Validation and performance of three-level procedure-based classification for laparoscopic liver resection
Background A procedure-based laparoscopic liver resection (LLR) classification (IMM classification) stratified 11 different LLR procedures into 3 grades. IMM classification assessed the difficulty of LLR differently than an index-based LLR classification (IWATE criteria), which scored each procedure...
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| Veröffentlicht in: | Surgical endoscopy 2020-05, Vol.34 (5), p.2056-2066 |
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| creator | Kawaguchi, Yoshikuni Tanaka, Shogo Fuks, David Kanazawa, Akishige Takeda, Yutaka Hirokawa, Fumitoshi Nitta, Hiroyuki Nakajima, Takayoshi Kaizu, Takashi Kaibori, Masaki Kojima, Toru Otsuka, Yuichiro Kubo, Shoji Hasegawa, Kiyoshi Kokudo, Norihiro Kaneko, Hironori Wakabayashi, Go Gayet, Brice |
| description | Background
A procedure-based laparoscopic liver resection (LLR) classification (IMM classification) stratified 11 different LLR procedures into 3 grades. IMM classification assessed the difficulty of LLR differently than an index-based LLR classification (IWATE criteria), which scored each procedure on an index scale of 12. We validated the difference of 3 IMM grades using an external cohort, evaluated the IMM classification using the scores of the IWATE criteria, and compared the performance of IMM classification with the IWATE criteria and the minor/major classification.
Methods
Patients undergoing LLR without simultaneous procedures were selected from a prospectively maintained database at the Institut Mutualiste Montsouris (IMM cohort) and from the database of 43 Japanese institutions (JMI cohort). Surgical and postoperative outcomes were evaluated according to the 3 IMM grades using the JMI cohort. The 11 LLR procedures included in the IMM classification were scored according to the IWATE criteria. The area under the curves (AUCs) for surgical and postoperative outcomes were compared.
Results
In the JMI (
n
= 1867) cohort, operative time, blood loss, conversion rate, and major complication rate were significantly associated with a stepwise increase in grades from I to III (all,
P
|
| doi_str_mv | 10.1007/s00464-019-06986-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2263323227</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2263323227</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-c1cbdc2e9d7524148c701eeb94fd22e31e0d50a7c281a24e24f7ad3c5d73aff03</originalsourceid><addsrcrecordid>eNp9kU9P3DAQxS3UCrZbvgAHZKkXLm7tsRMnR4RaWgmJC3C1vPYYjLxJam-Q-PZ4G0olDj3NYX7vzZ9HyIngXwXn-lvhXLWKcdEz3vZdy9oDshJKAgMQ3Qey4r3kDHSvjsinUh555XvRHJIjKaTs2rZZkXhnU_R2F8eB2sHTCXMY89YODukY6O4hI7KET5jolEeHfs7INragpy7ZUmKIblFXGU12snksbpyioyk-YaYZC7o98Jl8DDYVPH6ta3L74_vNxU92dX356-L8ijmpmx1zwm28A-y9bkAJ1TnNBeKmV8EDoBTIfcOtdtAJCwpBBW29dI3X0obA5ZqcLb51398zlp3ZxuIwJTvgOBcD0EoJEkBX9Ms79HGc81C321PQKN13e0NYKFdPKxmDmXLc2vxsBDf7IMwShKlBmD9BmLaKTl-t580W_Zvk7-crIBeg1NZwj_nf7P_YvgDECpVJ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2262547980</pqid></control><display><type>article</type><title>Validation and performance of three-level procedure-based classification for laparoscopic liver resection</title><source>SpringerLink Journals - AutoHoldings</source><creator>Kawaguchi, Yoshikuni ; Tanaka, Shogo ; Fuks, David ; Kanazawa, Akishige ; Takeda, Yutaka ; Hirokawa, Fumitoshi ; Nitta, Hiroyuki ; Nakajima, Takayoshi ; Kaizu, Takashi ; Kaibori, Masaki ; Kojima, Toru ; Otsuka, Yuichiro ; Kubo, Shoji ; Hasegawa, Kiyoshi ; Kokudo, Norihiro ; Kaneko, Hironori ; Wakabayashi, Go ; Gayet, Brice</creator><creatorcontrib>Kawaguchi, Yoshikuni ; Tanaka, Shogo ; Fuks, David ; Kanazawa, Akishige ; Takeda, Yutaka ; Hirokawa, Fumitoshi ; Nitta, Hiroyuki ; Nakajima, Takayoshi ; Kaizu, Takashi ; Kaibori, Masaki ; Kojima, Toru ; Otsuka, Yuichiro ; Kubo, Shoji ; Hasegawa, Kiyoshi ; Kokudo, Norihiro ; Kaneko, Hironori ; Wakabayashi, Go ; Gayet, Brice</creatorcontrib><description>Background
A procedure-based laparoscopic liver resection (LLR) classification (IMM classification) stratified 11 different LLR procedures into 3 grades. IMM classification assessed the difficulty of LLR differently than an index-based LLR classification (IWATE criteria), which scored each procedure on an index scale of 12. We validated the difference of 3 IMM grades using an external cohort, evaluated the IMM classification using the scores of the IWATE criteria, and compared the performance of IMM classification with the IWATE criteria and the minor/major classification.
Methods
Patients undergoing LLR without simultaneous procedures were selected from a prospectively maintained database at the Institut Mutualiste Montsouris (IMM cohort) and from the database of 43 Japanese institutions (JMI cohort). Surgical and postoperative outcomes were evaluated according to the 3 IMM grades using the JMI cohort. The 11 LLR procedures included in the IMM classification were scored according to the IWATE criteria. The area under the curves (AUCs) for surgical and postoperative outcomes were compared.
Results
In the JMI (
n
= 1867) cohort, operative time, blood loss, conversion rate, and major complication rate were significantly associated with a stepwise increase in grades from I to III (all,
P
< 0.001). In the IMM (
n
= 433) and JMI cohorts, IMM grades I, II, and III corresponded to three low-scoring, two intermediate-scoring, and six high-scoring LLR procedures as per the IWATE criteria, respectively. Mean ± standard deviation among the IMM grades were significantly different: 3.7 ± 1.4 (grade I) versus 7.5 ± 1.7 (grade II) versus 10.2 ± 1.0 (grade III) (
P
< 0.001) in the IMM cohort and 3.6 ± 1.4 (grade I) versus 6.7 ± 1.5 (grade II) versus 9.3 ± 1.4 (grade III) (
P
< 0.001) in the JMI cohort. The AUCs for surgical and postoperative outcomes are higher for the 3-level IMM classification than for the minor/major classification.
Conclusions
The difference of 3 IMM grades with respect to surgical and postoperative outcomes was validated using an external cohort. The 3-level procedure-based IMM classification was in accordance with the index-based IWATE criteria. The IMM classification performed better than the minor/major classification for stratifying LLR procedures.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-019-06986-6</identifier><identifier>PMID: 31338665</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Classification ; Gastroenterology ; Gynecology ; Hepatectomy ; Hepatology ; Laparoscopy ; Medicine ; Medicine & Public Health ; Postoperative period ; Proctology ; Surgery</subject><ispartof>Surgical endoscopy, 2020-05, Vol.34 (5), p.2056-2066</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-c1cbdc2e9d7524148c701eeb94fd22e31e0d50a7c281a24e24f7ad3c5d73aff03</citedby><cites>FETCH-LOGICAL-c375t-c1cbdc2e9d7524148c701eeb94fd22e31e0d50a7c281a24e24f7ad3c5d73aff03</cites><orcidid>0000-0003-2986-3224</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-019-06986-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-019-06986-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31338665$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kawaguchi, Yoshikuni</creatorcontrib><creatorcontrib>Tanaka, Shogo</creatorcontrib><creatorcontrib>Fuks, David</creatorcontrib><creatorcontrib>Kanazawa, Akishige</creatorcontrib><creatorcontrib>Takeda, Yutaka</creatorcontrib><creatorcontrib>Hirokawa, Fumitoshi</creatorcontrib><creatorcontrib>Nitta, Hiroyuki</creatorcontrib><creatorcontrib>Nakajima, Takayoshi</creatorcontrib><creatorcontrib>Kaizu, Takashi</creatorcontrib><creatorcontrib>Kaibori, Masaki</creatorcontrib><creatorcontrib>Kojima, Toru</creatorcontrib><creatorcontrib>Otsuka, Yuichiro</creatorcontrib><creatorcontrib>Kubo, Shoji</creatorcontrib><creatorcontrib>Hasegawa, Kiyoshi</creatorcontrib><creatorcontrib>Kokudo, Norihiro</creatorcontrib><creatorcontrib>Kaneko, Hironori</creatorcontrib><creatorcontrib>Wakabayashi, Go</creatorcontrib><creatorcontrib>Gayet, Brice</creatorcontrib><title>Validation and performance of three-level procedure-based classification for laparoscopic liver resection</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
A procedure-based laparoscopic liver resection (LLR) classification (IMM classification) stratified 11 different LLR procedures into 3 grades. IMM classification assessed the difficulty of LLR differently than an index-based LLR classification (IWATE criteria), which scored each procedure on an index scale of 12. We validated the difference of 3 IMM grades using an external cohort, evaluated the IMM classification using the scores of the IWATE criteria, and compared the performance of IMM classification with the IWATE criteria and the minor/major classification.
Methods
Patients undergoing LLR without simultaneous procedures were selected from a prospectively maintained database at the Institut Mutualiste Montsouris (IMM cohort) and from the database of 43 Japanese institutions (JMI cohort). Surgical and postoperative outcomes were evaluated according to the 3 IMM grades using the JMI cohort. The 11 LLR procedures included in the IMM classification were scored according to the IWATE criteria. The area under the curves (AUCs) for surgical and postoperative outcomes were compared.
Results
In the JMI (
n
= 1867) cohort, operative time, blood loss, conversion rate, and major complication rate were significantly associated with a stepwise increase in grades from I to III (all,
P
< 0.001). In the IMM (
n
= 433) and JMI cohorts, IMM grades I, II, and III corresponded to three low-scoring, two intermediate-scoring, and six high-scoring LLR procedures as per the IWATE criteria, respectively. Mean ± standard deviation among the IMM grades were significantly different: 3.7 ± 1.4 (grade I) versus 7.5 ± 1.7 (grade II) versus 10.2 ± 1.0 (grade III) (
P
< 0.001) in the IMM cohort and 3.6 ± 1.4 (grade I) versus 6.7 ± 1.5 (grade II) versus 9.3 ± 1.4 (grade III) (
P
< 0.001) in the JMI cohort. The AUCs for surgical and postoperative outcomes are higher for the 3-level IMM classification than for the minor/major classification.
Conclusions
The difference of 3 IMM grades with respect to surgical and postoperative outcomes was validated using an external cohort. The 3-level procedure-based IMM classification was in accordance with the index-based IWATE criteria. The IMM classification performed better than the minor/major classification for stratifying LLR procedures.</description><subject>Abdominal Surgery</subject><subject>Classification</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatectomy</subject><subject>Hepatology</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Postoperative period</subject><subject>Proctology</subject><subject>Surgery</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU9P3DAQxS3UCrZbvgAHZKkXLm7tsRMnR4RaWgmJC3C1vPYYjLxJam-Q-PZ4G0olDj3NYX7vzZ9HyIngXwXn-lvhXLWKcdEz3vZdy9oDshJKAgMQ3Qey4r3kDHSvjsinUh555XvRHJIjKaTs2rZZkXhnU_R2F8eB2sHTCXMY89YODukY6O4hI7KET5jolEeHfs7INragpy7ZUmKIblFXGU12snksbpyioyk-YaYZC7o98Jl8DDYVPH6ta3L74_vNxU92dX356-L8ijmpmx1zwm28A-y9bkAJ1TnNBeKmV8EDoBTIfcOtdtAJCwpBBW29dI3X0obA5ZqcLb51398zlp3ZxuIwJTvgOBcD0EoJEkBX9Ms79HGc81C321PQKN13e0NYKFdPKxmDmXLc2vxsBDf7IMwShKlBmD9BmLaKTl-t580W_Zvk7-crIBeg1NZwj_nf7P_YvgDECpVJ</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Kawaguchi, Yoshikuni</creator><creator>Tanaka, Shogo</creator><creator>Fuks, David</creator><creator>Kanazawa, Akishige</creator><creator>Takeda, Yutaka</creator><creator>Hirokawa, Fumitoshi</creator><creator>Nitta, Hiroyuki</creator><creator>Nakajima, Takayoshi</creator><creator>Kaizu, Takashi</creator><creator>Kaibori, Masaki</creator><creator>Kojima, Toru</creator><creator>Otsuka, Yuichiro</creator><creator>Kubo, Shoji</creator><creator>Hasegawa, Kiyoshi</creator><creator>Kokudo, Norihiro</creator><creator>Kaneko, Hironori</creator><creator>Wakabayashi, Go</creator><creator>Gayet, Brice</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2986-3224</orcidid></search><sort><creationdate>20200501</creationdate><title>Validation and performance of three-level procedure-based classification for laparoscopic liver resection</title><author>Kawaguchi, Yoshikuni ; Tanaka, Shogo ; Fuks, David ; Kanazawa, Akishige ; Takeda, Yutaka ; Hirokawa, Fumitoshi ; Nitta, Hiroyuki ; Nakajima, Takayoshi ; Kaizu, Takashi ; Kaibori, Masaki ; Kojima, Toru ; Otsuka, Yuichiro ; Kubo, Shoji ; Hasegawa, Kiyoshi ; Kokudo, Norihiro ; Kaneko, Hironori ; Wakabayashi, Go ; Gayet, Brice</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-c1cbdc2e9d7524148c701eeb94fd22e31e0d50a7c281a24e24f7ad3c5d73aff03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Classification</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatectomy</topic><topic>Hepatology</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Postoperative period</topic><topic>Proctology</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kawaguchi, Yoshikuni</creatorcontrib><creatorcontrib>Tanaka, Shogo</creatorcontrib><creatorcontrib>Fuks, David</creatorcontrib><creatorcontrib>Kanazawa, Akishige</creatorcontrib><creatorcontrib>Takeda, Yutaka</creatorcontrib><creatorcontrib>Hirokawa, Fumitoshi</creatorcontrib><creatorcontrib>Nitta, Hiroyuki</creatorcontrib><creatorcontrib>Nakajima, Takayoshi</creatorcontrib><creatorcontrib>Kaizu, Takashi</creatorcontrib><creatorcontrib>Kaibori, Masaki</creatorcontrib><creatorcontrib>Kojima, Toru</creatorcontrib><creatorcontrib>Otsuka, Yuichiro</creatorcontrib><creatorcontrib>Kubo, Shoji</creatorcontrib><creatorcontrib>Hasegawa, Kiyoshi</creatorcontrib><creatorcontrib>Kokudo, Norihiro</creatorcontrib><creatorcontrib>Kaneko, Hironori</creatorcontrib><creatorcontrib>Wakabayashi, Go</creatorcontrib><creatorcontrib>Gayet, Brice</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kawaguchi, Yoshikuni</au><au>Tanaka, Shogo</au><au>Fuks, David</au><au>Kanazawa, Akishige</au><au>Takeda, Yutaka</au><au>Hirokawa, Fumitoshi</au><au>Nitta, Hiroyuki</au><au>Nakajima, Takayoshi</au><au>Kaizu, Takashi</au><au>Kaibori, Masaki</au><au>Kojima, Toru</au><au>Otsuka, Yuichiro</au><au>Kubo, Shoji</au><au>Hasegawa, Kiyoshi</au><au>Kokudo, Norihiro</au><au>Kaneko, Hironori</au><au>Wakabayashi, Go</au><au>Gayet, Brice</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Validation and performance of three-level procedure-based classification for laparoscopic liver resection</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>34</volume><issue>5</issue><spage>2056</spage><epage>2066</epage><pages>2056-2066</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
A procedure-based laparoscopic liver resection (LLR) classification (IMM classification) stratified 11 different LLR procedures into 3 grades. IMM classification assessed the difficulty of LLR differently than an index-based LLR classification (IWATE criteria), which scored each procedure on an index scale of 12. We validated the difference of 3 IMM grades using an external cohort, evaluated the IMM classification using the scores of the IWATE criteria, and compared the performance of IMM classification with the IWATE criteria and the minor/major classification.
Methods
Patients undergoing LLR without simultaneous procedures were selected from a prospectively maintained database at the Institut Mutualiste Montsouris (IMM cohort) and from the database of 43 Japanese institutions (JMI cohort). Surgical and postoperative outcomes were evaluated according to the 3 IMM grades using the JMI cohort. The 11 LLR procedures included in the IMM classification were scored according to the IWATE criteria. The area under the curves (AUCs) for surgical and postoperative outcomes were compared.
Results
In the JMI (
n
= 1867) cohort, operative time, blood loss, conversion rate, and major complication rate were significantly associated with a stepwise increase in grades from I to III (all,
P
< 0.001). In the IMM (
n
= 433) and JMI cohorts, IMM grades I, II, and III corresponded to three low-scoring, two intermediate-scoring, and six high-scoring LLR procedures as per the IWATE criteria, respectively. Mean ± standard deviation among the IMM grades were significantly different: 3.7 ± 1.4 (grade I) versus 7.5 ± 1.7 (grade II) versus 10.2 ± 1.0 (grade III) (
P
< 0.001) in the IMM cohort and 3.6 ± 1.4 (grade I) versus 6.7 ± 1.5 (grade II) versus 9.3 ± 1.4 (grade III) (
P
< 0.001) in the JMI cohort. The AUCs for surgical and postoperative outcomes are higher for the 3-level IMM classification than for the minor/major classification.
Conclusions
The difference of 3 IMM grades with respect to surgical and postoperative outcomes was validated using an external cohort. The 3-level procedure-based IMM classification was in accordance with the index-based IWATE criteria. The IMM classification performed better than the minor/major classification for stratifying LLR procedures.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31338665</pmid><doi>10.1007/s00464-019-06986-6</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-2986-3224</orcidid></addata></record> |
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| ispartof | Surgical endoscopy, 2020-05, Vol.34 (5), p.2056-2066 |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Classification Gastroenterology Gynecology Hepatectomy Hepatology Laparoscopy Medicine Medicine & Public Health Postoperative period Proctology Surgery |
| title | Validation and performance of three-level procedure-based classification for laparoscopic liver resection |
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