Secondary endpoint | Definition and assessment of outcomes |
---|---|
Operation time | Time from incision to end of skin closure (minutes) |
Liver transection time | Time from beginning to end of liver resection (minutes) |
Liver transection area | Area estimated using Adobe Photoshop 7.0 (Adobe System Inc., San Jose, CA, USA) computer software, from the shape of the transection plane, which was traced onto a paper sheet at the end of liver resection (cm2) |
Liver transection speed | Speed calculated as the transection area divided by the transection time (cm2/min) |
Total blood loss per unit transection area | Blood loss calculated as the total blood loss divided by the transection area (ml/ cm2) |
Intraoperative blood transfusion | The indications for blood transfusion were massive hemorrhage (>1,500 ml) during surgery or a hemoglobin level <7 g/dl within stable hemodynamic measures. |
Postoperative hospital stay | Time from day of operation until discharge (days) |
Total hospitalization expenditure | Costs from admission to discharge ($) |
Postoperative liver injury | Serum levels of the aspartate aminotransferase, alanine aminotransferase, bilirubin, albumin and international normalized ratio on postoperative days one, three, five and seven |
Mortality | Death due to any cause until 90 days after the operation and the reason |
Morbidity | Postoperative complications will be recorded until 90 days after operation. The severity of complications will be graded according to the Clavien-Dindo classification [17]. |
Biliary leakage: the international study group of liver surgery (ISGLS) definition (grade A, B or C) [18] | |
Post-hepatectomy liver failure: ISGPS definition (grade A, B or C) [19] | |
Post-hepatectomy hemorrhage: ISGPS definition (grade A, B or C) [20] | |
Intra-abdominal fluid collection or abscess: any imaging modality detecting an intra-abdominal fluid collection associated with abdominal discomfort or pain, or elevation of infectious parameters. | |
Pneumonia: infection of the lung with evidence of increased infection parameters (C-reactive protein >2 mg/dl and/or leukocytes >100,000/ml) not caused by a different pathologic process or evidence of pulmonary infiltration on a chest X-ray, requiring antibiotic therapy. |