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Liver resection as a component of en‐bloc multivisceral resection for upper abdominal tumors is associated with increased morbidity
Author(s) -
Morris Paul David,
Coker David,
Crawford Michael,
Yeo David,
Sandroussi Charbel
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25824
Subject(s) - medicine , interquartile range , surgery , odds ratio , complication , retrospective cohort study , confidence interval , comorbidity
Abstract Background and Methods Complex en‐bloc multivisceral and oncovascular resections for upper abdominal tumors remain rare, but there is increasing interest in their role. We analyze complications and survival for these operations. We performed a retrospective cohort study of patients who underwent en‐bloc upper abdominal resections for tumors involving multiple organs. Primary outcomes were complications as per the Clavien‐Dindo Classification and Comprehensive Complication Index (CCI). Secondary outcome was overall survival (OS). Results We identified 60 consecutive patients who underwent resection from 2011 to 2018. Histopathology was heterogeneous, the most common being renal cell carcinoma. Eighteen patients had major complications. Mean (interquartile range) CCI was 29.6 (9.6‐43.9). Liver resection was significantly associated with an increased CCI and increased the odds of a major complication (odds ratio: 4.67, 95% confidence interval [CI]: 1.31‐16.59; P = .017). Charlson Comorbidity Score was significantly associated with the presence of at least one major complication. Mean OS was 47.1 months (95% CI: 37.6‐56.6). Conclusion In appropriately selected patients, and when undertaken in centers with appropriate subspecialist surgical teams and intensive care services, en‐bloc multivisceral resection of upper abdominal tumors is safe, but liver resection is associated with an increase in major complications.