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

Objective Minimally invasive direct coronary artery bypass (MIDCAB) has been proposed as an attractive alternative to full sternotomy (FS) revascularization in isolated left anterior descending (LAD) artery disease not suitable for percutaneous coronary intervention. However, surgeons are still reluctant to perform MIDCAB owing to concerns about early and late outcomes. We aimed to compare short- and long-term outcomes after MIDCAB versus FS revascularization. Methods Prospectively collected data from institutional database were reviewed. Data for late mortality were obtained from the General Register Office. MIDCAB was performed in 318 patients, whereas 159 had FS, according to the surgeon's preference, among 477 patients with isolated LAD disease. Inverse propensity score weighting was used to estimate treatment effects on short- and long-term outcomes. Results In the propensity score-adjusted analysis, FS revascularization versus MIDCAB was associated increased rate of surgical site infection [4 (2.8%) versus 1 (0.7%); P = 0.04]. The 2 groups did not significantly differ with regard to other complications including operative mortality. Mean length of hospital stay was similar for the 2 groups. After a mean follow-up time of 6.2 years (interquartile range, 3.5–9.7 years), compared to MIDCAB, FS was not associated with an improved late survival (β coef, −1.42; standard error, 1.65; P = 0.39) or risk reduction for repeat revascularization (β coef, 1.22; standard error, 1.41; P = 0.15). Conclusions MIDCAB was associated with a trend toward better short-term outcomes and excellent long-term results comparable to FS revascularization. According to these findings, surgeons should not be reluctant to perform MIDCAB in isolated LAD disease.

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Short and long-term outcomes in patient cohort with gastric stump cancer: A propensity score analysis

Asian Journal of Surgery ◽

10.1016/j.asjsur.2021.03.018 ◽

2021 ◽

Author(s):

Povilas Kavaliauskas ◽

Audrius Dulskas ◽

Ramune Kavaliauskaite ◽

Sarunas Dailidenas ◽

Marius Petrulionis ◽

...

Keyword(s):

Propensity Score ◽

Propensity Score Analysis ◽

Gastric Stump ◽

Long Term Outcomes ◽

Gastric Stump Cancer ◽

Patient Cohort ◽

Score Analysis ◽

Short And Long Term

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

International Journal of Colorectal Disease ◽

10.1007/s00384-021-03841-w ◽

2021 ◽

Author(s):

Giovanni Maria Garbarino ◽

Giulia Canali ◽

Giulia Tarantino ◽

Gianluca Costa ◽

Mario Ferri ◽

...

Keyword(s):

Propensity Score ◽

Anal Verge ◽

Disease Free Survival ◽

Oral Intake ◽

High Volume ◽

Long Term Outcomes ◽

Surgical Specimen ◽

N Stage ◽

Short And Long Term

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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