A novel difficulty scoring system of laparoscopic liver resection for liver tumor
ObjectivesTo develop a novel difficulty scoring system (NDSS) to predict the surgical difficulty of laparoscopic hepatectomy.Patients and methodsA total of 138 patients with liver tumors performed liver resection (LLR) between March 2017 to June 2022 were selected from Affiliated Hospital of Jiangna...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1019763/full |
| _version_ | 1811258206966513664 |
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| author | Cheng Xi Cheng Xi Maoqun Zhu Tianhao Ji Yulin Tan Yulin Tan Lin Zhuang Lin Zhuang Zhiping Yuan Zheng Zhang Zheng Zhang Litian Xu Zhilin Liu Xuezhong Xu Xuezhong Xu Wenbo Xue Wenbo Xue Wei Ding Wei Ding Wei Ding |
| author_facet | Cheng Xi Cheng Xi Maoqun Zhu Tianhao Ji Yulin Tan Yulin Tan Lin Zhuang Lin Zhuang Zhiping Yuan Zheng Zhang Zheng Zhang Litian Xu Zhilin Liu Xuezhong Xu Xuezhong Xu Wenbo Xue Wenbo Xue Wei Ding Wei Ding Wei Ding |
| author_sort | Cheng Xi |
| collection | DOAJ |
| description | ObjectivesTo develop a novel difficulty scoring system (NDSS) to predict the surgical difficulty of laparoscopic hepatectomy.Patients and methodsA total of 138 patients with liver tumors performed liver resection (LLR) between March 2017 to June 2022 were selected from Affiliated Hospital of Jiangnan University and Wujin Hospital Affiliated with Jiangsu University.Patient demographics, laboratory tests, intraoperative variables, pathological characteristics were assessed. We also assessed the Child Pugh score and the DSS-B score.ResultsPatients were divided into training and testing cohort according to their hospital. Patients in training cohort were divided into high and low difficult groups based on operation time, blood loss and conversion. Higher percentage of patients with malignant liver tumor (87.0% vs. 58.1%; P = 0.003) or history of hepatobiliary surgery (24.1% vs. 7.0%; P = 0.043) in high difficult group than in low difficult group. To improve the difficulty scoring system, we incorporated the history of hepatobiliary surgery and nature of the tumor. A novel difficulty scoring system was established. The results showed that the operation time (P < 0.001), blood loss (P < 0.001), ALT (P < 0.001) and AST (P = 0.001) were associated with the novel difficulty score significantly. Compared with DSS-B, the NDSS has a higher area under the receiver operating characteristic (AUROC) (0.838 vs. 0.814). The nomogram was established according to the NDSS. The AUROCs of the nomogram in training and testing cohort were 0.833 and 0.767. The calibration curves for the probability of adverse event showed optimal agreement between the probability as predicted by the nomogram and the actual probability.ConclusionsWe developed a nomogram with the NDSS that can predict the difficulty of LLR. This system could more accurately reflect the difficulty of surgery and help liver surgeons to make the surgical plan and ensure the safety of the operation. |
| first_indexed | 2024-04-12T18:09:43Z |
| format | Article |
| id | doaj.art-fdb840d8264e46f48afe55c0275804d0 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T18:09:43Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-fdb840d8264e46f48afe55c0275804d02022-12-22T03:21:52ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.10197631019763A novel difficulty scoring system of laparoscopic liver resection for liver tumorCheng Xi0Cheng Xi1Maoqun Zhu2Tianhao Ji3Yulin Tan4Yulin Tan5Lin Zhuang6Lin Zhuang7Zhiping Yuan8Zheng Zhang9Zheng Zhang10Litian Xu11Zhilin Liu12Xuezhong Xu13Xuezhong Xu14Wenbo Xue15Wenbo Xue16Wei Ding17Wei Ding18Wei Ding19Department of General Surgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, ChinaDepartment of General Surgery, The Wujin Clinical college of Xuzhou Medical University, Changzhou, ChinaDepartment of Hepatological Surgery, Affiliated Hospital of Jiangnan University, Wuxi, ChinaDepartment of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of General Surgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, ChinaDepartment of General Surgery, The Wujin Clinical college of Xuzhou Medical University, Changzhou, ChinaDepartment of General Surgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, ChinaDepartment of General Surgery, The Wujin Clinical college of Xuzhou Medical University, Changzhou, ChinaDepartment of Digestion, Wujin Hospital Affiliated with Jiangsu University, Changzhou, ChinaDepartment of General Surgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, ChinaDepartment of General Surgery, The Wujin Clinical college of Xuzhou Medical University, Changzhou, ChinaDepartment of Gastrointestinal Surgery, The Fifth General Hospital of Kunming, Kunming, ChinaDepartment of Gastrointestinal Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, ChinaDepartment of General Surgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, ChinaDepartment of General Surgery, The Wujin Clinical college of Xuzhou Medical University, Changzhou, ChinaDepartment of General Surgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, ChinaDepartment of General Surgery, The Wujin Clinical college of Xuzhou Medical University, Changzhou, ChinaDepartment of General Surgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, ChinaDepartment of General Surgery, The Wujin Clinical college of Xuzhou Medical University, Changzhou, ChinaChangzhou Key Laboratory of Molecular Diagnostics and Precision Cancer Medicine, Wujin Hospital Affiliated with Jiangsu University, Changzhou, ChinaObjectivesTo develop a novel difficulty scoring system (NDSS) to predict the surgical difficulty of laparoscopic hepatectomy.Patients and methodsA total of 138 patients with liver tumors performed liver resection (LLR) between March 2017 to June 2022 were selected from Affiliated Hospital of Jiangnan University and Wujin Hospital Affiliated with Jiangsu University.Patient demographics, laboratory tests, intraoperative variables, pathological characteristics were assessed. We also assessed the Child Pugh score and the DSS-B score.ResultsPatients were divided into training and testing cohort according to their hospital. Patients in training cohort were divided into high and low difficult groups based on operation time, blood loss and conversion. Higher percentage of patients with malignant liver tumor (87.0% vs. 58.1%; P = 0.003) or history of hepatobiliary surgery (24.1% vs. 7.0%; P = 0.043) in high difficult group than in low difficult group. To improve the difficulty scoring system, we incorporated the history of hepatobiliary surgery and nature of the tumor. A novel difficulty scoring system was established. The results showed that the operation time (P < 0.001), blood loss (P < 0.001), ALT (P < 0.001) and AST (P = 0.001) were associated with the novel difficulty score significantly. Compared with DSS-B, the NDSS has a higher area under the receiver operating characteristic (AUROC) (0.838 vs. 0.814). The nomogram was established according to the NDSS. The AUROCs of the nomogram in training and testing cohort were 0.833 and 0.767. The calibration curves for the probability of adverse event showed optimal agreement between the probability as predicted by the nomogram and the actual probability.ConclusionsWe developed a nomogram with the NDSS that can predict the difficulty of LLR. This system could more accurately reflect the difficulty of surgery and help liver surgeons to make the surgical plan and ensure the safety of the operation.https://www.frontiersin.org/articles/10.3389/fonc.2022.1019763/fulldifficulty scoring systemlaparoscopic surgeryliver resectionliver tumoroutcome |
| spellingShingle | Cheng Xi Cheng Xi Maoqun Zhu Tianhao Ji Yulin Tan Yulin Tan Lin Zhuang Lin Zhuang Zhiping Yuan Zheng Zhang Zheng Zhang Litian Xu Zhilin Liu Xuezhong Xu Xuezhong Xu Wenbo Xue Wenbo Xue Wei Ding Wei Ding Wei Ding A novel difficulty scoring system of laparoscopic liver resection for liver tumor Frontiers in Oncology difficulty scoring system laparoscopic surgery liver resection liver tumor outcome |
| title | A novel difficulty scoring system of laparoscopic liver resection for liver tumor |
| title_full | A novel difficulty scoring system of laparoscopic liver resection for liver tumor |
| title_fullStr | A novel difficulty scoring system of laparoscopic liver resection for liver tumor |
| title_full_unstemmed | A novel difficulty scoring system of laparoscopic liver resection for liver tumor |
| title_short | A novel difficulty scoring system of laparoscopic liver resection for liver tumor |
| title_sort | novel difficulty scoring system of laparoscopic liver resection for liver tumor |
| topic | difficulty scoring system laparoscopic surgery liver resection liver tumor outcome |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1019763/full |
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