scholarly journals Does the Endoscopic Surgical Skill Qualification System improve patients’ outcome following laparoscopic surgery for colon cancer? A multicentre, retrospective analysis with propensity score matching

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Keisuke Kazama ◽  
Masakatsu Numata ◽  
Toru Aoyama ◽  
Yosuke Atsumi ◽  
Hiroshi Tamagawa ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Operative Time ◽  
Operation Time ◽  
Surgical Skill ◽  
Rectosigmoid Cancer ◽  
Free Survival ◽  
Direct Operation

Abstract Background This study aimed to investigate the short-term and oncological impact of the Endoscopic Surgical Skill Qualification System (ESSQS) by the Japan Society for Endoscopic Surgery on the operator performing laparoscopic surgery for colon cancer. Methods This retrospective cohort study was based on medical records from a multicentre database. A total of 417 patients diagnosed with stage II/III colon and rectosigmoid cancer treated with curative resection were divided into two groups according to whether they were operated on by qualified surgeons (Q group, n=352) or not (NQ group, n=65). Through strict propensity score matching, 98 cases (49 in each group) were assessed. Results Operative time was significantly longer in the NQ group than in the Q group (199 vs. 168 min, p=0.029). The amount of blood loss, post-operative complications, and duration of hospitalisation were similar between both groups. No mortality was observed. One conversion case was seen in the NQ group. The 3-year recurrence-free survival rate was 86.6% in the NQ group and 88.2% in the Q group, which was not statistically significant (log-rank p=0.966). Conclusion Direct operation by ESSQS-qualified surgeons contributed to a shortened operation time. Under an organised educational environment, almost equivalent safety and oncological outcomes are expected regardless of the surgeon’s qualifications.

scholarly journals Does the Endoscopic Surgical Skill Qualification System improve patients’ outcome following laparoscopic surgery for colon cancer? A multicentre, retrospective analysis with propensity score matching.

2021 ◽  
Author(s):  
Keisuke Kazama ◽  
Masakatsu Numata ◽  
Toru Aoyama ◽  
Yosuke Atsumi ◽  
Hiroshi Tamagawa ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Operative Time ◽  
Operation Time ◽  
Surgical Skill ◽  
Rectosigmoid Cancer ◽  
Free Survival ◽  
Direct Operation

Abstract Purpose: This study aimed to investigate the short-term and oncological impact of the Endoscopic Surgical Skill Qualification System (ESSQS) by the Japan Society for Endoscopic Surgery on the operator performing laparoscopic surgery for colon cancer. Methods: This retrospective cohort study was based on medical records from a multicentre database. A total of 417 patients diagnosed with stage II/III colon and rectosigmoid cancer treated with curative resection were divided into two groups according to whether they were operated on by qualified surgeons (Q group, n=352) or not (NQ group, n=65). Through strict propensity score matching, 98 cases (49 in each group) were assessed. Results: Operative time was significantly longer in the NQ group than in the Q group (199 vs. 168 min, p=0.029). The amount of blood loss, postoperative complications, and duration of hospitalisation were similar between both groups. No mortality was observed. One conversion case was seen in the NQ group. The 3-year recurrence-free survival rate was 86.6% in the NQ group and 88.2% in the Q group, which was not statistically significant (log-rank p=0.966). Conclusion: Direct operation by ESSQS-qualified surgeons contributed to a shortened operation time. Under an organized educational environment, almost equivalent safety and oncological outcomes are expected regardless of the surgeon’s qualifications.

scholarly journals Does the Endoscopic Surgical Skill Qualification System improve patients’ outcome following laparoscopic surgery for colon cancer? A multicentre, retrospective analysis with propensity score matching.

2021 ◽  
Author(s):  
Keisuke Kazama ◽  
Masakatsu Numata ◽  
Toru Aoyama ◽  
Yosuke Atsumi ◽  
Hiroshi Tamagawa ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Operative Time ◽  
Operation Time ◽  
Surgical Skill ◽  
Rectosigmoid Cancer ◽  
Free Survival ◽  
Direct Operation

Abstract Background: This study aimed to investigate the short-term and oncological impact of the Endoscopic Surgical Skill Qualification System (ESSQS) by the Japan Society for Endoscopic Surgery on the operator performing laparoscopic surgery for colon cancer.Methods: This retrospective cohort study was based on medical records from a multicentre database. A total of 417 patients diagnosed with stage II/III colon and rectosigmoid cancer treated with curative resection were divided into two groups according to whether they were operated on by qualified surgeons (Q group, n=352) or not (NQ group, n=65). Through strict propensity score matching, 98 cases (49 in each group) were assessed.Results: Operative time was significantly longer in the NQ group than in the Q group (199 vs. 168 min, p=0.029). The amount of blood loss, post-operative complications, and duration of hospitalisation were similar between both groups. No mortality was observed. One conversion case was seen in the NQ group. The 3-year recurrence-free survival rate was 86.6% in the NQ group and 88.2% in the Q group, which was not statistically significant (log-rank p=0.966).Conclusion: Direct operation by ESSQS-qualified surgeons contributed to a shortened operation time. Under an organised educational environment, almost equivalent safety and oncological outcomes are expected regardless of the surgeon’s qualifications.

scholarly journals Does the Endoscopic Surgical Skill Qualification System Improve Patients’ Outcome Following Laparoscopic Surgery for Colon Cancer? A Multicentre, Retrospective Analysis with Propensity Score Matching.

2020 ◽  
Author(s):  
Keisuke Kazama ◽  
Masakatsu Numata ◽  
Toru Aoyama ◽  
Yosuke Atsumi ◽  
Hiroshi Tamagawa ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Operative Time ◽  
Operation Time ◽  
Surgical Skill ◽  
Rectosigmoid Cancer ◽  
Free Survival ◽  
Direct Operation

Abstract Background: This study aimed to investigate the short-term and oncological impact of the Endoscopic Surgical Skill Qualification System (ESSQS) by the Japan Society for Endoscopic Surgery on the operator performing laparoscopic surgery for colon cancer.Methods: This retrospective cohort study was based on medical records from a multicentre database. A total of 417 patients diagnosed with stage II/III colon and rectosigmoid cancer treated with curative resection were divided into two groups according to whether they were operated on by qualified surgeons (Q group, n=352) or not (NQ group, n=65). Through strict propensity score matching, 98 cases (49 in each group) were assessed.Results: Operative time was significantly longer in the NQ group than in the Q group (199 vs. 168 min, p=0.029). The amount of blood loss, post-operative complications, and duration of hospitalisation were similar between both groups. No mortality was observed. One conversion case was seen in the NQ group. The 3-year recurrence-free survival rate was 86.6% in the NQ group and 88.2% in the Q group, which was not statistically significant (log-rank p=0.966).Conclusion: Direct operation by ESSQS-qualified surgeons contributed to a shortened operation time. Under an organised educational environment, almost equivalent safety and oncological outcomes are expected regardless of the surgeon’s qualifications.

Laparoscopic versus open surgery for gastrointestinal stromal tumor in esophagogastric junction: A multi-center, retrospective cohort analysis with propensity score matching.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 11534-11534
Author(s):  
Wenjun Xiong ◽  
Tao Chen ◽  
Xingyu Feng ◽  
Yuting Xu ◽  
Jin Wan ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Propensity Score ◽  
Blood Loss ◽  
Gastrointestinal Stromal Tumor ◽  
Propensity Score Matching ◽  
Open Surgery ◽  
Esophagogastric Junction ◽  
Operative Time ◽  
Liquid Intake

11534 Background: Laparoscopic resection is increasingly performed for Gastrointestinal stromal tumor (GIST). Nevertheless, laparoscopic approach for the GIST located in the esophagogastric junction (EGJ-GIST) represent a surgical challenge. This study aims to investigate the efficacy of laparoscopic surgery and open procedure for EGJ-GIST through the propensity score matching (PSM) method. Methods: Between April 2006 and April 2018, 1824 patients underwent surgery were finally diagnosed with primary gastric GIST at four medical centers in South China. EGJ-GIST was defined as a GIST with an upper border of less than 5 cm from the EG line. Among them, 228 patients were identified and retrospectively reviewed with regard to clinicopathological characteristics, operative information and long-term outcomes. The PSM methods was used to eliminate the selection bias. Results: After PSM, 102 cases, consisted of 51 laparoscopic (LA) and 51 open surgery (OP), were enrolled. The match factors contained year of surgery, gender, age, BMI, tumor size, mitotic rate, recurrence risk and adjuvant tyrosine kinase inhibitors treatment. The LA group was superior to the OP group in operative time (108.5±56.5 vs. 169.3±79.0 min, P <0.001), blood loss (54.6±81.9 vs. 104.9±156.4 ml, P = 0.042), time to liquid intake (3.1±1.8 vs. 4.3±2.2 d, P = 0.003), hospital stay (6.0±2.3 vs. 9.9±8.1, P = 0.001), and postoperative complication (5.9% vs. 25.5%, P = 0.006). The median follow-up was 55 (range, 2-153) months in the entire cohort. No significant differences were detected in either the relapse-free survival (RFS, P = 0.109) or overall survival (OS, P = 0.113) between two groups. The 1-, 3-, and 5-year RFS in the LA and OP groups were 100.0%, 95.5%, 91.0% and 100.0%, 90.8%, 85.7%, respectively. The 1-, 3-, and 5-year OS in the LA and OP group were 100%, 95.6%, 91.3% and 100.0%, 91.1%, 85.4%, respectively. Conclusions: Laparoscopic surgery for EGJ-GIST is associated with the advantages of shorter operative time, reduced blood loss, shorter time to liquid intake and shorter length of stay, all without compromising post-operative outcomes and long-term survival.

scholarly journals Neutrophil-to-lymphocyte ratio has limited predictive value for determining outcomes in perforated colon cancer: a propensity score analysis.

2020 ◽  
Author(s):  
Chunyi Wu ◽  
Jy-Ming Chiang ◽  
Jeng-Fu You ◽  
Reiping Tang ◽  
Jinn-Shiun Chen ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Disease Free Survival ◽  
Neutrophil To Lymphocyte Ratio ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Disease Free ◽  
Perforated Colon

Abstract Background: The neutrophil-to-lymphocyte ratio is a significant prognostic marker in resectable colorectal cancer; however, there are no equivalent findings for perforated colon cancer. Using our colorectal cancer database, we retrospectively analyzed the data from 1995 to 2015 to determine whether the preoperative neutrophil-to-lymphocyte ratio is associated with survival outcomes in patients with perforated colon cancer.Methods: One-to-one propensity score matching was applied to minimize the difference between the high (>5) and low (≤5) neutrophil-to-lymphocyte ratio groups. Clinicopathological factors, long-term overall survival, and disease-free survival were analyzed and compared between the two groups. The primary outcomes were overall survival and disease-free survival.Results: Before propensity score matching, the high neutrophil-to-lymphocyte ratio group had a significantly higher prevalence of leukocytosis (low vs. high neutrophil-to-lymphocyte ratio groups: 12 [12.9%] vs. 46 [59.7%], p<0.001), lower serum albumin levels (low vs. high neutrophil-to-lymphocyte ratio groups: 30 [32.3%] vs. 42 [54.5%], p=0.003), and a higher emergent operation rate (low vs. high neutrophil-to-lymphocyte ratio groups: 5 [5.4%] vs. 20 [26.0%], p<0.001). After one-to-one propensity score matching, the groups comprised 41 patients each; none of the parameters were significantly different between the two groups. The mean follow-up period was 76.3 months. The 5-year overall survival (p=0.637) and disease-free survival (p=0.827) rates were not significantly different between the high and low neutrophil-to-lymphocyte ratio groups.Conclusions: The neutrophil-to-lymphocyte ratio has limited predictive value for determining outcomes in patients with perforated colon cancer.

scholarly journals Survival outcomes following laparoscopic vs open surgery for non-metastatic rectal cancer: a two-center cohort study with propensity score matching

2020 ◽  
Vol 8 (4) ◽  
pp. 319-325
Author(s):  
Kang-Lian Tan ◽  
Hai-Jun Deng ◽  
Zhi-Qiang Chen ◽  
Ting-Yu Mou ◽  
Hao Liu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Survival Rate ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Term Survival ◽  
Free Survival

Abstract Background:?&gt; Laparoscopic surgery for rectal cancer is commonly performed in China. However, compared with open surgery, the effectiveness of laparoscopic surgery, especially the long-term survival, has not been sufficiently proved. Methods:?&gt; Data of eligible patients with non-metastatic rectal cancer at Nanfang Hospital of Southern Medical University and Guangdong Provincial Hospital of Chinese Medicine between 2012 and 2014 were retrospectively reviewed. Long-term survival outcomes and short-term surgical safety were analysed with propensity score matching between groups. Results Of 430 cases collated from two institutes, 103 matched pairs were analysed after propensity score matching. The estimated blood loss during laparoscopic surgery was significantly less than that during open surgery (P = 0.019) and the operative time and hospital stay were shorter in the laparoscopic group (both P &lt; 0.001). The post-operative complications rate was 9.7% in the laparoscopic group and 10.7% in the open group (P = 0.818). No significant difference was observed between the laparoscopic group and the open group in the 5-year overall survival rate (75.7% vs 80.6%, P = 0.346), 5-year relapse-free survival rate (74.8% vs 76.7%, P = 0.527), or 5-year cancer-specific survival rate (79.6% vs 87.4%, P = 0.219). An elevated carcinoembryonic antigen, &lt;12 harvested lymph nodes, and perineural invasion were independent prognostic factors affecting overall survival and relapse-free survival. Conclusions:?&gt; Our findings suggest that open surgery should still be the priority recommendation, but laparoscopic surgery is also an acceptable treatment for non-metastatic rectal cancer.

scholarly journals Neutrophil-to-lymphocyte ratio has limited predictive value for determining outcomes in perforated colon cancer: a retrospective study.

2020 ◽  
Author(s):  
Chunyi Wu ◽  
Jy-Ming Chiang ◽  
Jeng-Fu You ◽  
Reiping Tang ◽  
Jinn-Shiun Chen ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Disease Free Survival ◽  
Neutrophil To Lymphocyte Ratio ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Disease Free ◽  
Perforated Colon

Abstract Background: The neutrophil-to-lymphocyte ratio is a significant prognostic marker in resectable colorectal cancer; however, there are no equivalent findings for perforated colon cancer. Using our colorectal cancer database, we retrospectively analyzed the data from 1995 to 2015 to determine whether the preoperative neutrophil-to-lymphocyte ratio is associated with survival outcomes in patients with perforated colon cancer.Methods: One-to-one propensity score matching was applied to minimize the difference between the high (>5) and low (≤5) neutrophil-to-lymphocyte ratio groups. Clinicopathological factors, long-term overall survival, and disease-free survival were analyzed and compared between the two groups. The primary outcomes were overall survival and disease-free survival.Results: Before propensity score matching, the high neutrophil-to-lymphocyte ratio group had a significantly higher prevalence of leukocytosis (low vs. high neutrophil-to-lymphocyte ratio groups: 12 [12.9%] vs. 46 [59.7%], p<0.001), lower serum albumin levels (low vs. high neutrophil-to-lymphocyte ratio groups: 30 [32.3%] vs. 42 [54.5%], p=0.003), and a higher emergent operation rate (low vs. high neutrophil-to-lymphocyte ratio groups: 5 [5.4%] vs. 20 [26.0%], p<0.001). After one-to-one propensity score matching, the groups comprised 41 patients each; none of the parameters were significantly different between the two groups. The mean follow-up period was 76.3 months. The 5-year overall survival (p=0.637) and disease-free survival (p=0.827) rates were not significantly different between the high and low neutrophil-to-lymphocyte ratio groups.Conclusions: The neutrophil-to-lymphocyte ratio has limited predictive value for determining outcomes in patients with perforated colon cancer.

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