SynthesisJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2023
Textbook Outcomes in Liver Surgery: a Systematic Review.
Synthesis in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 31 citations in OpenAlex.
- Textbook outcome after robotic liver surgery at a high-volume Scandinavian HPB center: an IWATE-based difficulty-stratified assessment of 200 cases.Surgical endoscopy · 2026Article
- Readmissions After Surgery for Colorectal Liver Metastases: A Propensity Score Analysis From the Colorectal Liver Operative Metastasis International Collaborative (COLOMIC).World journal of surgery · 2026Article
- Surgical Outcomes of Sequential Robot-Assisted Hepatobiliary-Pancreatic Surgery in a Single Operating Room: A Single-Center Retrospective Analysis of a High-Volume Center in Japan (TAKUMI-6).Annals of gastroenterological surgery · 2026Article
- Significance of the nutritional and body composition status for predicting a postoperative Textbook Outcome after pancreaticoduodenectomy.Surgery today · 2026Article
- Does calculating the textbook outcome based on its negative predictors enhance the transparency of intrahepatic cholangiocarcinoma surgery assessment?Annals of hepato-biliary-pancreatic surgery · 2026Article
- The textbook outcome of pancreaticoduodenectomy for adenocarcinoma of the pancreas in a high-volume centre.Surgery in practice and science · 2026Article
- Article
- Defining benchmarks for postoperative mobilization based on the recommendations of the Enhanced Recovery After Surgery (ERAS) program for liver surgery: a prospective study.Surgical endoscopy · 2025Observational
- The impact of liver transection depth on surgical difficulty in robotic versus laparoscopic limited liver resection (TAKUMI-5).Langenbeck's archives of surgery · 2025Article
- Impact of Neoadjuvant Chemotherapy with Gemcitabine Plus S-1 in Patients with Resectable Pancreatic Ductal Adenocarcinoma.Cancers · 2025Article
- A Composite Endpoint of Liver Surgery (CELS): Development and Validation of a Clinically Relevant Endpoint Requiring a Smaller Sample Size.Annals of surgical oncology · 2025Article
- Surgical Textbook Outcomes in the Era of Neoadjuvant Systemic Treatment for Skin Cancers.Journal of clinical medicine · 2024Review
- Realizing Textbook Outcomes Following Liver Resection for Hepatic Neoplasms with Development and Validation of a Predictive Nomogram.Annals of surgical oncology · 2024Article
- 6,126 hepatectomies in 2022: current trend of outcome in Italy.Langenbeck's archives of surgery · 2024Observational
- Achievement of textbook outcome after hepatectomy combined with thermal ablation for colorectal liver metastases.Surgical endoscopy · 2024Article
- Article
- The effect of an intraoperative patient-specific, surgery-specific haemodynamic algorithm in improving textbook outcomes for hepatobiliary-pancreatic surgery: a multicentre retrospective study.Frontiers in surgery · 2024Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAssessment of the quality of care among patients undergoing hepatectomy may be inadequate using traditional "siloed" postoperative surgical outcome metrics. In turn, the combination of several quality metrics into a single composite Textbook Outcome in Liver Surgery (TOLS) may be more representative of "ideal" surgical care.
methodsAdhering to PRISMA guidelines, a search for primary articles on post-operative TOLS evaluation after hepatectomy was performed. Studies that did not present hepatectomy outcomes, pediatric or transplantation populations, duplicated series, and editorials were excluded. Studies were evaluated in aggregate for methodological variation, TOLS rates, factors associated with TOLS, hospital variation, and overall findings.
resultsAmong 207 identified publications, 32 observational cohort studies were selected for inclusion in the review. There was a total of 90,077 hepatic resections performed from 1993 to 2020 in the analytic cohort. While TOLS definitions varied widely, all studies used an "all-or-none" composite structure combining a median of 5 (range: 4-7) discrete parameters. Observed TOLS rates varied in the different reported populations from 11.2 to 77.0%. TOLS was associated with patient, hospital, and operative factors.
conclusionsThis systematic review summarizes the contemporary international experience with TOLS to assess surgical performance following hepatobiliary surgery. TOLS is a single composite metric that may be more patient-centered, as well as better suited to quantify "optimal" care and compare performance among centers performing liver surgery.
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