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Laparoscopic versus open resections in the posterosuperior liver segments within an enhanced recovery programme (ORANGE Segments): study protocol for a multicentre randomised controlled trial

Laparoscopic versus open resections in the posterosuperior liver segments within an enhanced recovery programme (ORANGE Segments): study protocol for a multicentre randomised controlled trial
Laparoscopic versus open resections in the posterosuperior liver segments within an enhanced recovery programme (ORANGE Segments): study protocol for a multicentre randomised controlled trial
Abstract Background A shift towards parenchymal-sparing liver resections in open and laparoscopic surgery emerged in the last few years. Laparoscopic liver resection is technically feasible and safe, and consensus guidelines acknowledge the laparoscopic approach in the posterosuperior segments. Lesions situated in these segments are considered the most challenging for the laparoscopic approach. The aim of this trial is to compare the postoperative time to functional recovery, complications, oncological safety, quality of life, survival and costs after laparoscopic versus open parenchymal-sparing liver resections in the posterosuperior liver segments within an enhanced recovery setting. Methods The ORANGE Segments trial is an international multicentre randomised controlled superiority trial conducted in centres experienced in laparoscopic liver resection. Eligible patients for minor resections in the posterosuperior segments will be randomised in a 1:1 ratio to undergo laparoscopic or open resections in an enhanced recovery setting. Patients and ward personnel are blinded to the treatment allocation until postoperative day 4 using a large abdominal dressing. The primary endpoint is time to functional recovery. Secondary endpoints include intraoperative outcomes, length of stay, resection margin, postoperative complications, 90-day mortality, time to adjuvant chemotherapy initiation, quality of life and overall survival. Laparoscopic liver surgery of the posterosuperior segments is hypothesised to reduce time to functional recovery by 2 days in comparison with open surgery. With a power of 80% and alpha of 0.04 to adjust for interim analysis halfway the trial, a total of 250 patients are required to be randomised. Discussion The ORANGE Segments trial is the first multicentre international randomised controlled study to compare short- and long-term surgical and oncological outcomes of laparoscopic and open resections in the posterosuperior segments within an enhanced recovery programme. Trial registration ClinicalTrials.gov NCT03270917 . Registered on September 1, 2017. Before start of inclusion. Protocol version: version 12, May 9, 2017
figshare
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Aroori, Somaiah
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(2022) Laparoscopic versus open resections in the posterosuperior liver segments within an enhanced recovery programme (ORANGE Segments): study protocol for a multicentre randomised controlled trial. figshare doi:10.6084/m9.figshare.c.5886848 [Dataset]

Record type: Dataset

Abstract

Abstract Background A shift towards parenchymal-sparing liver resections in open and laparoscopic surgery emerged in the last few years. Laparoscopic liver resection is technically feasible and safe, and consensus guidelines acknowledge the laparoscopic approach in the posterosuperior segments. Lesions situated in these segments are considered the most challenging for the laparoscopic approach. The aim of this trial is to compare the postoperative time to functional recovery, complications, oncological safety, quality of life, survival and costs after laparoscopic versus open parenchymal-sparing liver resections in the posterosuperior liver segments within an enhanced recovery setting. Methods The ORANGE Segments trial is an international multicentre randomised controlled superiority trial conducted in centres experienced in laparoscopic liver resection. Eligible patients for minor resections in the posterosuperior segments will be randomised in a 1:1 ratio to undergo laparoscopic or open resections in an enhanced recovery setting. Patients and ward personnel are blinded to the treatment allocation until postoperative day 4 using a large abdominal dressing. The primary endpoint is time to functional recovery. Secondary endpoints include intraoperative outcomes, length of stay, resection margin, postoperative complications, 90-day mortality, time to adjuvant chemotherapy initiation, quality of life and overall survival. Laparoscopic liver surgery of the posterosuperior segments is hypothesised to reduce time to functional recovery by 2 days in comparison with open surgery. With a power of 80% and alpha of 0.04 to adjust for interim analysis halfway the trial, a total of 250 patients are required to be randomised. Discussion The ORANGE Segments trial is the first multicentre international randomised controlled study to compare short- and long-term surgical and oncological outcomes of laparoscopic and open resections in the posterosuperior segments within an enhanced recovery programme. Trial registration ClinicalTrials.gov NCT03270917 . Registered on September 1, 2017. Before start of inclusion. Protocol version: version 12, May 9, 2017

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Published date: 2022

Identifiers

Local EPrints ID: 477732
URI: http://eprints.soton.ac.uk/id/eprint/477732
PURE UUID: ff37b7d8-6778-4a31-b3ae-230592261a7b
ORCID for John N. Primrose: ORCID iD orcid.org/0000-0002-2069-7605

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Date deposited: 13 Jun 2023 17:24
Last modified: 24 Jan 2024 02:34

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Contributors

Contributor: Lloyd Brandts
Contributor: Gerard J. P. van Breukelen
Contributor: Somaiah Aroori
Contributor: Mikhail Efanov
Contributor: Bjørn Edwin
Contributor: Krishna V. Menon
Contributor: Marc G. H. Besselink
Contributor: Aali J. Sheen
Contributor: John N. Primrose ORCID iD
Contributor: Mohammed Abu Hilal
Contributor: Zina Eminton
Contributor: Jasper Sijberden
Contributor: Steven A. White
Contributor: Mathieu D’Hondt
Contributor: Rafael Díaz-Nieto
Contributor: Robert Sutcliffe
Contributor: Siân A. Pugh
Contributor: Christoph Kuemmerli
Contributor: Roberto I. Troisi
Contributor: Alma Moekotte
Contributor: Giuseppe M. Ettorre
Contributor: Ronald van Dam
Contributor: Luca A. Aldrighetti
Contributor: Zahir Soonawalla
Contributor: Robert S. Fichtinger

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