Safety and Economics of Parenchymal Transection in Minimally Invasive Liver Surgery
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- Это наблюдательное исследование: исследуемое лечение участникам по протоколу не назначают.
- Кому может быть актуально
- Состояния в реестре: Liver Surgery, MINIMALLY INVASIVE LIVER SURGERY, Liver Neoplasm. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Италия
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Safety and Economics of Parenchymal Transection in Minimally Invasive Liver Surgery (LIVER-MIND 2): a Multicentre Retrospective Registry of the Italian Society of Endoscopic Surgery (SICE)
Обзор
LIVER-MIND 2 is a multicentre, observational, retrospective registry coordinated by the SICE HPB and Minimally Invasive Surgery Working Group, enrolling consecutive adults undergoing elective minimally invasive (laparoscopic, robotic or hybrid) liver resection between January 2021 and December 2025 across ≥15 high-volume or dedicated centres (target \>30 centres).
Подробное описание
LIVER-MIND 2 is a multicentre, observational, retrospective registry coordinated by the SICE HPB and Minimally Invasive Surgery Working Group, enrolling consecutive adults undergoing elective minimally invasive (laparoscopic, robotic or hybrid) liver resection between January 2021 and December 2025 across ≥15 high-volume or dedicated centres (target \>30 centres). The first 65 robotic cases per centre are excluded to account for the robotic HPB learning curve. The primary exposure is the transection strategy/primary device, with the principal contrast between cavitron ultrasonic surgical aspirator (CUSA) and energy devices. The primary outcome is a 90-day composite transection-related complication: significant bleeding (estimated blood loss \>500 mL and/or transfusion and/or reintervention for haemostasis) and/or clinically relevant bile leak (ISGLS grade B-C). Secondary outcomes include conversion, Clavien-Dindo ≥IIIa morbidity, post-hepatectomy liver failure (PHLF), operative time, length of stay, 90-day readmission and mortality, oncological radicality, and direct costs. The target sample size is ≈900 patients (80% power, two-sided α = 0.05, expected composite event rate 12%, minimal clinically relevant difference 5%, 5% drop-out inflation). The primary analysis uses multivariable logistic regression with propensity-score matching and inverse-probability-of-treatment weighting; pre-specified subgroup analyses and a statistical analysis plan are deposited before database lock. An exploratory cost analysis adopts a hospital perspective combining DRG-based standard costing and device-level micro-costing.
Первичные конечные точки
- 1. Rate of bleeding according to Post-Hepatectomy Haemorrhage (PHH) by International Study Group of Liver Surgery (ISGLS) 2. Rate of bile leak according to ISGLS classification in patients with abdominal drainage and/or undergoing percutaneous drainage [Срок оценки: January 2021 to December 2025]
Критерии участия
Критерии включения
- Age ≥ 18 years
- Elective minimally invasive liver resection
- Laparoscopic, robotic or hybrid approach
- Benign or malignant disease
- Signed informed consent for use of anonymised data
- Data completeness ≥ 70% in the CRF
Критерии исключения
- Urgent or emergency surgery
- Liver transplantation (donor / recipient)
- Associated major non-hepatic biliary or vascular resection
- Lack of consent or follow-up
- Participation in conflicting interventional trials
- Surgery before January 2021
- Robotic procedures performed during the learning-curve phase (first 65 robotic cases per centre, per Rahimli et al.)
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Модель наблюдения
- Случай-кроссовер
Центры проведения
Италия · 1 центр
- University of Molise — Campobasso
Публикации
- Ceccarelli G, Avella P, Muttillo EM, Conticchio M, Tebala GD, Piccolo G, Romano L, Memeo R, Rocca A; LIVER-MIND (Minimally Invasive Surgery and pareNchyma transection Devices) Study Group. Devices for minimally invasive liver parenchyma transection: the SICE (Italian Society of Endoscopic Surgery) Italian and International survey. Surg Endosc. 2025 Aug;39(8):4822-4838. doi: 10.1007/s00464-025-1176 PMID 40523976
Идентификаторы
NCT: NCT07750275 · 29501