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- Title
Team Strategy Optimization in Combined Resections for Synchronous Colorectal Liver Metastases. A Comparative Study with Bootstrapping Analysis.
- Authors
Ratti, Francesca; Serenari, Matteo; Zanello, Matteo; Fuks, David; Rottoli, Matteo; Masetti, Michele; Tribillon, Ecoline; Ravaioli, Matteo; Elmore, Ugo; Rosati, Riccardo; Gayet, Brice; Cescon, Matteo; Jovine, Elio; Aldrighetti, Luca
- Abstract
Background: The aim of the study was to evaluate perioperative outcomes and to evaluate factors influencing rative morbidity and adoption of minimally invasive technique in 1-team (1-T) versus two teams (2-T) management of synchronous colorectal liver metastases. Methods: Within four referral centers, a group of 234 patients treated in 1-T centers was identified and compared with a group of 253 patients treated in 2-T. A nonparametric bootstrap process was applied to the original cohorts of 1-T group and 2-T group as a resampling method to obtain bootstrapped cohorts (155 patients per group). Results: 33.5% of patients in 1-T boot group and 38.1% in the 2-T boot group were operated by laparoscopic approach. Multivariate analysis revealed that approach to primary tumor (laparoscopic or open) and intraoperative blood loss were independent prognostic factors for morbidity. Team approach did not show any significant correlation with incidence of postoperative complications nor with choice for laparoscopic approach. Conclusion: The optimization of team strategy for patients with SCRLM is not solely based on the adoption of a 1-T or 2-T approach, but should instead be based on the implementation of a standard protocol for management of these patients.
- Subjects
SURGICAL blood loss; PROGNOSIS; LIVER surgery; SURGICAL complications; COMPARATIVE studies; COLORECTAL liver metastasis
- Publication
World Journal of Surgery, 2021, Vol 45, Issue 11, p3424
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-021-06260-8