Validation of textbook outcome model in assessing results of liver resection in patients with colorectal liver metastases

Aim. To validate the national model of the textbook outcome and modified textbook outcome when comparing shortterm outcomes of laparoscopic and open liver resections for colorectal liver metastases.

Material and Methods. A retrospective analysis was conducted on patients operated on between June 2017 and January 2020 in two specialized centers in Russia. Indicators of achieving the textbook outcome and modified textbook outcome, along with factors influencing their attainment were considered. The 75th percentile of the length of hospital stay was used as the modifier for the modified textbook outcome.

Results. Out of 171 cases who underwent surgery, 96 patients were treated in Center No. 1 and 75 in Center No. 2. A total of 85 open liver resections and 86 laparoscopic liver resections were performed. In Center No. 1, open and laparoscopic resections were performed in 47 (49%) and 49 (51%) patients, respectively; in Center No. 2, in 43 (57%) and 32 (43%) patients, respectively. The textbook outcome was achieved in 118 patients (69%), with 73 (76%) in Center No. 1 and 45 (60%) in Center No. 2 (p = 0.024).

Conclusions. The textbook outcome and modified textbook outcome models are suitable for clinical practice and can be used to compare liver resection results. Incorporating the 75th percentile of hospital stay into the modified textbook outcome reduces bias from non-clinical factors when evaluating treatment duration.

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