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. 2015 Jun;157(6):1055-64.
doi: 10.1016/j.surg.2015.01.015. Epub 2015 Mar 11.

National trends in the use of surgery for benign hepatic tumors in the United States

Yuhree Kim  1 , Neda Amini  1 , Jin He  1 , Georgios A Margonis  1 , Matthew Weiss  1 , Christopher L Wolfgang  1 , Martin Makary  1 , Kenzo Hirose  1 , Gaya Spolverato  1 , Timothy M Pawlik  2
Affiliations

National trends in the use of surgery for benign hepatic tumors in the United States

Yuhree Kim et al. Surgery. 2015 Jun.

Abstract

Background: The widespread use of diagnostic imaging has led to an increase in the incidence and diagnosis of benign liver tumors. The objective of this study was to define the overall use and temporal trends of operative procedures for benign liver tumors using a nationally representative cohort.

Methods: All patients who underwent liver surgery for benign liver tumors between 2000 and 2011 were identified from the Nationwide Inpatient Sample database. Trends in annual volume of liver procedures were analyzed using the average annual percent change (AAPC) assessed by joinpoint analysis.

Results: There were 2,489 open (94.5%) and 144 (5.5%) minimally invasive surgical (MIS) procedures. Partial hepatectomy accounted for 43.8% of all cases (n = 1,153). Surgery for patients with benign liver tumors increased from 156 in 2000 to 272 in 2011 (AAPC, 5.8%; 95% CI, 3.2-8.6%). There was decline in the relative use of open operative procedures from 98.1% in 2000 to 92.3% in 2011 (AAPC, -0.4%; 95% CI, -0.7 to -0.1%). In contrast, the proportion of MIS procedures increased from 1.9% in 2000 to 7.7% in 2011 (AAPC, 7.4%; 95% CI, 1.9-13.3%). The median duration of stay among all patients was 5 days (interquartile range, 4-7; 5 days [open] vs 3 days [MIS]; P < .001). Inpatient mortality was 0.6% (n = 15 [open] vs n = 0 [MIS]; P = .43) and did not change during the study period (P > .05).

Conclusion: Overall volume of surgical management of benign liver tumors has increased substantially over the past decade. There has been a relative shift away from open procedures toward MIS procedures.

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Conflict of interest statement

Conflict of interest: none.

Figures

Fig 1
Fig 1
Trends in (A) annual volume and (B) proportion of hepatic resection for benign liver tumors. (Color illustration of this figure is available online.)
Fig 2
Fig 2
Trends in annual volume of (A) open procedures and (B) minimally invasive surgery (MIS) procedures and proportion of (C) open procedure and (D) MIS procedures of hepatic resection for benign liver tumors.
See this image and copyright information in PMC

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