TY - JOUR
T1 - Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods
AU - European Consortium on Minimally Invasive Pancreatic Surgery
AU - Van Ramshorst, Tess M.E.
AU - Giani, Alessandro
AU - Mazzola, Michele
AU - Dokmak, Safi
AU - Ftériche, Fadhel Samir
AU - Esposito, Alessandro
AU - De Pastena, Matteo
AU - Lof, Sanne
AU - Edwin, Bjørn
AU - Sahakyan, Mushegh
AU - Boggi, Ugo
AU - Kauffman, Emanuele Federico
AU - Fabre, Jean Michel
AU - Souche, Regis Francois
AU - Zerbi, Alessandro
AU - Butturini, Giovanni
AU - Molenaar, Quintus
AU - Al-Sarire, Bilal
AU - Marino, Marco V.
AU - Keck, Tobias
AU - White, Steven A.
AU - Casadei, Riccardo
AU - Burdio, Fernando
AU - Björnsson, Bergthor
AU - Soonawalla, Zahir
AU - Koerkamp, Bas Groot
AU - Fusai, Giuseppe Kito
AU - Pessaux, Patrick
AU - Jah, Asif
AU - Pietrabissa, Andrea
AU - Hackert, Thilo
AU - D'Hondt, Mathieu
AU - Pando, Elizabeth
AU - Besselink, Marc G.
AU - Ferrari, Giovanni
AU - Hilaland, Mohammad Abu
N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.
PY - 2022/12/13
Y1 - 2022/12/13
N2 - Background: Benchmarking is an important tool for quality comparison and improvement. However, no benchmark values are available for minimally invasive spleen-preserving distal pancreatectomy, either laparoscopically or robotically assisted. The aim of this study was to establish benchmarks for these techniques using two different methods. Methods: Data from patients undergoing laparoscopically or robotically assisted spleen-preserving distal pancreatectomy were extracted from a multicentre database (2006-2019). Benchmarks for 10 outcomes were calculated using the Achievable Benchmark of Care (ABC) and best-patient-in-best-centre methods. Results: Overall, 951 laparoscopically assisted (77.3 per cent) and 279 robotically assisted (22.7 per cent) procedures were included. Using the ABC method, the benchmarks for laparoscopically assisted and robotically assisted spleen-preserving distal pancreatectomy respectively were: 150 and 207 min for duration of operation, 55 and 100 ml for blood loss, 3.5 and 1.7 per cent for conversion, 0 and 1.7 per cent for failure to preserve the spleen, 27.3 and 34.0 per cent for overall morbidity, 5.1 and 3.3 per cent for major morbidity, 3.6 and 7.1 per cent for pancreatic fistula grade B/C, 5 and 6 days for duration of hospital stay, 2.9 and 5.4 per cent for readmissions, and 0 and 0 per cent for 90-day mortality. Best-patient-in-best-centre methodology revealed milder benchmark cut-offs for laparoscopically and robotically assisted procedures, with operating times of 254 and 262.5 min, blood loss of 150 and 195 ml, conversion rates of 5.8 and 8.2 per cent, rates of failure to salvage spleen of 29.9 and 27.3 per cent, overall morbidity rates of 62.7 and 55.7 per cent, major morbidity rates of 20.4 and 14 per cent, POPF B/C rates of 23.8 and 24.2 per cent, duration of hospital stay of 8 and 8 days, readmission rates of 20 and 15.1 per cent, and 90-day mortality rates of 0 and 0 per cent respectively. Conclusion: Two benchmark methods for minimally invasive distal pancreatectomy produced different values, and should be interpreted and applied differently.
AB - Background: Benchmarking is an important tool for quality comparison and improvement. However, no benchmark values are available for minimally invasive spleen-preserving distal pancreatectomy, either laparoscopically or robotically assisted. The aim of this study was to establish benchmarks for these techniques using two different methods. Methods: Data from patients undergoing laparoscopically or robotically assisted spleen-preserving distal pancreatectomy were extracted from a multicentre database (2006-2019). Benchmarks for 10 outcomes were calculated using the Achievable Benchmark of Care (ABC) and best-patient-in-best-centre methods. Results: Overall, 951 laparoscopically assisted (77.3 per cent) and 279 robotically assisted (22.7 per cent) procedures were included. Using the ABC method, the benchmarks for laparoscopically assisted and robotically assisted spleen-preserving distal pancreatectomy respectively were: 150 and 207 min for duration of operation, 55 and 100 ml for blood loss, 3.5 and 1.7 per cent for conversion, 0 and 1.7 per cent for failure to preserve the spleen, 27.3 and 34.0 per cent for overall morbidity, 5.1 and 3.3 per cent for major morbidity, 3.6 and 7.1 per cent for pancreatic fistula grade B/C, 5 and 6 days for duration of hospital stay, 2.9 and 5.4 per cent for readmissions, and 0 and 0 per cent for 90-day mortality. Best-patient-in-best-centre methodology revealed milder benchmark cut-offs for laparoscopically and robotically assisted procedures, with operating times of 254 and 262.5 min, blood loss of 150 and 195 ml, conversion rates of 5.8 and 8.2 per cent, rates of failure to salvage spleen of 29.9 and 27.3 per cent, overall morbidity rates of 62.7 and 55.7 per cent, major morbidity rates of 20.4 and 14 per cent, POPF B/C rates of 23.8 and 24.2 per cent, duration of hospital stay of 8 and 8 days, readmission rates of 20 and 15.1 per cent, and 90-day mortality rates of 0 and 0 per cent respectively. Conclusion: Two benchmark methods for minimally invasive distal pancreatectomy produced different values, and should be interpreted and applied differently.
UR - http://www.scopus.com/inward/record.url?scp=85144584540&partnerID=8YFLogxK
U2 - 10.1093/bjs/znac352
DO - 10.1093/bjs/znac352
M3 - Journal articles
C2 - 36322465
AN - SCOPUS:85144584540
SN - 0007-1323
VL - 110
SP - 76
EP - 83
JO - British Journal of Surgery
JF - British Journal of Surgery
IS - 1
ER -