Sung Jun Jo, Jinsoo Rhu, Jongman Kim, Gyu-Seong Choi, Jae-Won Joh
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引用次数: 0
Abstract
Background: Laparoscopic repeat liver resection (LRLR) is still a challenging technique and requires a careful selection of indications. However, the current difficulty scoring system is not suitable for selecting indications. The purpose of this study is to develop the indication model for LRLR using machine learning and to identify factors associated with open conversion (OC).
Methods: Patients who underwent repeat hepatectomy (2017-2021) at Samsung Medical Center 2021 were investigated. Multiple indication models were developed using machine learning techniques (random forest, SVM, XGB) and logistic regression. The predictive performance of these models was compared, and risk factors associated with OC were analyzed.
Results: Among 221 patients (110 LRLR, 111 ORLR), the ORLR group had a higher previous open approach rate (75.7% vs. 38.2%, p<0.001). Twice previous abdominal surgery was the only independent OC risk factor (OR 6.56, p=0.009). The indication model showed moderate predictive power (random forest AUC=0.779, logistic regression AUC=0.725, p=0.710). Important variables were previous laparoscopic approach, present subsegmentectomy, and left-sided tumor location.
Conclusion: The performance of the indication model for LRLR showed moderate predictive power in both machine learning and logistic regression. The important variables for LRLR were previous laparoscopic approach, present subsegmentectomy, and left side location.
期刊介绍：
HPB is an international forum for clinical, scientific and educational communication.
Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice.
Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice.
HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields.
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HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).
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