Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 001] Postoperative Infective Complications Following Laparoscopic Versus Open Hepatectomy For Hepatocellular Carcinoma: A Multicenter Propensity Score Analysis Of 3,945 Patients
Jia-Le PU1 , Zhong CHEN2 , Yong-Kang DIAO1 , Xiao XU1 , Zhong-Qi FAN1 , Hang-Dong JIA4 , Ju-Dong LI5 , Ming-Cheng GUAN6 , Ying-Jian LIANG7 , Xian-Ming WANG8 , Zhi-Yu CHEN9 , Chao LI3 , Lan-Qing YAO3 , Ming-Da WANG3 , Feng SHEN3 , Guo-Yue LV1 , Tian YANG*1
1 Department Of Hepatobiliary And Pancreatic Surgery, First Hospital Of Jilin University, CHINA
2 Department Of Hepatobiliary Surgery, Affiliated Hospital Of Nantong University, CHINA
3 Department Of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, CHINA
4 Department Of General Surgery, Zhejiang Provincial People’s Hospital, CHINA
5 Department Of Pancreatic-biliary Surgery, Changzheng Hospital, CHINA
6 Department Of Medical Oncology, The First Affiliated Hospital Of Soochow University, CHINA
7 Department Of Hepatobiliary Surgery, The First Affiliated Hospital Of Harbin Medical University, CHINA
8 Department Of General Surgery, First Affiliated Hospital Of Shandong First Medical University, CHINA
9 Department Of Hepatobiliary Surgery, Southwest Hospital, CHINA
Background : The most common indication of hepatectomy is hepatocellular carcinoma (HCC), while the most common complication of hepatectomy is infection, including incisional and organ/space surgical site infection (SSI) and remote infection (RI). We sought to investigate the relationship of operative approach with the incidence of postoperative infective complications.
Methods : From a multicenter database, HCC patients who underwent laparoscopic hepatectomy (LH) or open hepatectomy (OH) were reviewed. Using propensity score matching (PSM), inverse probability of treatment weight (IPTW), and multivariate logistic regression analyses, the 30-day incidences of various postoperative infective complications were compared between patients who underwent LH and patients who underwent OH.
Results : Among 3,945 patients, 914 (23.2%) and 3031 (76.8%) patients underwent LH and OH, respectively. In the entire cohort, the incidences of overall infection, incisional SSI, organ/space SSI, and RI among patients who underwent LH were significantly lower than those who underwent OH (7.7%, 1.9%, 2.1% and 4.2% vs. 14.6%, 6.3%, 4.6% and 9.8%, all P<0.05). The similar results were identified in the PSM (7.7%, 1.9%, 2.1% and 4.2% vs. 14.0%, 5.6%, 5.3% and 10.0%, all P<0.05) and IPTW (10.1%, 2.2%, 2.2%, and 6.0% vs. 14.3%, 6.3%, 4.5%, and 9.8%, all P<0.05) cohorts, respectively. After adjustment for other confounding factors, multivariate analyses identified that laparoscopic approach was independently associated with lower incidences of overall infection, incisional SSI, organ/space SSI, and RI in the entire, PSM, and IPTW cohorts, respectively.
Conclusions : Compare with open approach, laparoscopic approach was associated with lower incidences of various postoperative infective complication among patients who underwent hepatectomy for HCC.
Methods : From a multicenter database, HCC patients who underwent laparoscopic hepatectomy (LH) or open hepatectomy (OH) were reviewed. Using propensity score matching (PSM), inverse probability of treatment weight (IPTW), and multivariate logistic regression analyses, the 30-day incidences of various postoperative infective complications were compared between patients who underwent LH and patients who underwent OH.
Results : Among 3,945 patients, 914 (23.2%) and 3031 (76.8%) patients underwent LH and OH, respectively. In the entire cohort, the incidences of overall infection, incisional SSI, organ/space SSI, and RI among patients who underwent LH were significantly lower than those who underwent OH (7.7%, 1.9%, 2.1% and 4.2% vs. 14.6%, 6.3%, 4.6% and 9.8%, all P<0.05). The similar results were identified in the PSM (7.7%, 1.9%, 2.1% and 4.2% vs. 14.0%, 5.6%, 5.3% and 10.0%, all P<0.05) and IPTW (10.1%, 2.2%, 2.2%, and 6.0% vs. 14.3%, 6.3%, 4.5%, and 9.8%, all P<0.05) cohorts, respectively. After adjustment for other confounding factors, multivariate analyses identified that laparoscopic approach was independently associated with lower incidences of overall infection, incisional SSI, organ/space SSI, and RI in the entire, PSM, and IPTW cohorts, respectively.
Conclusions : Compare with open approach, laparoscopic approach was associated with lower incidences of various postoperative infective complication among patients who underwent hepatectomy for HCC.
SESSION
E-poster
E-Session 03/23 ~ 03/25 ALL DAY