Association of standardized liver volume and body mass index with outcomes of minimally invasive liver resections
Introduction While minimally invasive liver resections (MILR) have demonstrated advantages in improved post-operative recovery, widespread adoption is hampered by inherent technical difficulties. Our study attempts to analyze the role of anthropometric measures in MILR-related outcomes. Methods Betw...
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| Veröffentlicht in: | Surgical endoscopy 2023, Vol.37 (1), p.456-465 |
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| creator | Chua, Darren W. Syn, Nicholas Koh, Ye-Xin Teo, Jin-Yao Cheow, Peng-Chung Chung, Alexander Y. F. Chan, Chung-Yip Goh, Brian K. P. |
| description | Introduction
While minimally invasive liver resections (MILR) have demonstrated advantages in improved post-operative recovery, widespread adoption is hampered by inherent technical difficulties. Our study attempts to analyze the role of anthropometric measures in MILR-related outcomes.
Methods
Between 2012 and 2020, 676 consecutive patients underwent MILR at the Singapore General Hospital of which 565 met study criteria and were included. Patients were stratified based on Body Mass Index (BMI) as well as Standardized Liver Volumes (SLV). Associations between BMI and SLV to selected peri-operative outcomes were analyzed using restricted cubic splines.
Results
A BMI of ≥ 29 was associated with increase in blood loss [Mean difference (MD) 69 mls, 95% CI 2 to 137] as well as operative conversions [Relative Risk (RR) 1.63, 95% CI 1.02 to 2.62] among patients undergoing MILR while a SLV of 1600 cc or higher was associated with an increase in blood loss (MD 30 mls, 95% CI 10 to 49). In addition, a BMI of ≤ 20 was associated with an increased risk of major complications (RR 2.25, 95% 1.16 to 4.35). The magnitude of differences observed in these findings increased with each unit change in BMI and SLV.
Conclusion
Both BMI and SLV were useful anthropometric measures in predicting peri-operative outcomes in MILR and may be considered for incorporation in future difficulty scoring systems for MILR. |
| doi_str_mv | 10.1007/s00464-022-09534-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2706182991</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2765218015</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-a22da9266ee3fa7456e3fd58627b73fa855de23079db609e538285cbe8ad5d933</originalsourceid><addsrcrecordid>eNp9kU1LxDAQhoMoun78AQ8S8OKlmo-mbY4ifoHgRc8hbWY10jaaadddf71Zd1Xw4Glg5nnfSeYl5JCzU85YeYaM5UWeMSEyppXMs_kGmfBcikwIXm2SCdOSZaLU-Q7ZRXxhiddcbZMdqbTWkrMJeTtHDI23gw89DVOKg-2djc5_gKOtn0Gks9COHdDUp3VwC9pZROp7B3P67odnGsahCR3gUt753ne2bRcJmFlM-rVJBIRmuQT3ydbUtggH67pHHq8uHy5usrv769uL87uskaUaMiuEs1oUBYCc2jJXRapOVYUo6zJ1KqUcCMlK7eqCaVCyEpVqaqisU05LuUdOVr6vMbyNgIPpPDbQtraHMKIRJSt4JbTmCT3-g76EMfbpdYkqVDom4ypRYkU1MSBGmJrXmD4bF4YzswzErAIxKRDzFYiZJ9HR2nqsO3A_ku8EEiBXAKZR_wTxd_c_tp9CKZhf</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2765218015</pqid></control><display><type>article</type><title>Association of standardized liver volume and body mass index with outcomes of minimally invasive liver resections</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Chua, Darren W. ; Syn, Nicholas ; Koh, Ye-Xin ; Teo, Jin-Yao ; Cheow, Peng-Chung ; Chung, Alexander Y. F. ; Chan, Chung-Yip ; Goh, Brian K. P.</creator><creatorcontrib>Chua, Darren W. ; Syn, Nicholas ; Koh, Ye-Xin ; Teo, Jin-Yao ; Cheow, Peng-Chung ; Chung, Alexander Y. F. ; Chan, Chung-Yip ; Goh, Brian K. P.</creatorcontrib><description>Introduction
While minimally invasive liver resections (MILR) have demonstrated advantages in improved post-operative recovery, widespread adoption is hampered by inherent technical difficulties. Our study attempts to analyze the role of anthropometric measures in MILR-related outcomes.
Methods
Between 2012 and 2020, 676 consecutive patients underwent MILR at the Singapore General Hospital of which 565 met study criteria and were included. Patients were stratified based on Body Mass Index (BMI) as well as Standardized Liver Volumes (SLV). Associations between BMI and SLV to selected peri-operative outcomes were analyzed using restricted cubic splines.
Results
A BMI of ≥ 29 was associated with increase in blood loss [Mean difference (MD) 69 mls, 95% CI 2 to 137] as well as operative conversions [Relative Risk (RR) 1.63, 95% CI 1.02 to 2.62] among patients undergoing MILR while a SLV of 1600 cc or higher was associated with an increase in blood loss (MD 30 mls, 95% CI 10 to 49). In addition, a BMI of ≤ 20 was associated with an increased risk of major complications (RR 2.25, 95% 1.16 to 4.35). The magnitude of differences observed in these findings increased with each unit change in BMI and SLV.
Conclusion
Both BMI and SLV were useful anthropometric measures in predicting peri-operative outcomes in MILR and may be considered for incorporation in future difficulty scoring systems for MILR.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-022-09534-x</identifier><identifier>PMID: 35999310</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Body Mass Index ; Body measurements ; Endoscopy ; Gastroenterology ; Gynecology ; Hepatectomy ; Hepatectomy - adverse effects ; Hepatology ; Hospitals ; Humans ; Laparoscopy ; Laparoscopy - adverse effects ; Length of Stay ; Liver ; Liver Neoplasms - surgery ; Medicine ; Medicine & Public Health ; Obesity ; Original Article ; Overweight ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Proctology ; Retrospective Studies ; Surgery</subject><ispartof>Surgical endoscopy, 2023, Vol.37 (1), p.456-465</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-a22da9266ee3fa7456e3fd58627b73fa855de23079db609e538285cbe8ad5d933</citedby><cites>FETCH-LOGICAL-c375t-a22da9266ee3fa7456e3fd58627b73fa855de23079db609e538285cbe8ad5d933</cites><orcidid>0000-0001-8218-4576</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/s00464-022-09534-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-022-09534-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35999310$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chua, Darren W.</creatorcontrib><creatorcontrib>Syn, Nicholas</creatorcontrib><creatorcontrib>Koh, Ye-Xin</creatorcontrib><creatorcontrib>Teo, Jin-Yao</creatorcontrib><creatorcontrib>Cheow, Peng-Chung</creatorcontrib><creatorcontrib>Chung, Alexander Y. F.</creatorcontrib><creatorcontrib>Chan, Chung-Yip</creatorcontrib><creatorcontrib>Goh, Brian K. P.</creatorcontrib><title>Association of standardized liver volume and body mass index with outcomes of minimally invasive liver resections</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Introduction
While minimally invasive liver resections (MILR) have demonstrated advantages in improved post-operative recovery, widespread adoption is hampered by inherent technical difficulties. Our study attempts to analyze the role of anthropometric measures in MILR-related outcomes.
Methods
Between 2012 and 2020, 676 consecutive patients underwent MILR at the Singapore General Hospital of which 565 met study criteria and were included. Patients were stratified based on Body Mass Index (BMI) as well as Standardized Liver Volumes (SLV). Associations between BMI and SLV to selected peri-operative outcomes were analyzed using restricted cubic splines.
Results
A BMI of ≥ 29 was associated with increase in blood loss [Mean difference (MD) 69 mls, 95% CI 2 to 137] as well as operative conversions [Relative Risk (RR) 1.63, 95% CI 1.02 to 2.62] among patients undergoing MILR while a SLV of 1600 cc or higher was associated with an increase in blood loss (MD 30 mls, 95% CI 10 to 49). In addition, a BMI of ≤ 20 was associated with an increased risk of major complications (RR 2.25, 95% 1.16 to 4.35). The magnitude of differences observed in these findings increased with each unit change in BMI and SLV.
Conclusion
Both BMI and SLV were useful anthropometric measures in predicting peri-operative outcomes in MILR and may be considered for incorporation in future difficulty scoring systems for MILR.</description><subject>Abdominal Surgery</subject><subject>Body Mass Index</subject><subject>Body measurements</subject><subject>Endoscopy</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatectomy</subject><subject>Hepatectomy - adverse effects</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - adverse effects</subject><subject>Length of Stay</subject><subject>Liver</subject><subject>Liver Neoplasms - surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obesity</subject><subject>Original Article</subject><subject>Overweight</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1LxDAQhoMoun78AQ8S8OKlmo-mbY4ifoHgRc8hbWY10jaaadddf71Zd1Xw4Glg5nnfSeYl5JCzU85YeYaM5UWeMSEyppXMs_kGmfBcikwIXm2SCdOSZaLU-Q7ZRXxhiddcbZMdqbTWkrMJeTtHDI23gw89DVOKg-2djc5_gKOtn0Gks9COHdDUp3VwC9pZROp7B3P67odnGsahCR3gUt753ne2bRcJmFlM-rVJBIRmuQT3ydbUtggH67pHHq8uHy5usrv769uL87uskaUaMiuEs1oUBYCc2jJXRapOVYUo6zJ1KqUcCMlK7eqCaVCyEpVqaqisU05LuUdOVr6vMbyNgIPpPDbQtraHMKIRJSt4JbTmCT3-g76EMfbpdYkqVDom4ypRYkU1MSBGmJrXmD4bF4YzswzErAIxKRDzFYiZJ9HR2nqsO3A_ku8EEiBXAKZR_wTxd_c_tp9CKZhf</recordid><startdate>2023</startdate><enddate>2023</enddate><creator>Chua, Darren W.</creator><creator>Syn, Nicholas</creator><creator>Koh, Ye-Xin</creator><creator>Teo, Jin-Yao</creator><creator>Cheow, Peng-Chung</creator><creator>Chung, Alexander Y. 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P.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><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/0000-0001-8218-4576</orcidid></search><sort><creationdate>2023</creationdate><title>Association of standardized liver volume and body mass index with outcomes of minimally invasive liver resections</title><author>Chua, Darren W. ; Syn, Nicholas ; Koh, Ye-Xin ; Teo, Jin-Yao ; Cheow, Peng-Chung ; Chung, Alexander Y. F. ; Chan, Chung-Yip ; Goh, Brian K. P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-a22da9266ee3fa7456e3fd58627b73fa855de23079db609e538285cbe8ad5d933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Abdominal Surgery</topic><topic>Body Mass Index</topic><topic>Body measurements</topic><topic>Endoscopy</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatectomy</topic><topic>Hepatectomy - adverse effects</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - adverse effects</topic><topic>Length of Stay</topic><topic>Liver</topic><topic>Liver Neoplasms - surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obesity</topic><topic>Original Article</topic><topic>Overweight</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chua, Darren W.</creatorcontrib><creatorcontrib>Syn, Nicholas</creatorcontrib><creatorcontrib>Koh, Ye-Xin</creatorcontrib><creatorcontrib>Teo, Jin-Yao</creatorcontrib><creatorcontrib>Cheow, Peng-Chung</creatorcontrib><creatorcontrib>Chung, Alexander Y. F.</creatorcontrib><creatorcontrib>Chan, Chung-Yip</creatorcontrib><creatorcontrib>Goh, Brian K. P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><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>Chua, Darren W.</au><au>Syn, Nicholas</au><au>Koh, Ye-Xin</au><au>Teo, Jin-Yao</au><au>Cheow, Peng-Chung</au><au>Chung, Alexander Y. F.</au><au>Chan, Chung-Yip</au><au>Goh, Brian K. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of standardized liver volume and body mass index with outcomes of minimally invasive liver resections</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2023</date><risdate>2023</risdate><volume>37</volume><issue>1</issue><spage>456</spage><epage>465</epage><pages>456-465</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Introduction
While minimally invasive liver resections (MILR) have demonstrated advantages in improved post-operative recovery, widespread adoption is hampered by inherent technical difficulties. Our study attempts to analyze the role of anthropometric measures in MILR-related outcomes.
Methods
Between 2012 and 2020, 676 consecutive patients underwent MILR at the Singapore General Hospital of which 565 met study criteria and were included. Patients were stratified based on Body Mass Index (BMI) as well as Standardized Liver Volumes (SLV). Associations between BMI and SLV to selected peri-operative outcomes were analyzed using restricted cubic splines.
Results
A BMI of ≥ 29 was associated with increase in blood loss [Mean difference (MD) 69 mls, 95% CI 2 to 137] as well as operative conversions [Relative Risk (RR) 1.63, 95% CI 1.02 to 2.62] among patients undergoing MILR while a SLV of 1600 cc or higher was associated with an increase in blood loss (MD 30 mls, 95% CI 10 to 49). In addition, a BMI of ≤ 20 was associated with an increased risk of major complications (RR 2.25, 95% 1.16 to 4.35). The magnitude of differences observed in these findings increased with each unit change in BMI and SLV.
Conclusion
Both BMI and SLV were useful anthropometric measures in predicting peri-operative outcomes in MILR and may be considered for incorporation in future difficulty scoring systems for MILR.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>35999310</pmid><doi>10.1007/s00464-022-09534-x</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8218-4576</orcidid></addata></record> |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Abdominal Surgery Body Mass Index Body measurements Endoscopy Gastroenterology Gynecology Hepatectomy Hepatectomy - adverse effects Hepatology Hospitals Humans Laparoscopy Laparoscopy - adverse effects Length of Stay Liver Liver Neoplasms - surgery Medicine Medicine & Public Health Obesity Original Article Overweight Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - surgery Proctology Retrospective Studies Surgery |
| title | Association of standardized liver volume and body mass index with outcomes of minimally invasive liver resections |
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