ArticleSurgical endoscopy2020
Minimally invasive hepatectomy is associated with decreased morbidity and resource utilization in the elderly.
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 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- EAES/SAGES evidence-based recommendations and expert consensus on optimization of perioperative care in older adults.Surgical endoscopy · 2024Guideline
- Impact of patient factors on outcomes in robotic major and minor hepatectomy: importance of patient selection.Journal of robotic surgery · 2026Article
- Review
- 10 years, 100 robotic major hepatectomies: a single-center experience.Surgical endoscopy · 2024Article
- A systematic review and meta-analysis of blood transfusion rates during liver resection by country.Annals of surgical treatment and research · 2023Article
- Propensity score matched comparison of robotic and open major hepatectomy for malignant liver tumors.Surgical endoscopy · 2022Article
- What Is the Current Role and What Are the Prospects of the Robotic Approach in Liver Surgery?Cancers · 2022Review
- Bile leak incidence, risk factors and associated outcomes in patients undergoing hepatectomy: a contemporary NSQIP propensity matched analysis.Surgical endoscopy · 2022Article
- Realization of improved outcomes following liver resection in hepatocellular carcinoma patients aged 75 years and older.Annals of surgical treatment and research · 2021Article
- Minimally Invasive Hepatectomy in North America: Laparoscopic Versus Robotic.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Minimally invasive versus open right hepatectomy: comparative study with propensity score matching analysis.BMC surgery · 2020Article
- Article
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to evaluate whether elderly patients undergoing elective hepatectomy experience increased morbidity/mortality and whether these outcomes could be mitigated by minimally invasive hepatectomy (MIH).
methods15,612 patients from 2014 to 2017 were identified in the Hepatectomy Targeted Procedure Participant Use File of the American College of Surgeons National Surgical Quality Improvement Program. Multivariable logistic regression models were constructed to examine the effect of elderly status (age ≥ 75 years, N = 1769) on outcomes with a subgroup analysis of elderly only patients by open (OH) versus MIH (robotic, laparoscopic, and hybrid, N = 4044). Propensity score matching was conducted comparing the effect of MIH to OH in elderly patients to ensure that results are not the artifact of imbalance in baseline characteristics.
resultsOverall, elderly patients had increased risk for 30-day mortality, major morbidity, prolonged length of hospital stay, and discharge to destination other than home. In the elderly subgroup, MIH was associated with decreased major morbidity (OR 0.71, P = 0.031), invasive intervention (OR 0.61, P = 0.032), liver failure (OR 0.15, P = 0.011), bleeding (OR 0.46, P < 0.001), and prolonged length of stay (OR 0.46, P < 0.001). Propensity score-matched analyses successfully matched 4021 pairs of patients treated by MIH vs. OH, and logistic regression analyses on this matched sample found that MIH was associated with decreased major complications (OR 0.69, P = 0.023), liver failure (OR 0.14, P = 0.010), bile leak (OR 0.46, P = 0.009), bleeding requiring transfusion (OR 0.46, P < 0.001), prolonged length of stay (OR 0.46, P < 0.001), and discharge to destination other than home (OR 0.691, P = 0.035) compared to OH.
conclusionMIH is associated with decreased risk of major morbidity, liver failure, bile leak, bleeding, prolonged length of stay, and discharge to destination other than home among elderly patients in this retrospective study. However, MIH in elderly patients does not protect against postoperative mortality.
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