Variation in complications and mortality following ALPPS at early-adopting centers |
| |
| Authors: | Kerollos N. Wanis Michael Linecker Arin L. Madenci Philip C. Müller Natascha Nüssler Roberto Brusadin Ricardo Robles-Campos Oszkar Hahn Matteo Serenari Elio Jovine Nadja Lehwald Wolfram T. Knoefel Tim Reese Karl Oldhafer Martin de Santibañes Victoria Ardiles Georg Lurje Rafaela Capelli Roberto Hernandez-Alejandro |
| |
| Affiliation: | 1. Department of Surgery, Western University, Ontario, Canada;2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA;3. Department of Surgery and Transplantation, University Hospital Zurich, Switzerland;4. Department of Surgery, Klinikum Neuperlach, Städtisches Klinikum München, Munich, Germany;5. Department of Surgery and Liver and Pancreas Transplantation, Virgen de la Arrixaca Clinic and University Hospital, Murcia, Spain;6. Hepato-Pancreatico-Biliary (HPB) Surgical Research Center Hungary, 1st Department of Surgery, Semmelweis University, Budapest, Hungary;7. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy;8. Department of Surgery, C. A. Pizzardi Maggiore Hospital, Bologna, Italy;9. Department of General, Visceral and Pediatric Surgery, Medical Faculty, University of Duesseldorf, University Hospital Düsseldorf, Düsseldorf, Germany;10. Department of General, Visceral and Oncological Surgery, Asklepios Klinik Barmbek, Hamburg, Germany;11. Department of Surgery, Hospital Italiano, Buenos Aires, Argentina;12. Department of Surgery and Transplantation, University Hospital RWTH Aachen, Germany;13. Department of Surgery, Charité Universitätsmedizin Berlin, Campus Charité Mitte I Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany;14. Hepatobiliary Surgery, Ipanema Federal Hospital, Health Ministry, Rio de Janeiro, Brazil;15. Department of Surgery, Ospedale San Raffaele, Milan, Italy;16. Department of Surgery, A.I. Burnazyan FMBC Russian State Scientific Center of FMBA, Moscow, Russia;17. Department of Surgery, University of São Paulo, São Paulo, Brazil;18. Hepato-Biliary Center, AP-HP Paul Brousse Hospital, University of Paris-Sud, Inserm U776, Villejuif, France;19. Research Center of Surgery, Russian Academy of Medical Science, Moscow, Russia;20. Department of General Surgery, HM Sanchinarro Hospital, Madrid, Spain;21. Division of Transplantation/Hepatobiliary Surgery, Department of Surgery, University of Rochester, NY, USA |
| |
| Abstract: | ![]()
BackgroundVarious, often conflicting, estimates for post-operative morbidity and mortality following ALPPS have been reported in the literature, suggesting that considerable center-level variation exists. Some of this variation may be related to center volume and experience.MethodsUsing data from seventeen centers who were early adopters of the ALPPS technique, we estimated the variation, by center, in standardized 90-day mortality and comprehensive complication index (CCI) for patients treated between 2012 and 2018.ResultsWe estimated that center-specific 90-day mortality following treatment with ALPPS varied from 4.2% (95% CI: 0.8, 9.9) to 29.1% (95% CI: 13.9, 50.9), and that center-specific CCI following treatment with ALPPS varied from 17.0 (95% CI: 7.5, 26.5) to 49.8 (95% CI: 38.1, 61.8). Declines in estimated 90-day mortality and CCI were observed over time, and almost all individual centers followed this trend. Patients treated at centers with a higher number of ALPPS cases performed over the prior year had a lower risk of post-operative mortality.ConclusionDespite considerable center-level variation in ALPPS outcomes, perioperative outcomes following ALPPS have improved over time and treatment at higher volume centers results in a lower risk of 90-day mortality. Morbidity and mortality remain concerningly high at some centers. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
