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The LiMAx Test as Selection Criteria in Minimally Invasive Liver Surgery

Background: Liver failure is a crucial predictor for relevant morbidity and mortality after hepatic surgery. Hence, a good patient selection is mandatory. We use the LiMAx test for patient selection for major or minor liver resections in robotic and laparoscopic liver surgery and share our experienc...

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Autores principales: Rahimli, Mirhasan, Perrakis, Aristotelis, Gumbs, Andrew A., Andric, Mihailo, Al-Madhi, Sara, Arend, Joerg, Croner, Roland S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181538/
https://www.ncbi.nlm.nih.gov/pubmed/35683406
http://dx.doi.org/10.3390/jcm11113018
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author Rahimli, Mirhasan
Perrakis, Aristotelis
Gumbs, Andrew A.
Andric, Mihailo
Al-Madhi, Sara
Arend, Joerg
Croner, Roland S.
author_facet Rahimli, Mirhasan
Perrakis, Aristotelis
Gumbs, Andrew A.
Andric, Mihailo
Al-Madhi, Sara
Arend, Joerg
Croner, Roland S.
author_sort Rahimli, Mirhasan
collection PubMed
description Background: Liver failure is a crucial predictor for relevant morbidity and mortality after hepatic surgery. Hence, a good patient selection is mandatory. We use the LiMAx test for patient selection for major or minor liver resections in robotic and laparoscopic liver surgery and share our experience here. Patients and methods: We identified patients in the Magdeburg registry of minimally invasive liver surgery (MD-MILS) who underwent robotic or laparoscopic minor or major liver surgery and received a LiMAx test for preoperative evaluation of the liver function. This cohort was divided in two groups: patients with normal (LiMAx normal) and decreased (LiMAx decreased) liver function measured by the LiMAx test. Results: Forty patients were selected from the MD-MILS regarding the selection criteria (LiMAx normal, n = 22 and LiMAx decreased, n = 18). Significantly more major liver resections were performed in the LiMAx normal vs. the LiMAx decreased group (13 vs. 2; p = 0.003). Hence, the mean operation time was significantly longer in the LiMAx normal vs. the LiMAx decreased group (356.6 vs. 228.1 min; p = 0.003) and the intraoperative blood transfusion significantly higher in the LiMAx normal vs. the LiMAx decreased group (8 vs. 1; p = 0.027). There was no significant difference between the LiMAx groups regarding the length of hospital stay, intraoperative blood loss, liver surgery related morbidity or mortality, and resection margin status. Conclusion: The LiMAx test is a helpful and reliable tool to precisely determine the liver function capacity. It aids in accurate patient selection for major or minor liver resections in minimally invasive liver surgery, which consequently serves to improve patients’ safety. In this way, liver resections can be performed safely, even in patients with reduced liver function, without negatively affecting morbidity, mortality and the resection margin status, which is an important predictive oncological factor.
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spelling pubmed-91815382022-06-10 The LiMAx Test as Selection Criteria in Minimally Invasive Liver Surgery Rahimli, Mirhasan Perrakis, Aristotelis Gumbs, Andrew A. Andric, Mihailo Al-Madhi, Sara Arend, Joerg Croner, Roland S. J Clin Med Article Background: Liver failure is a crucial predictor for relevant morbidity and mortality after hepatic surgery. Hence, a good patient selection is mandatory. We use the LiMAx test for patient selection for major or minor liver resections in robotic and laparoscopic liver surgery and share our experience here. Patients and methods: We identified patients in the Magdeburg registry of minimally invasive liver surgery (MD-MILS) who underwent robotic or laparoscopic minor or major liver surgery and received a LiMAx test for preoperative evaluation of the liver function. This cohort was divided in two groups: patients with normal (LiMAx normal) and decreased (LiMAx decreased) liver function measured by the LiMAx test. Results: Forty patients were selected from the MD-MILS regarding the selection criteria (LiMAx normal, n = 22 and LiMAx decreased, n = 18). Significantly more major liver resections were performed in the LiMAx normal vs. the LiMAx decreased group (13 vs. 2; p = 0.003). Hence, the mean operation time was significantly longer in the LiMAx normal vs. the LiMAx decreased group (356.6 vs. 228.1 min; p = 0.003) and the intraoperative blood transfusion significantly higher in the LiMAx normal vs. the LiMAx decreased group (8 vs. 1; p = 0.027). There was no significant difference between the LiMAx groups regarding the length of hospital stay, intraoperative blood loss, liver surgery related morbidity or mortality, and resection margin status. Conclusion: The LiMAx test is a helpful and reliable tool to precisely determine the liver function capacity. It aids in accurate patient selection for major or minor liver resections in minimally invasive liver surgery, which consequently serves to improve patients’ safety. In this way, liver resections can be performed safely, even in patients with reduced liver function, without negatively affecting morbidity, mortality and the resection margin status, which is an important predictive oncological factor. MDPI 2022-05-27 /pmc/articles/PMC9181538/ /pubmed/35683406 http://dx.doi.org/10.3390/jcm11113018 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rahimli, Mirhasan
Perrakis, Aristotelis
Gumbs, Andrew A.
Andric, Mihailo
Al-Madhi, Sara
Arend, Joerg
Croner, Roland S.
The LiMAx Test as Selection Criteria in Minimally Invasive Liver Surgery
title The LiMAx Test as Selection Criteria in Minimally Invasive Liver Surgery
title_full The LiMAx Test as Selection Criteria in Minimally Invasive Liver Surgery
title_fullStr The LiMAx Test as Selection Criteria in Minimally Invasive Liver Surgery
title_full_unstemmed The LiMAx Test as Selection Criteria in Minimally Invasive Liver Surgery
title_short The LiMAx Test as Selection Criteria in Minimally Invasive Liver Surgery
title_sort limax test as selection criteria in minimally invasive liver surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181538/
https://www.ncbi.nlm.nih.gov/pubmed/35683406
http://dx.doi.org/10.3390/jcm11113018
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