Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy
Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical app...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Xourafas, Dimitrios [verfasserIn] |
|---|
| Format: |
E-Artikel |
|---|---|
| Sprache: |
Englisch |
| Erschienen: |
2018 |
|---|
| Schlagwörter: |
|---|
| Anmerkung: |
© The Society for Surgery of the Alimentary Tract 2018 |
|---|
| Übergeordnetes Werk: |
Enthalten in: Journal of gastrointestinal surgery - New York, NY : Springer, 1997, 22(2018), 11 vom: 25. Juni, Seite 1911-1919 |
|---|---|
| Übergeordnetes Werk: |
volume:22 ; year:2018 ; number:11 ; day:25 ; month:06 ; pages:1911-1919 |
| Links: |
|---|
| DOI / URN: |
10.1007/s11605-018-3834-6 |
|---|
| Katalog-ID: |
SPR021078904 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | SPR021078904 | ||
| 003 | DE-627 | ||
| 005 | 20230520003605.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 201006s2018 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s11605-018-3834-6 |2 doi | |
| 035 | |a (DE-627)SPR021078904 | ||
| 035 | |a (SPR)s11605-018-3834-6-e | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Xourafas, Dimitrios |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy |
| 264 | 1 | |c 2018 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a © The Society for Surgery of the Alimentary Tract 2018 | ||
| 520 | |a Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources. | ||
| 650 | 4 | |a Open |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Laparoscopic |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Robotic pancreatoduodenectomy |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a ACS NSQIP database |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Predictors |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Operative time |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Hospital length of stay |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Pawlik, Timothy M. |4 aut | |
| 700 | 1 | |a Cloyd, Jordan M. |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of gastrointestinal surgery |d New York, NY : Springer, 1997 |g 22(2018), 11 vom: 25. Juni, Seite 1911-1919 |w (DE-627)334375053 |w (DE-600)2057634-1 |x 1873-4626 |7 nnns |
| 773 | 1 | 8 | |g volume:22 |g year:2018 |g number:11 |g day:25 |g month:06 |g pages:1911-1919 |
| 856 | 4 | 0 | |u https://dx.doi.org/10.1007/s11605-018-3834-6 |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_SPRINGER | ||
| 912 | |a SSG-OLC-PHA | ||
| 912 | |a GBV_ILN_11 | ||
| 912 | |a GBV_ILN_20 | ||
| 912 | |a GBV_ILN_22 | ||
| 912 | |a GBV_ILN_23 | ||
| 912 | |a GBV_ILN_24 | ||
| 912 | |a GBV_ILN_31 | ||
| 912 | |a GBV_ILN_32 | ||
| 912 | |a GBV_ILN_39 | ||
| 912 | |a GBV_ILN_40 | ||
| 912 | |a GBV_ILN_60 | ||
| 912 | |a GBV_ILN_62 | ||
| 912 | |a GBV_ILN_63 | ||
| 912 | |a GBV_ILN_65 | ||
| 912 | |a GBV_ILN_69 | ||
| 912 | |a GBV_ILN_70 | ||
| 912 | |a GBV_ILN_73 | ||
| 912 | |a GBV_ILN_74 | ||
| 912 | |a GBV_ILN_90 | ||
| 912 | |a GBV_ILN_95 | ||
| 912 | |a GBV_ILN_100 | ||
| 912 | |a GBV_ILN_101 | ||
| 912 | |a GBV_ILN_105 | ||
| 912 | |a GBV_ILN_110 | ||
| 912 | |a GBV_ILN_120 | ||
| 912 | |a GBV_ILN_138 | ||
| 912 | |a GBV_ILN_150 | ||
| 912 | |a GBV_ILN_151 | ||
| 912 | |a GBV_ILN_161 | ||
| 912 | |a GBV_ILN_165 | ||
| 912 | |a GBV_ILN_170 | ||
| 912 | |a GBV_ILN_171 | ||
| 912 | |a GBV_ILN_187 | ||
| 912 | |a GBV_ILN_213 | ||
| 912 | |a GBV_ILN_224 | ||
| 912 | |a GBV_ILN_230 | ||
| 912 | |a GBV_ILN_250 | ||
| 912 | |a GBV_ILN_281 | ||
| 912 | |a GBV_ILN_285 | ||
| 912 | |a GBV_ILN_293 | ||
| 912 | |a GBV_ILN_370 | ||
| 912 | |a GBV_ILN_602 | ||
| 912 | |a GBV_ILN_636 | ||
| 912 | |a GBV_ILN_702 | ||
| 912 | |a GBV_ILN_2001 | ||
| 912 | |a GBV_ILN_2003 | ||
| 912 | |a GBV_ILN_2004 | ||
| 912 | |a GBV_ILN_2005 | ||
| 912 | |a GBV_ILN_2006 | ||
| 912 | |a GBV_ILN_2007 | ||
| 912 | |a GBV_ILN_2008 | ||
| 912 | |a GBV_ILN_2009 | ||
| 912 | |a GBV_ILN_2010 | ||
| 912 | |a GBV_ILN_2011 | ||
| 912 | |a GBV_ILN_2014 | ||
| 912 | |a GBV_ILN_2015 | ||
| 912 | |a GBV_ILN_2020 | ||
| 912 | |a GBV_ILN_2021 | ||
| 912 | |a GBV_ILN_2025 | ||
| 912 | |a GBV_ILN_2026 | ||
| 912 | |a GBV_ILN_2027 | ||
| 912 | |a GBV_ILN_2031 | ||
| 912 | |a GBV_ILN_2034 | ||
| 912 | |a GBV_ILN_2037 | ||
| 912 | |a GBV_ILN_2038 | ||
| 912 | |a GBV_ILN_2039 | ||
| 912 | |a GBV_ILN_2044 | ||
| 912 | |a GBV_ILN_2048 | ||
| 912 | |a GBV_ILN_2049 | ||
| 912 | |a GBV_ILN_2050 | ||
| 912 | |a GBV_ILN_2055 | ||
| 912 | |a GBV_ILN_2057 | ||
| 912 | |a GBV_ILN_2059 | ||
| 912 | |a GBV_ILN_2061 | ||
| 912 | |a GBV_ILN_2064 | ||
| 912 | |a GBV_ILN_2065 | ||
| 912 | |a GBV_ILN_2068 | ||
| 912 | |a GBV_ILN_2070 | ||
| 912 | |a GBV_ILN_2086 | ||
| 912 | |a GBV_ILN_2088 | ||
| 912 | |a GBV_ILN_2093 | ||
| 912 | |a GBV_ILN_2106 | ||
| 912 | |a GBV_ILN_2107 | ||
| 912 | |a GBV_ILN_2108 | ||
| 912 | |a GBV_ILN_2110 | ||
| 912 | |a GBV_ILN_2111 | ||
| 912 | |a GBV_ILN_2112 | ||
| 912 | |a GBV_ILN_2113 | ||
| 912 | |a GBV_ILN_2116 | ||
| 912 | |a GBV_ILN_2118 | ||
| 912 | |a GBV_ILN_2119 | ||
| 912 | |a GBV_ILN_2122 | ||
| 912 | |a GBV_ILN_2129 | ||
| 912 | |a GBV_ILN_2143 | ||
| 912 | |a GBV_ILN_2144 | ||
| 912 | |a GBV_ILN_2147 | ||
| 912 | |a GBV_ILN_2148 | ||
| 912 | |a GBV_ILN_2152 | ||
| 912 | |a GBV_ILN_2153 | ||
| 912 | |a GBV_ILN_2188 | ||
| 912 | |a GBV_ILN_2190 | ||
| 912 | |a GBV_ILN_2232 | ||
| 912 | |a GBV_ILN_2336 | ||
| 912 | |a GBV_ILN_2446 | ||
| 912 | |a GBV_ILN_2470 | ||
| 912 | |a GBV_ILN_2472 | ||
| 912 | |a GBV_ILN_2507 | ||
| 912 | |a GBV_ILN_2522 | ||
| 912 | |a GBV_ILN_4012 | ||
| 912 | |a GBV_ILN_4035 | ||
| 912 | |a GBV_ILN_4037 | ||
| 912 | |a GBV_ILN_4046 | ||
| 912 | |a GBV_ILN_4112 | ||
| 912 | |a GBV_ILN_4125 | ||
| 912 | |a GBV_ILN_4126 | ||
| 912 | |a GBV_ILN_4242 | ||
| 912 | |a GBV_ILN_4246 | ||
| 912 | |a GBV_ILN_4249 | ||
| 912 | |a GBV_ILN_4251 | ||
| 912 | |a GBV_ILN_4305 | ||
| 912 | |a GBV_ILN_4306 | ||
| 912 | |a GBV_ILN_4307 | ||
| 912 | |a GBV_ILN_4313 | ||
| 912 | |a GBV_ILN_4322 | ||
| 912 | |a GBV_ILN_4323 | ||
| 912 | |a GBV_ILN_4324 | ||
| 912 | |a GBV_ILN_4325 | ||
| 912 | |a GBV_ILN_4326 | ||
| 912 | |a GBV_ILN_4333 | ||
| 912 | |a GBV_ILN_4334 | ||
| 912 | |a GBV_ILN_4335 | ||
| 912 | |a GBV_ILN_4336 | ||
| 912 | |a GBV_ILN_4338 | ||
| 912 | |a GBV_ILN_4393 | ||
| 912 | |a GBV_ILN_4700 | ||
| 951 | |a AR | ||
| 952 | |d 22 |j 2018 |e 11 |b 25 |c 06 |h 1911-1919 | ||
| author_variant |
d x dx t m p tm tmp j m c jm jmc |
|---|---|
| matchkey_str |
article:18734626:2018----::neednpeitroicesdprtvtmadoptleghftyrcnitnarsdfeetugc |
| hierarchy_sort_str |
2018 |
| publishDate |
2018 |
| allfields |
10.1007/s11605-018-3834-6 doi (DE-627)SPR021078904 (SPR)s11605-018-3834-6-e DE-627 ger DE-627 rakwb eng Xourafas, Dimitrios verfasserin aut Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Society for Surgery of the Alimentary Tract 2018 Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources. Open (dpeaa)DE-He213 Laparoscopic (dpeaa)DE-He213 Robotic pancreatoduodenectomy (dpeaa)DE-He213 ACS NSQIP database (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Operative time (dpeaa)DE-He213 Hospital length of stay (dpeaa)DE-He213 Pawlik, Timothy M. aut Cloyd, Jordan M. aut Enthalten in Journal of gastrointestinal surgery New York, NY : Springer, 1997 22(2018), 11 vom: 25. Juni, Seite 1911-1919 (DE-627)334375053 (DE-600)2057634-1 1873-4626 nnns volume:22 year:2018 number:11 day:25 month:06 pages:1911-1919 https://dx.doi.org/10.1007/s11605-018-3834-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 22 2018 11 25 06 1911-1919 |
| spelling |
10.1007/s11605-018-3834-6 doi (DE-627)SPR021078904 (SPR)s11605-018-3834-6-e DE-627 ger DE-627 rakwb eng Xourafas, Dimitrios verfasserin aut Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Society for Surgery of the Alimentary Tract 2018 Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources. Open (dpeaa)DE-He213 Laparoscopic (dpeaa)DE-He213 Robotic pancreatoduodenectomy (dpeaa)DE-He213 ACS NSQIP database (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Operative time (dpeaa)DE-He213 Hospital length of stay (dpeaa)DE-He213 Pawlik, Timothy M. aut Cloyd, Jordan M. aut Enthalten in Journal of gastrointestinal surgery New York, NY : Springer, 1997 22(2018), 11 vom: 25. Juni, Seite 1911-1919 (DE-627)334375053 (DE-600)2057634-1 1873-4626 nnns volume:22 year:2018 number:11 day:25 month:06 pages:1911-1919 https://dx.doi.org/10.1007/s11605-018-3834-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 22 2018 11 25 06 1911-1919 |
| allfields_unstemmed |
10.1007/s11605-018-3834-6 doi (DE-627)SPR021078904 (SPR)s11605-018-3834-6-e DE-627 ger DE-627 rakwb eng Xourafas, Dimitrios verfasserin aut Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Society for Surgery of the Alimentary Tract 2018 Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources. Open (dpeaa)DE-He213 Laparoscopic (dpeaa)DE-He213 Robotic pancreatoduodenectomy (dpeaa)DE-He213 ACS NSQIP database (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Operative time (dpeaa)DE-He213 Hospital length of stay (dpeaa)DE-He213 Pawlik, Timothy M. aut Cloyd, Jordan M. aut Enthalten in Journal of gastrointestinal surgery New York, NY : Springer, 1997 22(2018), 11 vom: 25. Juni, Seite 1911-1919 (DE-627)334375053 (DE-600)2057634-1 1873-4626 nnns volume:22 year:2018 number:11 day:25 month:06 pages:1911-1919 https://dx.doi.org/10.1007/s11605-018-3834-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 22 2018 11 25 06 1911-1919 |
| allfieldsGer |
10.1007/s11605-018-3834-6 doi (DE-627)SPR021078904 (SPR)s11605-018-3834-6-e DE-627 ger DE-627 rakwb eng Xourafas, Dimitrios verfasserin aut Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Society for Surgery of the Alimentary Tract 2018 Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources. Open (dpeaa)DE-He213 Laparoscopic (dpeaa)DE-He213 Robotic pancreatoduodenectomy (dpeaa)DE-He213 ACS NSQIP database (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Operative time (dpeaa)DE-He213 Hospital length of stay (dpeaa)DE-He213 Pawlik, Timothy M. aut Cloyd, Jordan M. aut Enthalten in Journal of gastrointestinal surgery New York, NY : Springer, 1997 22(2018), 11 vom: 25. Juni, Seite 1911-1919 (DE-627)334375053 (DE-600)2057634-1 1873-4626 nnns volume:22 year:2018 number:11 day:25 month:06 pages:1911-1919 https://dx.doi.org/10.1007/s11605-018-3834-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 22 2018 11 25 06 1911-1919 |
| allfieldsSound |
10.1007/s11605-018-3834-6 doi (DE-627)SPR021078904 (SPR)s11605-018-3834-6-e DE-627 ger DE-627 rakwb eng Xourafas, Dimitrios verfasserin aut Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Society for Surgery of the Alimentary Tract 2018 Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources. Open (dpeaa)DE-He213 Laparoscopic (dpeaa)DE-He213 Robotic pancreatoduodenectomy (dpeaa)DE-He213 ACS NSQIP database (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Operative time (dpeaa)DE-He213 Hospital length of stay (dpeaa)DE-He213 Pawlik, Timothy M. aut Cloyd, Jordan M. aut Enthalten in Journal of gastrointestinal surgery New York, NY : Springer, 1997 22(2018), 11 vom: 25. Juni, Seite 1911-1919 (DE-627)334375053 (DE-600)2057634-1 1873-4626 nnns volume:22 year:2018 number:11 day:25 month:06 pages:1911-1919 https://dx.doi.org/10.1007/s11605-018-3834-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 22 2018 11 25 06 1911-1919 |
| language |
English |
| source |
Enthalten in Journal of gastrointestinal surgery 22(2018), 11 vom: 25. Juni, Seite 1911-1919 volume:22 year:2018 number:11 day:25 month:06 pages:1911-1919 |
| sourceStr |
Enthalten in Journal of gastrointestinal surgery 22(2018), 11 vom: 25. Juni, Seite 1911-1919 volume:22 year:2018 number:11 day:25 month:06 pages:1911-1919 |
| format_phy_str_mv |
Article |
| institution |
findex.gbv.de |
| topic_facet |
Open Laparoscopic Robotic pancreatoduodenectomy ACS NSQIP database Predictors Operative time Hospital length of stay |
| isfreeaccess_bool |
false |
| container_title |
Journal of gastrointestinal surgery |
| authorswithroles_txt_mv |
Xourafas, Dimitrios @@aut@@ Pawlik, Timothy M. @@aut@@ Cloyd, Jordan M. @@aut@@ |
| publishDateDaySort_date |
2018-06-25T00:00:00Z |
| hierarchy_top_id |
334375053 |
| id |
SPR021078904 |
| language_de |
englisch |
| fullrecord |
<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR021078904</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230520003605.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201006s2018 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s11605-018-3834-6</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR021078904</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s11605-018-3834-6-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Xourafas, Dimitrios</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2018</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Society for Surgery of the Alimentary Tract 2018</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Open</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Laparoscopic</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Robotic pancreatoduodenectomy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">ACS NSQIP database</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Predictors</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Operative time</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Hospital length of stay</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Pawlik, Timothy M.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Cloyd, Jordan M.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">Journal of gastrointestinal surgery</subfield><subfield code="d">New York, NY : Springer, 1997</subfield><subfield code="g">22(2018), 11 vom: 25. Juni, Seite 1911-1919</subfield><subfield code="w">(DE-627)334375053</subfield><subfield code="w">(DE-600)2057634-1</subfield><subfield code="x">1873-4626</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:22</subfield><subfield code="g">year:2018</subfield><subfield code="g">number:11</subfield><subfield code="g">day:25</subfield><subfield code="g">month:06</subfield><subfield code="g">pages:1911-1919</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://dx.doi.org/10.1007/s11605-018-3834-6</subfield><subfield code="z">lizenzpflichtig</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_SPRINGER</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SSG-OLC-PHA</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_11</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_20</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_22</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_23</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_24</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_31</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_32</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_39</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_40</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_60</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_62</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_63</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_65</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_69</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_70</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_73</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_74</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_90</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_95</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_100</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_101</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_105</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_110</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_120</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_138</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_150</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_151</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_161</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_165</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_170</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_171</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_187</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_213</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_224</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_230</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_250</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_281</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_285</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_293</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_370</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_602</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_636</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_702</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2001</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2003</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2004</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2005</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2006</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2007</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2008</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2009</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2010</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2011</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2014</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2015</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2020</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2021</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2025</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2026</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2027</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2031</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2034</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2037</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2038</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2039</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2044</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2048</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2049</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2050</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2055</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2057</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2059</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2061</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2064</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2065</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2068</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2070</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2086</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2088</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2093</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2106</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2107</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2108</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2110</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2111</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2112</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2113</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2116</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2118</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2119</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2122</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2129</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2143</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2144</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2147</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2148</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2152</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2153</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2188</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2190</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2232</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2336</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2446</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2470</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2472</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2507</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2522</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4012</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4035</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4037</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4046</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4112</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4125</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4126</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4242</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4246</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4249</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4251</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4305</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4306</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4307</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4313</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4322</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4323</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4324</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4325</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4326</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4333</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4334</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4335</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4336</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4338</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4393</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4700</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">22</subfield><subfield code="j">2018</subfield><subfield code="e">11</subfield><subfield code="b">25</subfield><subfield code="c">06</subfield><subfield code="h">1911-1919</subfield></datafield></record></collection>
|
| author |
Xourafas, Dimitrios |
| spellingShingle |
Xourafas, Dimitrios misc Open misc Laparoscopic misc Robotic pancreatoduodenectomy misc ACS NSQIP database misc Predictors misc Operative time misc Hospital length of stay Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy |
| authorStr |
Xourafas, Dimitrios |
| ppnlink_with_tag_str_mv |
@@773@@(DE-627)334375053 |
| format |
electronic Article |
| delete_txt_mv |
keep |
| author_role |
aut aut aut |
| collection |
springer |
| remote_str |
true |
| illustrated |
Not Illustrated |
| issn |
1873-4626 |
| topic_title |
Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy Open (dpeaa)DE-He213 Laparoscopic (dpeaa)DE-He213 Robotic pancreatoduodenectomy (dpeaa)DE-He213 ACS NSQIP database (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Operative time (dpeaa)DE-He213 Hospital length of stay (dpeaa)DE-He213 |
| topic |
misc Open misc Laparoscopic misc Robotic pancreatoduodenectomy misc ACS NSQIP database misc Predictors misc Operative time misc Hospital length of stay |
| topic_unstemmed |
misc Open misc Laparoscopic misc Robotic pancreatoduodenectomy misc ACS NSQIP database misc Predictors misc Operative time misc Hospital length of stay |
| topic_browse |
misc Open misc Laparoscopic misc Robotic pancreatoduodenectomy misc ACS NSQIP database misc Predictors misc Operative time misc Hospital length of stay |
| format_facet |
Elektronische Aufsätze Aufsätze Elektronische Ressource |
| format_main_str_mv |
Text Zeitschrift/Artikel |
| carriertype_str_mv |
cr |
| hierarchy_parent_title |
Journal of gastrointestinal surgery |
| hierarchy_parent_id |
334375053 |
| hierarchy_top_title |
Journal of gastrointestinal surgery |
| isfreeaccess_txt |
false |
| familylinks_str_mv |
(DE-627)334375053 (DE-600)2057634-1 |
| title |
Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy |
| ctrlnum |
(DE-627)SPR021078904 (SPR)s11605-018-3834-6-e |
| title_full |
Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy |
| author_sort |
Xourafas, Dimitrios |
| journal |
Journal of gastrointestinal surgery |
| journalStr |
Journal of gastrointestinal surgery |
| lang_code |
eng |
| isOA_bool |
false |
| recordtype |
marc |
| publishDateSort |
2018 |
| contenttype_str_mv |
txt |
| container_start_page |
1911 |
| author_browse |
Xourafas, Dimitrios Pawlik, Timothy M. Cloyd, Jordan M. |
| container_volume |
22 |
| format_se |
Elektronische Aufsätze |
| author-letter |
Xourafas, Dimitrios |
| doi_str_mv |
10.1007/s11605-018-3834-6 |
| title_sort |
independent predictors of increased operative time and hospital length of stay are consistent across different surgical approaches to pancreatoduodenectomy |
| title_auth |
Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy |
| abstract |
Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources. © The Society for Surgery of the Alimentary Tract 2018 |
| abstractGer |
Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources. © The Society for Surgery of the Alimentary Tract 2018 |
| abstract_unstemmed |
Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources. © The Society for Surgery of the Alimentary Tract 2018 |
| collection_details |
GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 |
| container_issue |
11 |
| title_short |
Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy |
| url |
https://dx.doi.org/10.1007/s11605-018-3834-6 |
| remote_bool |
true |
| author2 |
Pawlik, Timothy M. Cloyd, Jordan M. |
| author2Str |
Pawlik, Timothy M. Cloyd, Jordan M. |
| ppnlink |
334375053 |
| mediatype_str_mv |
c |
| isOA_txt |
false |
| hochschulschrift_bool |
false |
| doi_str |
10.1007/s11605-018-3834-6 |
| up_date |
2024-07-03T20:14:10.555Z |
| _version_ |
1803590199472553984 |
| fullrecord_marcxml |
<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR021078904</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230520003605.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201006s2018 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s11605-018-3834-6</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR021078904</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s11605-018-3834-6-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Xourafas, Dimitrios</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2018</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Society for Surgery of the Alimentary Tract 2018</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background While minimally invasive approaches are increasingly being utilized for pancreatoduodenectomy (PD), factors associated with prolonged operative time (OpTime) and hospital length of stay (LOS) remain poorly defined, and it is unclear whether these factors are consistent across surgical approaches. Methods The ACS-NSQIP targeted pancreatectomy database from 2014 to 2016 was used to identify all patients who underwent open (OPD), laparoscopic (LPD), or robotic (RPD) pancreatoduodenectomy. Multivariable linear regression analyses were used to evaluate predictors of OpTime and LOS, as well as quantify the changes observed relative to each surgical approach. Results Among 10,970 patients, PD procedure types varied: 9963 (92%) open, 418 (4%) laparoscopic, and 409 (4%) robotic. LOS was longer for the open and laparoscopic approaches (11 vs. 11 vs. 10 days, P = 0.0068), whereas OpTime was shortest for OPD (366 vs. 426 vs. 435 min, P < 0.0001). Independent predictors of a prolonged OpTime were ASA class ≥ 3 (P = 0.0002), preoperative XRT (P < 0.0001), pancreatic duct < 3 mm (P = 0.0001), T stage ≥ 3 (P = 0.0108), and vascular resection (P < 0.0001) for OPD; T stage ≥ 3 (P = 0.0510) and vascular resection (P = 0.0062) for LPD; and malignancy (P = 0.0460) and conversion to laparotomy (P = 0.0001) for RPD. Independent predictors of increased LOS were age ≥ 65 years (P = 0.0002), ASA class ≥ 3 (P = 0.0012), hypoalbuminemia (P < 0.0001), and preoperative blood transfusion (P < 0.0001) for OPD as well as an OpTime > 370 min (all p < 0.05) and specific postoperative complications (all p < 0.05) for all surgical approaches. Conclusions Perioperative risk factors for prolonged OpTime and hospital LOS are relatively consistent across open, laparoscopic, and robotic approaches to PD. Particular attention to these factors may help identify opportunities to improve perioperative quality, enhance patient satisfaction, and ensure an efficient allocation of hospital resources.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Open</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Laparoscopic</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Robotic pancreatoduodenectomy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">ACS NSQIP database</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Predictors</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Operative time</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Hospital length of stay</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Pawlik, Timothy M.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Cloyd, Jordan M.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">Journal of gastrointestinal surgery</subfield><subfield code="d">New York, NY : Springer, 1997</subfield><subfield code="g">22(2018), 11 vom: 25. Juni, Seite 1911-1919</subfield><subfield code="w">(DE-627)334375053</subfield><subfield code="w">(DE-600)2057634-1</subfield><subfield code="x">1873-4626</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:22</subfield><subfield code="g">year:2018</subfield><subfield code="g">number:11</subfield><subfield code="g">day:25</subfield><subfield code="g">month:06</subfield><subfield code="g">pages:1911-1919</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://dx.doi.org/10.1007/s11605-018-3834-6</subfield><subfield code="z">lizenzpflichtig</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_SPRINGER</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SSG-OLC-PHA</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_11</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_20</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_22</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_23</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_24</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_31</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_32</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_39</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_40</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_60</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_62</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_63</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_65</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_69</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_70</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_73</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_74</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_90</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_95</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_100</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_101</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_105</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_110</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_120</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_138</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_150</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_151</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_161</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_165</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_170</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_171</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_187</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_213</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_224</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_230</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_250</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_281</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_285</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_293</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_370</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_602</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_636</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_702</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2001</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2003</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2004</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2005</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2006</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2007</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2008</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2009</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2010</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2011</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2014</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2015</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2020</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2021</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2025</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2026</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2027</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2031</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2034</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2037</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2038</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2039</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2044</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2048</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2049</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2050</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2055</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2057</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2059</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2061</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2064</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2065</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2068</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2070</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2086</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2088</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2093</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2106</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2107</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2108</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2110</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2111</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2112</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2113</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2116</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2118</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2119</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2122</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2129</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2143</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2144</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2147</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2148</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2152</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2153</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2188</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2190</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2232</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2336</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2446</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2470</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2472</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2507</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2522</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4012</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4035</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4037</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4046</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4112</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4125</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4126</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4242</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4246</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4249</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4251</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4305</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4306</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4307</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4313</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4322</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4323</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4324</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4325</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4326</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4333</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4334</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4335</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4336</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4338</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4393</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4700</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">22</subfield><subfield code="j">2018</subfield><subfield code="e">11</subfield><subfield code="b">25</subfield><subfield code="c">06</subfield><subfield code="h">1911-1919</subfield></datafield></record></collection>
|
| score |
7.400879 |