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Ablation approach for primary liver tumors: Peri-operative outcomes. J Surg Oncol 2018 Jun;117(7):1493-1499

Date

02/28/2018

Pubmed ID

29484654

DOI

10.1002/jso.25019

Scopus ID

2-s2.0-85042551881   5 Citations

Abstract

BACKGROUND AND OBJECTIVES: Ablation is a common treatment modality for malignant primary liver tumors(PLTs), outcomes following laparoscopic (LA) versus open ablation (OA) are ill-defined. This project compares peri-procedural outcomes of LA versus OA for PLTs.

MATERIALS AND METHODS: Patients with PLTs undergoing radiofrequency ablation were queried from ACS NSQIP Database (2005-2013) using CPT codes. Patients undergoing percutaneous ablation or hepatic resection were excluded. Multivariable logistic regression analyses determined the association of ablation approach with 30-day morbidity and mortality.

RESULTS: Of 5747 with PLTs, 655 (11.4%) ablations were identified: 177 (27.0%) underwent OA, 478 (73.0%) underwent LA. Patients undergoing LA had lower mortality (1.9% vs 5.1%, Pa??=a??0.026), lower minor morbidity (2.3% vs 5.7%, Pa??=a??0.031), and lower major morbidity (4.2% vs 17.0%, Pa??<a??0.001). Adjusting for demographics, disease-specific variables (preoperative ascites, total bilirubin, platelet count, albumin, and INR), 30-day mortality (OR 3.85, 95%CI: 1.38-10.80, Pa??=a??0.010), minor morbidity (OR 2.98, 95%CI: 1.16-7.67, Pa??=a??0.024), and major morbidity (OR 4.59 95%CI: 2.41-8.76, Pa??<a??0.001) were statistically lower in LA. OA demonstrated increased length of stay(LOS) (5 vs 2 days, Pa??<a??0.001), and longer operative time (152 vs 112a??min, Pa??<a??0.001).

CONCLUSION: LA offers decreased peri-procedural morbidity, mortality, and reduced LOS. LA should be the preferred method for hepatic ablation.

Author List

Berger NG, Herren JL, Liu C, Burrow RH, Silva JP, Tsai S, Christians KK, Gamblin TC

Authors

Kathleen K. Christians MD Professor in the Surgery department at Medical College of Wisconsin
Thomas Clark Gamblin MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Susan Tsai MD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Catheter Ablation
Female
Follow-Up Studies
Humans
Laparoscopy
Length of Stay
Liver Neoplasms
Male
Middle Aged
Operative Time
Perioperative Care
Postoperative Complications
Retrospective Studies
Treatment Outcome