Evidence map›Paper›PMID 31016458›Full record

ArticleSurgical endoscopy2020

Predictors and outcomes of converted minimally invasive pancreaticoduodenectomy: a propensity score matched analysis.

Caitlin A Hester, Ibrahim Nassour, Alana Christie, Mathew M Augustine, John C Mansour, Patricio M Polanco, Matthew R Porembka, Thomas H Shoultz, Sam C Wang, Adam C Yopp and 2 more

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Caitlin A HesterDivision of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID 0000-0002-3302-0839
Ibrahim NassourDivision of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Alana ChristieDepartment of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Mathew M AugustineDivision of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
John C MansourDivision of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Patricio M PolancoDivision of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Matthew R PorembkaDivision of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Thomas H ShoultzDivision of General and Acute Care Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Sam C WangDivision of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Adam C YoppDivision of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Herbert J ZehDivision of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Rebecca M MinterDepartment of Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine, 600 Highland Avenue, Madison, WI, USA. minter@surgery.wisc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundData-driven patient selection guidelines are not available to optimize outcomes in minimally invasive pancreaticoduodenectomy (MIPD). We aimed to define risk factors associated with conversion from MIPD to open PD and to determine the impact of conversion on post-operative outcomes.

methodsWe conducted a retrospective review of MIPD using NSQIP from 2014 to 2015. Propensity score was used to match patients who underwent completed MIPD to converted MIPD.

results467 patients were included: 375 (80.3%) MIPD and 92 (19.7%) converted. Converted patients were more often male (64% vs. 52%, p = 0.030), had higher rates of dyspnea (10% vs. 3%, p = 0.009), underwent more vascular (44% vs. 14%, p < 0.001) or multivisceral resection (19% vs. 6%, p = 0.0005), and were more likely attempted laparoscopically compared to robotically (76% vs. 51%, p < 0.001). Robotic approach was independently associated with reduced risk of conversion (OR 0.40, 95% CI 0.23-0.69), while male gender (OR 1.70, 95% CI 1.02-2.84), history of dyspnea (OR 3.85, 95% CI 1.49-9.96), vascular resection (OR 4.32, 95% CI 2.53-7.37), and multivisceral resection (OR 2.18, 95% CI 1.05-4.52) were associated with increased risk. Major complications were more common in converted patients (68% vs. 37%, p < 0.001). Converted patients had increased odds of non-home discharge (OR 3.25, 95% CI 1.06-9.97) and an associated increased length of stay of 3 days (95% CI 0.1-6.7).

conclusionPatients with a history of dyspnea or tumors requiring vascular or multivisceral resection were at increased risk of conversion, and the robotic platform was associated with a lower rate of conversion. Conversion was independently associated with increased overall complications, increased length of stay, and non-home discharge.

Indexed as

Outcome and Process Assessment, Health CarePropensity ScoreAgedConversion to Open SurgeryCytoreduction Surgical ProceduresFemaleHumansLaparoscopyMaleMatched-Pair AnalysisMiddle AgedMinimally Invasive Surgical ProceduresPancreaticoduodenectomyPostoperative ComplicationsRetrospective StudiesRisk FactorsConvertedMinimally invasiveOutcomesPancreaticoduodenectomyPredictors

Identifiers

PMID31016458

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.