Oncological Impact and Risk Factors of Anastomotic Leakage after Colorectal Surgery for Colorectal Cancer: A Propensity Score-Matching Analysis

Abstract Background Delayed post-polypectomy bleeding (PPB) is a major complication of polypectomy. The effect of prophylactic hemoclipping on delayed PPB is uncertain. The aim of this study was to evaluate the effectiveness of prophylactic hemoclipping and identify the risk factors of delayed PPB. Methods Patients with polyps sized 6 to 20 mm underwent snare polypectomy from 2015 to 2017 were retrospectively reviewed. The patients with prophylactic hemoclipping for delayed PPB prevention were included in the clipping group, and those without prophylactic hemoclipping were included in the non-clipping group. The incidence of delayed PPB and time to bleeding were compared between the groups. Multivariate analysis was used to identify the risk factors of delayed PPB. Propensity score matching was used to minimize potential bias. Results After propensity score matching, 612 patients with 806 polyps were in the clipping group, and 576 patients with 806 polyps were in the non-clipping group. There were no significant differences in the incidence of delayed PPB and days to bleeding between two groups (0.8% vs 1.3%, p = 0.4; 3.4 ± 1.94 days vs 4.13 ± 3.39 days, p = 0.94). In the multivariate analysis, the polyp size [Odds ratio (OR):1.16, 95% confidence interval (CI):1.01–1.16, p = 0.03), multiple polypectomies (OR: 4.64, 95% CI:1.24–17.44, p = 0.02) and a history of anticoagulant use (OR:37.52, 95% CI:6.49–216.8, p < 0.001) were associated with delayed PPB. Conclusions In polyps sized 6 to 20 mm, prophylactic hemoclip placement did not decrease the risk of delayed PPB. Patients without risk factors including multiple polypectomies and anticoagulant use are no need to performing prophylactic hemoclipping.

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Effects of a Diverting Stoma on Symptomatic Anastomotic Leakage after Low Anterior Resection for Rectal Cancer: A Propensity Score Matching Analysis of 1,014 Consecutive Patients

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2014.10.017 ◽

2015 ◽

Vol 220 (2) ◽

pp. 186-194 ◽

Cited By ~ 79

Author(s):

Akio Shiomi ◽

Masaaki Ito ◽

Kotaro Maeda ◽

Yusuke Kinugasa ◽

Mitsuyoshi Ota ◽

...

Keyword(s):

Rectal Cancer ◽

Propensity Score ◽

Anastomotic Leakage ◽

Propensity Score Matching ◽

Anterior Resection ◽

Low Anterior Resection ◽

Propensity Score Matching Analysis ◽

Diverting Stoma

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The Effect of Type 2 Diabetes Mellitus on the Short-Term Outcomes and Prognosis of Stage I–III Colorectal Cancer: A Propensity Score Matching Analysis

Cancer Management and Research ◽

10.2147/cmar.s347242 ◽

2022 ◽

Vol Volume 14 ◽

pp. 205-214

Author(s):

Yong Cheng ◽

Yu-Xi Cheng ◽

Xiao-Yu Liu ◽

Bing Kang ◽

Wei Tao ◽

...

Keyword(s):

Diabetes Mellitus ◽

Colorectal Cancer ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Propensity Score ◽

Propensity Score Matching ◽

Stage I ◽

Short Term ◽

Propensity Score Matching Analysis

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Efficacy of adjuvant chemotherapy after resection of pulmonary metastasis from colorectal cancer: A propensity score matching analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.788 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 788-788

Author(s):

Mamiko Imanishi ◽

Yoshiyuki Yamamoto ◽

Yukako Hamano ◽

Takeshi Yamada ◽

Toshikazu Moriwaki ◽

...

Keyword(s):

Colorectal Cancer ◽

Adjuvant Chemotherapy ◽

Propensity Score ◽

Propensity Score Matching ◽

Curative Resection ◽

Large Scale ◽

Disease Free Survival ◽

R0 Resection ◽

Propensity Score Matching Analysis ◽

Secondary Endpoints

788 Background: A number of retrospective studies reported that 5-year survival rate was 30-60% in patients who underwent curative resection of pulmonary metastases (PM) from colorectal cancer (CRC), and PM-CRC resection was recommended in clinical practice. Efficacy of adjuvant chemotherapy after resection of PM remains unclear. Therefore, using a large-scale data obtained from patients who underwent R0 resection of PM in Japan, we investigated it with a propensity score-matching analysis. Methods: We retrospectively collected clinical data of 1237 patients who underwent metastasectomy of PM-CRC at 46 Japanese institutions from 2004 to 2008. Excluding non-curative resection, preoperative chemotherapies, extra-thoratic metastases, complications after surgery, and inadequate data, 530 patients’ data (surgery alone 269 and surgery with adjuvant chemotherapy 261) were used for the matching. Patient backgrounds affecting doctor’s recommendation of adjuvant chemotherapy and including commonly reported prognostic factors were adjusted, using a propensity score-matching method. Primary and secondary endpoints were overall survival (OS) and disease-free survival (DFS), respectively. Results: After the matching with propensity-score, 167 patients for each group were selected. Patient backgrounds were balanced between both groups. Adjuvant chemotherapies were fluorouracil alone (67%), oxaliplatine-containing regimen (24%), irinotecan-containing regimen (7%) and others (2%). There were no significant differences between both groups in OS (HR 0.97, 95%CI 0.64-1.46, p = 0.88) and DFS (HR 0.99, 95%CI 0.75-1.32, p = 0.96). Conclusions: A propensity score-matching analysis did not show a survival benefit of adjuvant chemotherapy after resection of PM in patients with CRC. A large prospective observational study with high quality or randomized clinical trial is needed.

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The Outcome of Complex Hepato-Pancreato-Biliary Surgery for Elderly Patients: A Propensity Score Matching Analysis

Digestive Surgery ◽

10.1159/000489826 ◽

2018 ◽

Vol 36 (4) ◽

pp. 323-330 ◽

Cited By ~ 2

Author(s):

Kosei Takagi ◽

Yuzo Umeda ◽

Ryuichi Yoshida ◽

Daisuke Nobuoka ◽

Takashi Kuise ◽

...

Keyword(s):

Risk Factors ◽

Propensity Score ◽

Elderly Patients ◽

Propensity Score Matching ◽

Postoperative Morbidity ◽

Postoperative Mortality ◽

Elderly Group ◽

Postoperative Outcomes ◽

Mortality And Morbidity ◽

Propensity Score Matching Analysis

Background/Aims: Postoperative mortality and morbidity rates after hepato-pancreato-biliary (HPB) surgery remain high, and the number of elderly patients requiring such surgery has been increasing. This study aimed to investigate postoperative outcomes of complex HPB surgery for elderly patients. Methods: We retrospectively reviewed perioperative data of 721 patients who underwent complex HPB surgery between 2010 and 2015. The patients were divided into 2 groups: elderly (≥75 years) and non-elderly (< 75 years). Surgical outcomes of both groups were compared after propensity score-matching analysis. Subsequently, risk factors for serious postoperative morbidity were identified by multivariate analysis. Results: Before matching, the elderly group (n = 170) had more comorbidities, such as cardiovascular and renal disease, than the non-elderly group (n = 551). Matching yielded elderly (n = 170) and non-elderly groups (n = 170) with similar preoperative backgrounds. The mortality and morbidity rates did not differ significantly between the groups. In multivariate analyses, operative time (OR 1.79; p = 0.005) and blood loss (OR 1.66; p = 0.03) were identified as independent risk factors for serious postoperative morbidity, whereas older age did not have a predictive impact (OR 1.16; p = 0.52). Conclusions: Although elderly patients had more comorbidities and higher incidences of postoperative mortality and several complications before matching, their postoperative outcomes were equivalent to those of non-elderly patients after matching.

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