Laparoscopic versus open rectal resection: a 1:2 propensity score–matched analysis of oncological adequateness, short- and long-term outcomes

Abstract Background Laparoscopic resections for rectal cancer are routinely performed in high-volume centres. Despite short-term advantages have been demonstrated, the oncological outcomes are still debated. The aim of this study was to compare the oncological adequateness of the surgical specimen and the long-term outcomes between open (ORR) and laparoscopic (LRR) rectal resections. Methods Patients undergoing laparoscopic or open rectal resections from January 1, 2013, to December 31, 2019, were enrolled. A 1:2 propensity score matching was performed according to age, sex, BMI, ASA score, comorbidities, distance from the anal verge, and clinical T and N stage. Results Ninety-eight ORR were matched to 50 LRR. No differences were observed in terms of operative time (224.9 min. vs. 230.7; p = 0.567) and postoperative morbidity (18.6% vs. 20.8%; p = 0.744). LRR group had a significantly earlier soft oral intake (p < 0.001), first bowel movement (p < 0.001), and shorter hospital stay (p < 0.001). Oncological adequateness was achieved in 85 (86.7%) open and 44 (88.0%) laparoscopic resections (p = 0.772). Clearance of the distal (99.0% vs. 100%; p = 0.474) and radial margins (91.8 vs. 90.0%, p = 0.709), and mesorectal integrity (94.9% vs. 98.0%, p = 0.365) were comparable between groups. No differences in local recurrence (6.1% vs.4.0%, p = 0.589), 3-year overall survival (82.9% vs. 91.4%, p = 0.276), and disease-free survival (73.1% vs. 74.3%, p = 0.817) were observed. Conclusions LRR is associated with good postoperative results, safe oncological adequateness of the surgical specimen, and comparable survivals to open surgery.

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Effect of surgical start time on short- and long-term outcomes after minimally invasive esophagectomy: a propensity-score matching analysis

Diseases of the Esophagus ◽

10.1093/dote/doaa108 ◽

2020 ◽

Author(s):

Tao Bao ◽

Xiao-Long Zhao ◽

Kun-Kun Li ◽

Ying-Jian Wang ◽

Wei Guo

Keyword(s):

Propensity Score ◽

Minimally Invasive ◽

Propensity Score Matching ◽

Survival Rates ◽

Disease Free Survival ◽

Long Term Outcomes ◽

Start Time ◽

Short And Long Term ◽

Mckeown Esophagectomy

Summary There is growing focus on the relationship between surgical start time and postoperative outcomes. However, the extent to which the operation start time affects the surgical and oncological outcomes of patients undergoing esophagectomy has not previously been studied. The purpose of this retrospective study was to investigate the potential effect of surgical start time on the short- and long-term outcomes for patients who underwent thoracoscopic–laparoscopic McKeown esophagectomy. From September 2009 to June 2019, a total of 700 consecutive patients suffering from esophageal cancer underwent thoracoscopic–laparoscopic McKeown esophagectomy in the Department of Thoracic Surgery at Daping Hospital. Among these patients, 166 esophagectomies were performed on the same day and were classified as the first- or second-start group. Patients in the first-start group were more likely to be older than those in the second-start group: (64.73 vs. 61.28, P = 0.002). In addition, patients with diabetes mellitus were more likely to be first-start cases (8.4 vs. 1.2%). After propensity score matching (52 matched patients in first-start cases and 52 matched patients in second-start cases), these findings were no longer statistically significant. There was no difference in the incidence rate of peri- or postoperative adverse events between the first- and second-start groups. The disease-specific survival rates and disease-free survival rates were comparable between the two groups (P = 0.236 and 0.292, respectively). On the basis of the present results, a later start time does not negatively affect the short- or long-term outcomes of patients undergoing minimally invasive McKeown esophagectomy.

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Short- and Long-Term Outcomes of Robotic Surgery for Rectal Neuroendocrine Tumor

Surgical Innovation ◽

10.1177/15533506211030436 ◽

2021 ◽

pp. 155335062110304

Author(s):

Kentaro Saito ◽

Yusuke Yamaoka ◽

Akio Shiomi ◽

Hiroyasu Kagawa ◽

Hitoshi Hino ◽

...

Keyword(s):

Robotic Surgery ◽

Neuroendocrine Tumor ◽

Surgical Approach ◽

Anal Verge ◽

Survival Rates ◽

Long Term Outcomes ◽

Conversion To Open Surgery ◽

Short And Long Term ◽

Rectal Neuroendocrine Tumor

Background. The optimal radical surgical approach for rectal neuroendocrine tumor (NET) is unknown. Methods. This study evaluated the short- and long-term outcomes of 27 patients who underwent robotic radical surgery for rectal NET between 2011 and 2019. Results. The median distance from the lower border of the tumor to the anal verge was 5.0 cm. The median tumor size was 9.5 mm. Six patients (22%) had lymph node metastasis. The incidences of postoperative complications of grade II and grade III or more according to the Clavien–Dindo classification were 11% and 0%, respectively. All patients underwent sphincter-preserving surgery, and no patients required conversion to open surgery. The median follow-up time was 48.9 months, and both the 3-year overall survival and relapse-free survival rates were 100%. Conclusions. Short- and long-term outcomes of robotic surgery for rectal NET tumor were favorable. Robotic surgery may be a useful surgical approach for rectal NET.

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More Favorable Short and Long-Term Outcomes for Screen-Detected Colorectal Cancer Patients

Frontiers in Oncology ◽

10.3389/fonc.2021.620644 ◽

2021 ◽

Vol 11 ◽

Author(s):

Gaya Spolverato ◽

Giulia Capelli ◽

Jessica Battagello ◽

Andrea Barina ◽

Susi Nordio ◽

...

Keyword(s):

Colorectal Cancer ◽

Disease Free Survival ◽

Target Population ◽

Proximal Colon ◽

Long Term Outcomes ◽

Curative Intent ◽

Diagnostic Modality ◽

Screening Programs ◽

Short And Long Term

BackgroundScreening significantly reduces mortality from colorectal cancer (CRC). Screen detected (SD) tumors associate with better prognosis, even at later stage, compared to non-screen detected (NSD) tumors. We aimed to evaluate the association between diagnostic modality (SD vs. NSD) and short- and long-term outcomes of patients undergoing surgery for CRC.Materials and MethodsThis retrospective cohort study involved patients aged 50–69 years, residing in Veneto, Italy, who underwent curative-intent surgery for CRC between 2006 and 2018. The clinical multi-institutional dataset was linked with the screening dataset in order to define diagnostic modality (SD vs. NSD). Short- and long-term outcomes were compared between the two groups.ResultsOf 1,360 patients included, 464 were SD (34.1%) and 896 NSD (65.9%). Patients with a SD CRC were more likely to have less comorbidities (p = 0.013), lower ASA score (p = 0.001), tumors located in the proximal colon (p = 0.0018) and earlier stage at diagnosis (p < 0.0001). NSD patients were found to have more aggressive disease at diagnosis, higher complication rate and higher readmission rate due to surgical complications (all p < 0.05). NSD patients had a significantly lower Disease Free Survival and Overall Survival (all p < 0.0001), even after adjusting by demographic, clinic-pathological, tumor, and treatment characteristics.ConclusionsSD tumors were associated with better long-term outcomes, even after multiple adjustments. Our results confirm the advantages for the target population to participate in the screening programs and comply with their therapeutic pathways.

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Total pancreatectomy: short- and long-term outcomes at a high-volume pancreas center

HPB ◽

10.1016/j.hpb.2019.10.1485 ◽

2019 ◽

Vol 21 ◽

pp. S752

Author(s):

H. Zakaria ◽

J. Stauffer ◽

M. Raimondo ◽

T. Woodward ◽

M. Wallace ◽

...

Keyword(s):

Total Pancreatectomy ◽

High Volume ◽

Long Term Outcomes ◽

Short And Long Term

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Short- and Long-term Outcomes after Robotic and Laparoscopic Liver Resection for Malignancies: A Propensity Score-Matched Study

World Journal of Surgery ◽

10.1007/s00268-019-04927-x ◽

2019 ◽

Vol 43 (6) ◽

pp. 1594-1603 ◽

Cited By ~ 12

Author(s):

Chetana Lim ◽

Chady Salloum ◽

Antonella Tudisco ◽

Claudio Ricci ◽

Michael Osseis ◽

...

Keyword(s):

Liver Resection ◽

Propensity Score ◽

Laparoscopic Liver Resection ◽

Long Term Outcomes ◽

Short And Long Term ◽

Matched Study

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Impact of the second internal thoracic artery on short- and long-term outcomes in obese patients: A propensity score matched analysis

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2014.08.060 ◽

2015 ◽

Vol 149 (3) ◽

pp. 841-847.e2 ◽

Cited By ~ 23

Author(s):

Umberto Benedetto ◽

Alessandro Montecalvo ◽

Hassan Kattach ◽

Mohamed Amrani ◽

Shahzad G. Raja

Keyword(s):

Propensity Score ◽

Internal Thoracic Artery ◽

Obese Patients ◽

Long Term Outcomes ◽

Short And Long Term

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Propensity-score-matched analysis of short- and long-term outcomes in patients with an ileocolic artery crossing anterior vs posterior to the superior mesenteric vein during curative resection for right-sided colon cancer

Surgical Endoscopy ◽

10.1007/s00464-019-07333-5 ◽

2020 ◽

Vol 34 (12) ◽

pp. 5384-5392 ◽

Cited By ~ 3

Author(s):

Yasuhiro Ishiyama ◽

Chiyo Maeda ◽

Syoji Shimada ◽

Shin-ei Kudo

Keyword(s):

Colon Cancer ◽

Propensity Score ◽

Curative Resection ◽

Superior Mesenteric Vein ◽

Long Term Outcomes ◽

Mesenteric Vein ◽

Ileocolic Artery ◽

Short And Long Term

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195 – Comparison of Short- and Long-Term Outcomes Between Anatomical Subtypes of Resected Biliary Tract Cancer in a Western High-Volume Center

Gastroenterology ◽

10.1016/s0016-5085(19)40495-2 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-1386

Author(s):

Eva Roos ◽

Marin Strijker ◽

Lotte C. Franken ◽

Olivier R. Busch ◽

Jeanin E. Van Hooft ◽

...

Keyword(s):

Biliary Tract ◽

Biliary Tract Cancer ◽

High Volume ◽

Long Term Outcomes ◽

Tract Cancer ◽

High Volume Center ◽

Short And Long Term

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Comparison of short- and long-term outcomes between anatomical subtypes of resected biliary tract cancer in a Western high-volume center

HPB ◽

10.1016/j.hpb.2019.07.011 ◽

2020 ◽

Vol 22 (3) ◽

pp. 405-414 ◽

Cited By ~ 2

Author(s):

Eva Roos ◽

Marin Strijker ◽

Lotte C. Franken ◽

Olivier R. Busch ◽

Jeanin E. van Hooft ◽

...

Keyword(s):

Biliary Tract ◽

Biliary Tract Cancer ◽

High Volume ◽

Long Term Outcomes ◽

Tract Cancer ◽

High Volume Center ◽

Short And Long Term

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Comparison of short- and long-term outcomes between 3-field and modern 2-field lymph node dissections for thoracic oesophageal squamous cell carcinoma: a propensity score matching analysis

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz108 ◽

2019 ◽

Vol 29 (3) ◽

pp. 434-441 ◽

Cited By ~ 1

Author(s):

Ningbo Fan ◽

Han Yang ◽

Jiabo Zheng ◽

Dongni Chen ◽

Weidong Wang ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Disease Free Survival ◽

Oesophageal Squamous Cell Carcinoma ◽

Long Term Outcomes ◽

Free Survival ◽

Short And Long Term ◽

Disease Free

Abstract OBJECTIVES Our goal was to compare short- and long-term outcomes between 3-field lymphadenectomy (3-FL) and modern 2-field lymphadenectomy (2-FL) in patients with thoracic oesophageal squamous cell carcinoma. METHODS We reviewed clinical outcomes for 298 patients with thoracic oesophageal squamous cell carcinoma who underwent 3-FL or modern 2-FL from March 2008 to December 2013 at a major cancer hospital in Guangzhou, southern China. Propensity score matching was used to balance baseline differences, and 83 pairs of cases were selected. Postoperative complications, recurrence patterns and survival outcomes were compared between the 2 groups. RESULTS Compared with modern 2-FL, 3-FL led to higher overall operative morbidity rates [78.3% vs 61.4%, odds ratio (OR) 2.266, 95% confidence interval (CI) 1.143–4.490; P = 0.019], with higher recurrent nerve palsy rates (47.0% vs 19.3%, OR 3.712, 95% CI 1.852–7.438; P < 0.0001), more respiratory failures (18.1% vs 6.0%, OR 3.441, 95% CI 1.189–9.963; P = 0.023) and longer postoperative hospital stays (23 vs 17 days, P = 0.002). The 5-year overall survival rate (58.5% vs 59.4%; P = 0.960) and the 5-year disease-free survival rate 50.1% vs 54.5%; P = 0.482) were comparable between the 2 groups. Multivariable analysis showed that additional cervical lymph node dissection was not associated with overall survival [hazard ratio (HR) 1.039, 95% CI 0.637–1.696; P = 0.878] and disease-free survival (HR 0.868, 95% CI 0.548–1.376; P = 0.547). The overall recurrence rate and cervical nodal recurrence rate were not significantly different between the 2 groups. CONCLUSIONS Additional cervical lymphadenectomy did not lead to added survival benefit when compared with modern 2-FL in patients with thoracic oesophageal squamous cell carcinoma. Recurrence was similar in patients undergoing 3-FL and modern 2-FL. 3-FL resulted in more postoperative complications.

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