert centers. The benchmark values were set at the 75th percentile of median outcomes among these expert centers.
Among 4,400 LLRs performed in 29 centers, 855 patients who underwent LLLS and 488 who underwent LRH were identified. The overall incidences of TO after LLLS and LRH were 43.7% and 23.8%, respectively. LLR volume cut-offs of 25 LLR/year (odds ratio [OR] 2.45; bootstrap 95% CI 1.65–3.69; p = 0.001) and 35 LLR/year (OR 2.55; bootstrap 95% CI 1.34–5.63; p = 0.003) were independently associated with completion of TO after LLLS and LRH, respectively. Eight centers for LLLS and 6 centers for LRH, including 516 and 346 patients undergoing LLLS/LRH respectively, reached these cut-offs and were identified as expert centers. After LLLS, benchmark values of severe complication, mortality and TO completion were defined as ≤5.3%, ≤1.2% and ≥46.6%, respectively. After LRH, benchmark values of severe complication, mortality and TO completion were ≤20.4%, ≤2.8% and ≥24.2%, respectively.
This study provides an up-to-date reference on the benchmark performance of LLLS and LRH in expert centers.
In a nationwide French survey of laparoscopic liver resection, expert centers were defined according to the completion of a textbook outcome, which is a composite indicator of healthcare quality. Benchmark values regarding intra-operative details and outcomes were established using data from 516 patients with laparoscopic left lateral sectionectiomy and 346 patients with laparoscopic right hepatectomy from expert centers. These values should be used as a reference point to improve the quality of laparoscopic resections.
[Display omitted]
•Laparoscopic left lateral sectionectomies/right hepatectomies from nationwide survey.•Identif |
| doi_str_mv | 10.1016/j.jhep.2020.05.003 |
| format | Article |
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Data from a nationwide multicenter survey including all patients undergoing LLLS and LRH between 2000 and 2017 were analyzed. Textbook outcome (TO) completion was considered in patients fulfilling all 6 of the following characteristics: negative margins, no transfusion, no complication, no prolonged hospital stay, no readmission and no mortality. For each procedure, a cut-off laparoscopic liver resection (LLR) volume by center was associated with TO on multivariable analysis. These cut-offs defined the expert centers. The benchmark values were set at the 75th percentile of median outcomes among these expert centers.
Among 4,400 LLRs performed in 29 centers, 855 patients who underwent LLLS and 488 who underwent LRH were identified. The overall incidences of TO after LLLS and LRH were 43.7% and 23.8%, respectively. LLR volume cut-offs of 25 LLR/year (odds ratio [OR] 2.45; bootstrap 95% CI 1.65–3.69; p = 0.001) and 35 LLR/year (OR 2.55; bootstrap 95% CI 1.34–5.63; p = 0.003) were independently associated with completion of TO after LLLS and LRH, respectively. Eight centers for LLLS and 6 centers for LRH, including 516 and 346 patients undergoing LLLS/LRH respectively, reached these cut-offs and were identified as expert centers. After LLLS, benchmark values of severe complication, mortality and TO completion were defined as ≤5.3%, ≤1.2% and ≥46.6%, respectively. After LRH, benchmark values of severe complication, mortality and TO completion were ≤20.4%, ≤2.8% and ≥24.2%, respectively.
This study provides an up-to-date reference on the benchmark performance of LLLS and LRH in expert centers.
In a nationwide French survey of laparoscopic liver resection, expert centers were defined according to the completion of a textbook outcome, which is a composite indicator of healthcare quality. Benchmark values regarding intra-operative details and outcomes were established using data from 516 patients with laparoscopic left lateral sectionectiomy and 346 patients with laparoscopic right hepatectomy from expert centers. These values should be used as a reference point to improve the quality of laparoscopic resections.
[Display omitted]
•Laparoscopic left lateral sectionectomies/right hepatectomies from nationwide survey.•Identification of centers with best practices using textbook outcome as indicator.•Benchmarking from outcomes of centers with best practices.•Laparoscopic left lateral sectionectomy: severe complication ≤5%, mortality ≤1%.•Laparoscopic right hepatectomy: severe complication ≤20%, mortality ≤3%.</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2020.05.003</identifier><identifier>PMID: 32407812</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Benchmark ; Benchmarking ; Blood Transfusion ; Cancer ; Female ; France ; Health Care Surveys ; Hepatectomy ; Hospitals ; Humans ; Laparoscopic liver resection ; Laparoscopy ; Left lateral sectionectomy ; Length of Stay ; Life Sciences ; Liver ; Liver Neoplasms ; Male ; Margins of Excision ; Mortality ; Outcome and Process Assessment, Health Care ; Patient Readmission ; Postoperative Complications ; Quality Indicators, Health Care ; Quality of care ; Right hepatectomy ; Textbook outcome</subject><ispartof>Journal of hepatology, 2020-11, Vol.73 (5), p.1100-1108</ispartof><rights>2020 European Association for the Study of the Liver</rights><rights>Copyright © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Nov 2020</rights><rights>Attribution - NonCommercial</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-d54be164dc3d27f72b8b9e0849a0a7412835ac6570f61102a711bcb45d2cf21c3</citedby><cites>FETCH-LOGICAL-c462t-d54be164dc3d27f72b8b9e0849a0a7412835ac6570f61102a711bcb45d2cf21c3</cites><orcidid>0000-0002-2059-1237 ; 0000-0003-1372-0843 ; 0000-0002-9592-2520 ; 0000-0001-7631-9112 ; 0000-0002-1372-3182 ; 0000-0001-9908-8265 ; 0000-0001-5635-7437</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhep.2020.05.003$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32407812$$D View this record in 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S.</creatorcontrib><creatorcontrib>Petrucciani, N.</creatorcontrib><creatorcontrib>Laurent, A.</creatorcontrib><creatorcontrib>Bucur, P.</creatorcontrib><creatorcontrib>Barbier, L.</creatorcontrib><creatorcontrib>Trechot, B.</creatorcontrib><creatorcontrib>Nunèz, J.</creatorcontrib><creatorcontrib>Tedeschi, M.</creatorcontrib><creatorcontrib>Allard, M.-A.</creatorcontrib><creatorcontrib>Golse, N.</creatorcontrib><creatorcontrib>Ciacio, O.</creatorcontrib><creatorcontrib>Pittau, G.</creatorcontrib><creatorcontrib>Sa Cunha, A.</creatorcontrib><creatorcontrib>Adam, R.</creatorcontrib><creatorcontrib>Laurent, C.</creatorcontrib><creatorcontrib>Chiche, L.</creatorcontrib><creatorcontrib>Leourier, P.</creatorcontrib><creatorcontrib>Rebibo, L.</creatorcontrib><creatorcontrib>Regimbeau, J.-M.</creatorcontrib><creatorcontrib>Ferre, L.</creatorcontrib><creatorcontrib>Souche, F.R.</creatorcontrib><creatorcontrib>Chauvat, J.</creatorcontrib><creatorcontrib>Fabre, J.-M.</creatorcontrib><creatorcontrib>Jehaes, F.</creatorcontrib><creatorcontrib>Mohkam, K.</creatorcontrib><creatorcontrib>Lesurtel, M.</creatorcontrib><creatorcontrib>Ducerf, C.</creatorcontrib><creatorcontrib>Mabrut, J.-Y.</creatorcontrib><creatorcontrib>Hor, T.</creatorcontrib><creatorcontrib>Paye, F.</creatorcontrib><creatorcontrib>Balladur, P.</creatorcontrib><creatorcontrib>Suc, B.</creatorcontrib><creatorcontrib>Muscari, F.</creatorcontrib><creatorcontrib>Millet, G.</creatorcontrib><creatorcontrib>El Amrani, M.</creatorcontrib><creatorcontrib>Ratajczak, C.</creatorcontrib><creatorcontrib>Lecolle, K.</creatorcontrib><creatorcontrib>Boleslawski, E.</creatorcontrib><creatorcontrib>Truant, S.</creatorcontrib><creatorcontrib>Pruvot, F.-R.</creatorcontrib><creatorcontrib>Kianmanesh, A.-R.</creatorcontrib><creatorcontrib>Codjia, T.</creatorcontrib><creatorcontrib>Schwarz, L.</creatorcontrib><creatorcontrib>Girard, E.</creatorcontrib><creatorcontrib>Abba, J.</creatorcontrib><creatorcontrib>Letoublon, C.</creatorcontrib><creatorcontrib>Chirica, M.</creatorcontrib><creatorcontrib>Carmelo, A.</creatorcontrib><creatorcontrib>VanBrugghe, C.</creatorcontrib><creatorcontrib>Cherkaoui, Z.</creatorcontrib><creatorcontrib>Unterteiner, X.</creatorcontrib><creatorcontrib>Memeo, R.</creatorcontrib><creatorcontrib>Pessaux, P.</creatorcontrib><creatorcontrib>Buc, E.</creatorcontrib><creatorcontrib>Lermite, E.</creatorcontrib><creatorcontrib>Barbieux, J.</creatorcontrib><creatorcontrib>Bougard, M.</creatorcontrib><creatorcontrib>Marchese, U.</creatorcontrib><creatorcontrib>Ewald, J.</creatorcontrib><creatorcontrib>Turini, O.</creatorcontrib><creatorcontrib>Thobie, A.</creatorcontrib><creatorcontrib>Menahem, B.</creatorcontrib><creatorcontrib>Mulliri, A.</creatorcontrib><creatorcontrib>Lubrano, J.</creatorcontrib><creatorcontrib>Zemour, J.</creatorcontrib><creatorcontrib>Fagot, H.</creatorcontrib><creatorcontrib>Passot, G.</creatorcontrib><creatorcontrib>Gregoire, E.</creatorcontrib><creatorcontrib>Hardwigsen, J.</creatorcontrib><creatorcontrib>le Treut, Y.-P.</creatorcontrib><creatorcontrib>Patrice, D.</creatorcontrib><creatorcontrib>AFC-LLR-2018 study group</creatorcontrib><title>Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>Herein, we aimed to establish benchmark values – based on a composite indicator of healthcare quality – for the performance of laparoscopic left lateral sectionectomy (LLLS) and laparoscopic right hepatectomy (LRH) using data from expert centers.
Data from a nationwide multicenter survey including all patients undergoing LLLS and LRH between 2000 and 2017 were analyzed. Textbook outcome (TO) completion was considered in patients fulfilling all 6 of the following characteristics: negative margins, no transfusion, no complication, no prolonged hospital stay, no readmission and no mortality. For each procedure, a cut-off laparoscopic liver resection (LLR) volume by center was associated with TO on multivariable analysis. These cut-offs defined the expert centers. The benchmark values were set at the 75th percentile of median outcomes among these expert centers.
Among 4,400 LLRs performed in 29 centers, 855 patients who underwent LLLS and 488 who underwent LRH were identified. The overall incidences of TO after LLLS and LRH were 43.7% and 23.8%, respectively. LLR volume cut-offs of 25 LLR/year (odds ratio [OR] 2.45; bootstrap 95% CI 1.65–3.69; p = 0.001) and 35 LLR/year (OR 2.55; bootstrap 95% CI 1.34–5.63; p = 0.003) were independently associated with completion of TO after LLLS and LRH, respectively. Eight centers for LLLS and 6 centers for LRH, including 516 and 346 patients undergoing LLLS/LRH respectively, reached these cut-offs and were identified as expert centers. After LLLS, benchmark values of severe complication, mortality and TO completion were defined as ≤5.3%, ≤1.2% and ≥46.6%, respectively. After LRH, benchmark values of severe complication, mortality and TO completion were ≤20.4%, ≤2.8% and ≥24.2%, respectively.
This study provides an up-to-date reference on the benchmark performance of LLLS and LRH in expert centers.
In a nationwide French survey of laparoscopic liver resection, expert centers were defined according to the completion of a textbook outcome, which is a composite indicator of healthcare quality. Benchmark values regarding intra-operative details and outcomes were established using data from 516 patients with laparoscopic left lateral sectionectiomy and 346 patients with laparoscopic right hepatectomy from expert centers. These values should be used as a reference point to improve the quality of laparoscopic resections.
[Display omitted]
•Laparoscopic left lateral sectionectomies/right hepatectomies from nationwide survey.•Identification of centers with best practices using textbook outcome as indicator.•Benchmarking from outcomes of centers with best practices.•Laparoscopic left lateral sectionectomy: severe complication ≤5%, mortality ≤1%.•Laparoscopic right hepatectomy: severe complication ≤20%, mortality ≤3%.</description><subject>Benchmark</subject><subject>Benchmarking</subject><subject>Blood Transfusion</subject><subject>Cancer</subject><subject>Female</subject><subject>France</subject><subject>Health Care Surveys</subject><subject>Hepatectomy</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laparoscopic liver resection</subject><subject>Laparoscopy</subject><subject>Left lateral sectionectomy</subject><subject>Length of Stay</subject><subject>Life Sciences</subject><subject>Liver</subject><subject>Liver Neoplasms</subject><subject>Male</subject><subject>Margins of Excision</subject><subject>Mortality</subject><subject>Outcome and Process Assessment, Health Care</subject><subject>Patient Readmission</subject><subject>Postoperative Complications</subject><subject>Quality Indicators, Health Care</subject><subject>Quality of care</subject><subject>Right hepatectomy</subject><subject>Textbook 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J.</creator><creator>Fabre, J.-M.</creator><creator>Jehaes, F.</creator><creator>Mohkam, K.</creator><creator>Lesurtel, M.</creator><creator>Ducerf, C.</creator><creator>Mabrut, J.-Y.</creator><creator>Hor, T.</creator><creator>Paye, F.</creator><creator>Balladur, P.</creator><creator>Suc, B.</creator><creator>Muscari, F.</creator><creator>Millet, G.</creator><creator>El Amrani, M.</creator><creator>Ratajczak, C.</creator><creator>Lecolle, K.</creator><creator>Boleslawski, E.</creator><creator>Truant, S.</creator><creator>Pruvot, F.-R.</creator><creator>Kianmanesh, A.-R.</creator><creator>Codjia, T.</creator><creator>Schwarz, L.</creator><creator>Girard, E.</creator><creator>Abba, J.</creator><creator>Letoublon, C.</creator><creator>Chirica, M.</creator><creator>Carmelo, A.</creator><creator>VanBrugghe, C.</creator><creator>Cherkaoui, Z.</creator><creator>Unterteiner, X.</creator><creator>Memeo, R.</creator><creator>Pessaux, P.</creator><creator>Buc, E.</creator><creator>Lermite, E.</creator><creator>Barbieux, J.</creator><creator>Bougard, M.</creator><creator>Marchese, U.</creator><creator>Ewald, J.</creator><creator>Turini, O.</creator><creator>Thobie, A.</creator><creator>Menahem, B.</creator><creator>Mulliri, A.</creator><creator>Lubrano, J.</creator><creator>Zemour, J.</creator><creator>Fagot, H.</creator><creator>Passot, G.</creator><creator>Gregoire, E.</creator><creator>Hardwigsen, J.</creator><creator>le Treut, Y.-P.</creator><creator>Patrice, D.</creator><general>Elsevier B.V</general><general>Elsevier Science Ltd</general><general>Elsevier</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0002-2059-1237</orcidid><orcidid>https://orcid.org/0000-0003-1372-0843</orcidid><orcidid>https://orcid.org/0000-0002-9592-2520</orcidid><orcidid>https://orcid.org/0000-0001-7631-9112</orcidid><orcidid>https://orcid.org/0000-0002-1372-3182</orcidid><orcidid>https://orcid.org/0000-0001-9908-8265</orcidid><orcidid>https://orcid.org/0000-0001-5635-7437</orcidid></search><sort><creationdate>202011</creationdate><title>Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers</title><author>Hobeika, Christian ; Fuks, David ; Cauchy, François ; Goumard, Claire ; Gayet, Brice ; Laurent, Alexis ; Soubrane, Olivier ; Salamé, Ephrem ; Cherqui, Daniel ; Regimbeau, Jean-Marc ; Mabrut, Jean-Yves ; Scatton, Olivier ; Vibert, Eric ; Nomi, T. ; Oudafal, N. ; Kawai, T. ; Komatsu, S. ; Okumura, S. ; Petrucciani, N. ; Laurent, A. ; Bucur, P. ; Barbier, L. ; Trechot, B. ; Nunèz, J. ; Tedeschi, M. ; Allard, M.-A. ; Golse, N. ; Ciacio, O. ; Pittau, G. ; Sa Cunha, A. ; Adam, R. ; Laurent, C. ; Chiche, L. ; Leourier, P. ; Rebibo, L. ; Regimbeau, J.-M. ; Ferre, L. ; Souche, F.R. ; Chauvat, J. ; Fabre, J.-M. ; Jehaes, F. ; Mohkam, K. ; Lesurtel, M. ; Ducerf, C. ; Mabrut, J.-Y. ; Hor, T. ; Paye, F. ; Balladur, P. ; Suc, B. ; Muscari, F. ; Millet, G. ; El Amrani, M. ; Ratajczak, C. ; Lecolle, K. ; Boleslawski, E. ; Truant, S. ; Pruvot, F.-R. ; Kianmanesh, A.-R. ; Codjia, T. ; Schwarz, L. ; Girard, E. ; Abba, J. ; Letoublon, C. ; Chirica, M. ; Carmelo, A. ; VanBrugghe, C. ; Cherkaoui, Z. ; Unterteiner, X. ; Memeo, R. ; Pessaux, P. ; Buc, E. ; Lermite, E. ; Barbieux, J. ; Bougard, M. ; Marchese, U. ; Ewald, J. ; Turini, O. ; Thobie, A. ; Menahem, B. ; Mulliri, A. ; Lubrano, J. ; Zemour, J. ; Fagot, H. ; Passot, G. ; Gregoire, E. ; Hardwigsen, J. ; le Treut, Y.-P. ; Patrice, D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-d54be164dc3d27f72b8b9e0849a0a7412835ac6570f61102a711bcb45d2cf21c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Benchmark</topic><topic>Benchmarking</topic><topic>Blood Transfusion</topic><topic>Cancer</topic><topic>Female</topic><topic>France</topic><topic>Health Care Surveys</topic><topic>Hepatectomy</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Laparoscopic liver resection</topic><topic>Laparoscopy</topic><topic>Left lateral sectionectomy</topic><topic>Length of Stay</topic><topic>Life Sciences</topic><topic>Liver</topic><topic>Liver Neoplasms</topic><topic>Male</topic><topic>Margins of Excision</topic><topic>Mortality</topic><topic>Outcome and Process Assessment, Health Care</topic><topic>Patient Readmission</topic><topic>Postoperative Complications</topic><topic>Quality Indicators, Health Care</topic><topic>Quality of care</topic><topic>Right hepatectomy</topic><topic>Textbook outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hobeika, Christian</creatorcontrib><creatorcontrib>Fuks, David</creatorcontrib><creatorcontrib>Cauchy, François</creatorcontrib><creatorcontrib>Goumard, Claire</creatorcontrib><creatorcontrib>Gayet, Brice</creatorcontrib><creatorcontrib>Laurent, Alexis</creatorcontrib><creatorcontrib>Soubrane, Olivier</creatorcontrib><creatorcontrib>Salamé, Ephrem</creatorcontrib><creatorcontrib>Cherqui, Daniel</creatorcontrib><creatorcontrib>Regimbeau, Jean-Marc</creatorcontrib><creatorcontrib>Mabrut, Jean-Yves</creatorcontrib><creatorcontrib>Scatton, Olivier</creatorcontrib><creatorcontrib>Vibert, Eric</creatorcontrib><creatorcontrib>Nomi, T.</creatorcontrib><creatorcontrib>Oudafal, N.</creatorcontrib><creatorcontrib>Kawai, T.</creatorcontrib><creatorcontrib>Komatsu, S.</creatorcontrib><creatorcontrib>Okumura, S.</creatorcontrib><creatorcontrib>Petrucciani, N.</creatorcontrib><creatorcontrib>Laurent, A.</creatorcontrib><creatorcontrib>Bucur, P.</creatorcontrib><creatorcontrib>Barbier, L.</creatorcontrib><creatorcontrib>Trechot, B.</creatorcontrib><creatorcontrib>Nunèz, J.</creatorcontrib><creatorcontrib>Tedeschi, M.</creatorcontrib><creatorcontrib>Allard, M.-A.</creatorcontrib><creatorcontrib>Golse, N.</creatorcontrib><creatorcontrib>Ciacio, O.</creatorcontrib><creatorcontrib>Pittau, G.</creatorcontrib><creatorcontrib>Sa Cunha, A.</creatorcontrib><creatorcontrib>Adam, R.</creatorcontrib><creatorcontrib>Laurent, C.</creatorcontrib><creatorcontrib>Chiche, L.</creatorcontrib><creatorcontrib>Leourier, P.</creatorcontrib><creatorcontrib>Rebibo, L.</creatorcontrib><creatorcontrib>Regimbeau, J.-M.</creatorcontrib><creatorcontrib>Ferre, L.</creatorcontrib><creatorcontrib>Souche, F.R.</creatorcontrib><creatorcontrib>Chauvat, J.</creatorcontrib><creatorcontrib>Fabre, J.-M.</creatorcontrib><creatorcontrib>Jehaes, F.</creatorcontrib><creatorcontrib>Mohkam, K.</creatorcontrib><creatorcontrib>Lesurtel, M.</creatorcontrib><creatorcontrib>Ducerf, C.</creatorcontrib><creatorcontrib>Mabrut, J.-Y.</creatorcontrib><creatorcontrib>Hor, T.</creatorcontrib><creatorcontrib>Paye, F.</creatorcontrib><creatorcontrib>Balladur, P.</creatorcontrib><creatorcontrib>Suc, B.</creatorcontrib><creatorcontrib>Muscari, F.</creatorcontrib><creatorcontrib>Millet, G.</creatorcontrib><creatorcontrib>El Amrani, M.</creatorcontrib><creatorcontrib>Ratajczak, C.</creatorcontrib><creatorcontrib>Lecolle, K.</creatorcontrib><creatorcontrib>Boleslawski, E.</creatorcontrib><creatorcontrib>Truant, S.</creatorcontrib><creatorcontrib>Pruvot, F.-R.</creatorcontrib><creatorcontrib>Kianmanesh, A.-R.</creatorcontrib><creatorcontrib>Codjia, T.</creatorcontrib><creatorcontrib>Schwarz, L.</creatorcontrib><creatorcontrib>Girard, E.</creatorcontrib><creatorcontrib>Abba, J.</creatorcontrib><creatorcontrib>Letoublon, C.</creatorcontrib><creatorcontrib>Chirica, M.</creatorcontrib><creatorcontrib>Carmelo, A.</creatorcontrib><creatorcontrib>VanBrugghe, C.</creatorcontrib><creatorcontrib>Cherkaoui, Z.</creatorcontrib><creatorcontrib>Unterteiner, X.</creatorcontrib><creatorcontrib>Memeo, R.</creatorcontrib><creatorcontrib>Pessaux, P.</creatorcontrib><creatorcontrib>Buc, E.</creatorcontrib><creatorcontrib>Lermite, E.</creatorcontrib><creatorcontrib>Barbieux, J.</creatorcontrib><creatorcontrib>Bougard, M.</creatorcontrib><creatorcontrib>Marchese, U.</creatorcontrib><creatorcontrib>Ewald, J.</creatorcontrib><creatorcontrib>Turini, O.</creatorcontrib><creatorcontrib>Thobie, A.</creatorcontrib><creatorcontrib>Menahem, B.</creatorcontrib><creatorcontrib>Mulliri, A.</creatorcontrib><creatorcontrib>Lubrano, J.</creatorcontrib><creatorcontrib>Zemour, J.</creatorcontrib><creatorcontrib>Fagot, H.</creatorcontrib><creatorcontrib>Passot, G.</creatorcontrib><creatorcontrib>Gregoire, E.</creatorcontrib><creatorcontrib>Hardwigsen, J.</creatorcontrib><creatorcontrib>le Treut, Y.-P.</creatorcontrib><creatorcontrib>Patrice, D.</creatorcontrib><creatorcontrib>AFC-LLR-2018 study group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hobeika, Christian</au><au>Fuks, David</au><au>Cauchy, François</au><au>Goumard, Claire</au><au>Gayet, Brice</au><au>Laurent, Alexis</au><au>Soubrane, Olivier</au><au>Salamé, Ephrem</au><au>Cherqui, Daniel</au><au>Regimbeau, Jean-Marc</au><au>Mabrut, Jean-Yves</au><au>Scatton, Olivier</au><au>Vibert, Eric</au><au>Nomi, T.</au><au>Oudafal, N.</au><au>Kawai, T.</au><au>Komatsu, S.</au><au>Okumura, S.</au><au>Petrucciani, N.</au><au>Laurent, A.</au><au>Bucur, P.</au><au>Barbier, L.</au><au>Trechot, B.</au><au>Nunèz, J.</au><au>Tedeschi, M.</au><au>Allard, M.-A.</au><au>Golse, N.</au><au>Ciacio, O.</au><au>Pittau, G.</au><au>Sa Cunha, A.</au><au>Adam, R.</au><au>Laurent, C.</au><au>Chiche, L.</au><au>Leourier, P.</au><au>Rebibo, L.</au><au>Regimbeau, J.-M.</au><au>Ferre, L.</au><au>Souche, F.R.</au><au>Chauvat, J.</au><au>Fabre, J.-M.</au><au>Jehaes, F.</au><au>Mohkam, K.</au><au>Lesurtel, M.</au><au>Ducerf, C.</au><au>Mabrut, J.-Y.</au><au>Hor, T.</au><au>Paye, F.</au><au>Balladur, P.</au><au>Suc, B.</au><au>Muscari, F.</au><au>Millet, G.</au><au>El Amrani, M.</au><au>Ratajczak, C.</au><au>Lecolle, K.</au><au>Boleslawski, E.</au><au>Truant, S.</au><au>Pruvot, F.-R.</au><au>Kianmanesh, A.-R.</au><au>Codjia, T.</au><au>Schwarz, L.</au><au>Girard, E.</au><au>Abba, J.</au><au>Letoublon, C.</au><au>Chirica, M.</au><au>Carmelo, A.</au><au>VanBrugghe, C.</au><au>Cherkaoui, Z.</au><au>Unterteiner, X.</au><au>Memeo, R.</au><au>Pessaux, P.</au><au>Buc, E.</au><au>Lermite, E.</au><au>Barbieux, J.</au><au>Bougard, M.</au><au>Marchese, U.</au><au>Ewald, J.</au><au>Turini, O.</au><au>Thobie, A.</au><au>Menahem, B.</au><au>Mulliri, A.</au><au>Lubrano, J.</au><au>Zemour, J.</au><au>Fagot, H.</au><au>Passot, G.</au><au>Gregoire, E.</au><au>Hardwigsen, J.</au><au>le Treut, Y.-P.</au><au>Patrice, D.</au><aucorp>AFC-LLR-2018 study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2020-11</date><risdate>2020</risdate><volume>73</volume><issue>5</issue><spage>1100</spage><epage>1108</epage><pages>1100-1108</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><abstract>Herein, we aimed to establish benchmark values – based on a composite indicator of healthcare quality – for the performance of laparoscopic left lateral sectionectomy (LLLS) and laparoscopic right hepatectomy (LRH) using data from expert centers.
Data from a nationwide multicenter survey including all patients undergoing LLLS and LRH between 2000 and 2017 were analyzed. Textbook outcome (TO) completion was considered in patients fulfilling all 6 of the following characteristics: negative margins, no transfusion, no complication, no prolonged hospital stay, no readmission and no mortality. For each procedure, a cut-off laparoscopic liver resection (LLR) volume by center was associated with TO on multivariable analysis. These cut-offs defined the expert centers. The benchmark values were set at the 75th percentile of median outcomes among these expert centers.
Among 4,400 LLRs performed in 29 centers, 855 patients who underwent LLLS and 488 who underwent LRH were identified. The overall incidences of TO after LLLS and LRH were 43.7% and 23.8%, respectively. LLR volume cut-offs of 25 LLR/year (odds ratio [OR] 2.45; bootstrap 95% CI 1.65–3.69; p = 0.001) and 35 LLR/year (OR 2.55; bootstrap 95% CI 1.34–5.63; p = 0.003) were independently associated with completion of TO after LLLS and LRH, respectively. Eight centers for LLLS and 6 centers for LRH, including 516 and 346 patients undergoing LLLS/LRH respectively, reached these cut-offs and were identified as expert centers. After LLLS, benchmark values of severe complication, mortality and TO completion were defined as ≤5.3%, ≤1.2% and ≥46.6%, respectively. After LRH, benchmark values of severe complication, mortality and TO completion were ≤20.4%, ≤2.8% and ≥24.2%, respectively.
This study provides an up-to-date reference on the benchmark performance of LLLS and LRH in expert centers.
In a nationwide French survey of laparoscopic liver resection, expert centers were defined according to the completion of a textbook outcome, which is a composite indicator of healthcare quality. Benchmark values regarding intra-operative details and outcomes were established using data from 516 patients with laparoscopic left lateral sectionectiomy and 346 patients with laparoscopic right hepatectomy from expert centers. These values should be used as a reference point to improve the quality of laparoscopic resections.
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•Laparoscopic left lateral sectionectomies/right hepatectomies from nationwide survey.•Identification of centers with best practices using textbook outcome as indicator.•Benchmarking from outcomes of centers with best practices.•Laparoscopic left lateral sectionectomy: severe complication ≤5%, mortality ≤1%.•Laparoscopic right hepatectomy: severe complication ≤20%, mortality ≤3%.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>32407812</pmid><doi>10.1016/j.jhep.2020.05.003</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2059-1237</orcidid><orcidid>https://orcid.org/0000-0003-1372-0843</orcidid><orcidid>https://orcid.org/0000-0002-9592-2520</orcidid><orcidid>https://orcid.org/0000-0001-7631-9112</orcidid><orcidid>https://orcid.org/0000-0002-1372-3182</orcidid><orcidid>https://orcid.org/0000-0001-9908-8265</orcidid><orcidid>https://orcid.org/0000-0001-5635-7437</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0168-8278 |
| ispartof | Journal of hepatology, 2020-11, Vol.73 (5), p.1100-1108 |
| issn | 0168-8278 1600-0641 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_03574625v1 |
| source | Access via ScienceDirect (Elsevier) |
| subjects | Benchmark Benchmarking Blood Transfusion Cancer Female France Health Care Surveys Hepatectomy Hospitals Humans Laparoscopic liver resection Laparoscopy Left lateral sectionectomy Length of Stay Life Sciences Liver Liver Neoplasms Male Margins of Excision Mortality Outcome and Process Assessment, Health Care Patient Readmission Postoperative Complications Quality Indicators, Health Care Quality of care Right hepatectomy Textbook outcome |
| title | Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers |
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