Can Preoperative Characteristics Predict the Outcomes of Laparoscopic Cholecystectomy?
Intraoperative findings during laparoscopic cholecystectomy (LC) are highly unpredictable and operative difficulty varies from straightforward to very challenging procedures. Several studies described predictors of technical difficulty and graded intraoperative findings of LC; however, none specific...
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| Veröffentlicht in: | Journal of laparoendoscopic & advanced surgical techniques. Part A 2022-05, Vol.32 (5), p.532-537 |
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| container_title | Journal of laparoendoscopic & advanced surgical techniques. Part A |
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| creator | Orabi, Amira Di Mauro, Davide Njere, Ikechukwu Ratano, Marco Thavakumar, Sankavi Reece-Smith, Alex Wajed, Shahjehan Manzelli, Antonio |
| description | Intraoperative findings during laparoscopic cholecystectomy (LC) are highly unpredictable and operative difficulty varies from straightforward to very challenging procedures. Several studies described predictors of technical difficulty and graded intraoperative findings of LC; however, none specifically reported on the effect of such factors on clinical outcomes. This study aims to evaluate if preoperative characteristics of patients undergoing LC predict how likely they are to fail to be day case (DC).
Data of patients who underwent LC from 2015 to 2017 were retrospectively analyzed. Subjects were divided into four groups, according to Nassar's classification of intraoperative difficulty. Differences in frequencies were evaluated with the the chi square and
chi square tests or Fisher's exact test; logistic regression analysis was used to identify independent variables that were predictors of intraoperative complexity, postoperative morbidity, and length of stay.
A total of 1043 patient were included with male to female ratio of 1:2.5. Older age, male gender, and comorbidities were associated with higher Nassar score (
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| doi_str_mv | 10.1089/lap.2021.0398 |
| format | Article |
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Data of patients who underwent LC from 2015 to 2017 were retrospectively analyzed. Subjects were divided into four groups, according to Nassar's classification of intraoperative difficulty. Differences in frequencies were evaluated with the the chi square and
chi square tests or Fisher's exact test; logistic regression analysis was used to identify independent variables that were predictors of intraoperative complexity, postoperative morbidity, and length of stay.
A total of 1043 patient were included with male to female ratio of 1:2.5. Older age, male gender, and comorbidities were associated with higher Nassar score (
< .0001); Nassar 3 and 4 were predictors of postoperative morbidity (
< .05). The DC rate was 74.2% (Nassar 1), 75.8% (Nassar 2), 61.1% (Nassar 3), and 26.2% (Nassar 4), respectively. Age ≥60 years (
< .05), body mass index ≥35 (
< .05), and Nassar 3 and 4 (
< .05) were predictors of increased conversion from DC to inpatient (IP) stay.
LC can be safely performed on a DC basis even when surgery is technically challenging. The need of IP stay can be predicted in comorbid old adult men with anticipated higher Nassar's score.</description><identifier>ISSN: 1092-6429</identifier><identifier>EISSN: 1557-9034</identifier><identifier>DOI: 10.1089/lap.2021.0398</identifier><identifier>PMID: 34357804</identifier><language>eng</language><publisher>United States</publisher><ispartof>Journal of laparoendoscopic & advanced surgical techniques. Part A, 2022-05, Vol.32 (5), p.532-537</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c293t-c6c2686873be8e96b3b7004c19997e2f483b379d8af691e7f41564fd65602de23</citedby><cites>FETCH-LOGICAL-c293t-c6c2686873be8e96b3b7004c19997e2f483b379d8af691e7f41564fd65602de23</cites><orcidid>0000-0003-1366-436X ; 0000-0002-8767-0490 ; 0000-0003-2348-5664</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34357804$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Orabi, Amira</creatorcontrib><creatorcontrib>Di Mauro, Davide</creatorcontrib><creatorcontrib>Njere, Ikechukwu</creatorcontrib><creatorcontrib>Ratano, Marco</creatorcontrib><creatorcontrib>Thavakumar, Sankavi</creatorcontrib><creatorcontrib>Reece-Smith, Alex</creatorcontrib><creatorcontrib>Wajed, Shahjehan</creatorcontrib><creatorcontrib>Manzelli, Antonio</creatorcontrib><title>Can Preoperative Characteristics Predict the Outcomes of Laparoscopic Cholecystectomy?</title><title>Journal of laparoendoscopic & advanced surgical techniques. Part A</title><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><description>Intraoperative findings during laparoscopic cholecystectomy (LC) are highly unpredictable and operative difficulty varies from straightforward to very challenging procedures. Several studies described predictors of technical difficulty and graded intraoperative findings of LC; however, none specifically reported on the effect of such factors on clinical outcomes. This study aims to evaluate if preoperative characteristics of patients undergoing LC predict how likely they are to fail to be day case (DC).
Data of patients who underwent LC from 2015 to 2017 were retrospectively analyzed. Subjects were divided into four groups, according to Nassar's classification of intraoperative difficulty. Differences in frequencies were evaluated with the the chi square and
chi square tests or Fisher's exact test; logistic regression analysis was used to identify independent variables that were predictors of intraoperative complexity, postoperative morbidity, and length of stay.
A total of 1043 patient were included with male to female ratio of 1:2.5. Older age, male gender, and comorbidities were associated with higher Nassar score (
< .0001); Nassar 3 and 4 were predictors of postoperative morbidity (
< .05). The DC rate was 74.2% (Nassar 1), 75.8% (Nassar 2), 61.1% (Nassar 3), and 26.2% (Nassar 4), respectively. Age ≥60 years (
< .05), body mass index ≥35 (
< .05), and Nassar 3 and 4 (
< .05) were predictors of increased conversion from DC to inpatient (IP) stay.
LC can be safely performed on a DC basis even when surgery is technically challenging. The need of IP stay can be predicted in comorbid old adult men with anticipated higher Nassar's score.</description><issn>1092-6429</issn><issn>1557-9034</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNo9kMtLw0AQhxdRbK0evUqOXlL3lX2cRIovKNSDel02mwmNJN24uxH635vQ6lxmYL75MXwIXRO8JFjpu9b2S4opWWKm1Qmak6KQucaMn44z1jQXnOoZuojxC4-lGT9HM8ZZIRXmc_S5srvsLYDvIdjU_EC22tpgXYLQxNS4OC2rxqUsbSHbDMn5DmLm62xtext8dL5v3HjkW3D7mMAl3-3vL9FZbdsIV8e-QB9Pj--rl3y9eX5dPaxzRzVLuROOCiWUZCUo0KJkpcSYO6K1lkBrrljJpK6UrYUmIGtOCsHrShQC0wooW6DbQ24f_PcAMZmuiQ7a1u7AD9HQotCcCan1iOYH1I1fxwC16UPT2bA3BJtJpRlVmkmlmVSO_M0xeig7qP7pP3fsFzVHb4A</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Orabi, Amira</creator><creator>Di Mauro, Davide</creator><creator>Njere, Ikechukwu</creator><creator>Ratano, Marco</creator><creator>Thavakumar, Sankavi</creator><creator>Reece-Smith, Alex</creator><creator>Wajed, Shahjehan</creator><creator>Manzelli, Antonio</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1366-436X</orcidid><orcidid>https://orcid.org/0000-0002-8767-0490</orcidid><orcidid>https://orcid.org/0000-0003-2348-5664</orcidid></search><sort><creationdate>20220501</creationdate><title>Can Preoperative Characteristics Predict the Outcomes of Laparoscopic Cholecystectomy?</title><author>Orabi, Amira ; Di Mauro, Davide ; Njere, Ikechukwu ; Ratano, Marco ; Thavakumar, Sankavi ; Reece-Smith, Alex ; Wajed, Shahjehan ; Manzelli, Antonio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c293t-c6c2686873be8e96b3b7004c19997e2f483b379d8af691e7f41564fd65602de23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Orabi, Amira</creatorcontrib><creatorcontrib>Di Mauro, Davide</creatorcontrib><creatorcontrib>Njere, Ikechukwu</creatorcontrib><creatorcontrib>Ratano, Marco</creatorcontrib><creatorcontrib>Thavakumar, Sankavi</creatorcontrib><creatorcontrib>Reece-Smith, Alex</creatorcontrib><creatorcontrib>Wajed, Shahjehan</creatorcontrib><creatorcontrib>Manzelli, Antonio</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of laparoendoscopic & advanced surgical techniques. Part A</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Orabi, Amira</au><au>Di Mauro, Davide</au><au>Njere, Ikechukwu</au><au>Ratano, Marco</au><au>Thavakumar, Sankavi</au><au>Reece-Smith, Alex</au><au>Wajed, Shahjehan</au><au>Manzelli, Antonio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can Preoperative Characteristics Predict the Outcomes of Laparoscopic Cholecystectomy?</atitle><jtitle>Journal of laparoendoscopic & advanced surgical techniques. Part A</jtitle><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>32</volume><issue>5</issue><spage>532</spage><epage>537</epage><pages>532-537</pages><issn>1092-6429</issn><eissn>1557-9034</eissn><abstract>Intraoperative findings during laparoscopic cholecystectomy (LC) are highly unpredictable and operative difficulty varies from straightforward to very challenging procedures. Several studies described predictors of technical difficulty and graded intraoperative findings of LC; however, none specifically reported on the effect of such factors on clinical outcomes. This study aims to evaluate if preoperative characteristics of patients undergoing LC predict how likely they are to fail to be day case (DC).
Data of patients who underwent LC from 2015 to 2017 were retrospectively analyzed. Subjects were divided into four groups, according to Nassar's classification of intraoperative difficulty. Differences in frequencies were evaluated with the the chi square and
chi square tests or Fisher's exact test; logistic regression analysis was used to identify independent variables that were predictors of intraoperative complexity, postoperative morbidity, and length of stay.
A total of 1043 patient were included with male to female ratio of 1:2.5. Older age, male gender, and comorbidities were associated with higher Nassar score (
< .0001); Nassar 3 and 4 were predictors of postoperative morbidity (
< .05). The DC rate was 74.2% (Nassar 1), 75.8% (Nassar 2), 61.1% (Nassar 3), and 26.2% (Nassar 4), respectively. Age ≥60 years (
< .05), body mass index ≥35 (
< .05), and Nassar 3 and 4 (
< .05) were predictors of increased conversion from DC to inpatient (IP) stay.
LC can be safely performed on a DC basis even when surgery is technically challenging. The need of IP stay can be predicted in comorbid old adult men with anticipated higher Nassar's score.</abstract><cop>United States</cop><pmid>34357804</pmid><doi>10.1089/lap.2021.0398</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-1366-436X</orcidid><orcidid>https://orcid.org/0000-0002-8767-0490</orcidid><orcidid>https://orcid.org/0000-0003-2348-5664</orcidid></addata></record> |
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| title | Can Preoperative Characteristics Predict the Outcomes of Laparoscopic Cholecystectomy? |
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