scholarly journals Impact of Previous Abdominal Surgery on Robotic-Assisted Rectal Surgery in Patients with Locally Advanced Rectal Adenocarcinoma: A Propensity Score Matching Study

2020 ◽  
Author(s):  
Ching-Wen Huang ◽  
Wei-Chih Su ◽  
Tsung-Kun Chang ◽  
Cheng-Jen Ma ◽  
Tzu-Chieh Yin ◽  
...  
Keyword(s):  
Propensity Score ◽  
Abdominal Surgery ◽  
Propensity Score Matching ◽  
Locally Advanced ◽  
Rectal Adenocarcinoma ◽  
Rectal Surgery ◽  
Perioperative Outcomes ◽  
Group Differences ◽  
Robotic Assisted ◽  
Previous Abdominal Surgery

Abstract Background: The application of minimally invasive surgery in patients with colorectal cancer (CRC) and a history of previous abdominal surgery (PAS) remains controversial. This retrospective study with propensity score matching (PSM) investigated the impact of PAS on robotic-assisted rectal surgery outcomes in patients with locally advanced rectal adenocarcinoma undergoing preoperative concurrent chemoradiotherapy (CCRT).Methods: In total, 203 patients with locally advanced rectal adenocarcinoma who underwent preoperative CCRT and robotic-assisted rectal surgery between May 2013 and December 2019 were enrolled. Patients were categorized into PAS and non-PAS groups based on the PAS history. The PSM caliper matching method with 1-to-3 match was used to match PAS patients with non-PAS.Results: Of the 203 enrolled patients, 35 were PAS patients 168 were non-PAS patients. After PSM, 32 PAS patients and 96 non-PAS patients were included for analysis. No significant between-group differences were noted in the perioperative outcomes, including median console time [165 min (PAS) vs 175 min (non-PAS), P = 0.4542)] and median operation time [275 min (PAS) vs 290 min (non-PAS), P = 0.5943)] after PSM. Postoperative recovery and overall complication rates were also similar (all P > 0.05). Moreover, the between-group differences in pathological or short-term oncological outcomes were also nonsignificant (all P > 0.05). No 30-day postoperative deaths were observed in either group.Conclusion: The current results indicate that robotic-assisted surgery is safe and feasible for PAS patients with locally advanced rectal adenocarcinoma undergoing preoperative CCRT. However, future prospective randomized clinical trials are required to verify these findings.

scholarly journals Impact of previous abdominal surgery on robotic-assisted rectal surgery in patients with locally advanced rectal adenocarcinoma: a propensity score matching study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ching-Wen Huang ◽  
Wei-Chih Su ◽  
Tsung-Kun Chang ◽  
Cheng-Jen Ma ◽  
Tzu-Chieh Yin ◽  
...  
Keyword(s):  
Propensity Score ◽  
Abdominal Surgery ◽  
Propensity Score Matching ◽  
Locally Advanced ◽  
Rectal Adenocarcinoma ◽  
Rectal Surgery ◽  
Perioperative Outcomes ◽  
Group Differences ◽  
Robotic Assisted ◽  
Previous Abdominal Surgery

Abstract Background The application of minimally invasive surgery in patients with colorectal cancer (CRC) and a history of previous abdominal surgery (PAS) remains controversial. This retrospective study with propensity score matching (PSM) investigated the impact of PAS on robotic-assisted rectal surgery outcomes in patients with locally advanced rectal adenocarcinoma undergoing preoperative concurrent chemoradiotherapy (CCRT). Methods In total, 203 patients with locally advanced rectal adenocarcinoma who underwent preoperative CCRT and robotic-assisted rectal surgery between May 2013 and December 2019 were enrolled. Patients were categorized into PAS and non-PAS groups based on the PAS history. The PSM caliper matching method with 1-to-3 matches was used to match PAS patients with non-PAS. Results Of the 203 enrolled patients, 35 were PAS patients and 168 were non-PAS patients. After PSM, 32 PAS patients and 96 non-PAS patients were included for analysis. No significant between-group differences were noted in the perioperative outcomes, including median console time (165 min (PAS) vs. 175 min (non-PAS), P = 0.4542) and median operation time (275 min (PAS) vs. 290 min (non-PAS), P = 0.5943) after PSM. Postoperative recovery and overall complication rates were also similar (all P > 0.05). Moreover, the between-group differences in pathological or short-term oncological outcomes were also nonsignificant (all P > 0.05). No 30-day postoperative deaths were observed in either group. Conclusion The current results indicate that robotic-assisted surgery is safe and feasible for PAS patients with locally advanced rectal adenocarcinoma undergoing preoperative CCRT. However, future prospective randomized clinical trials are required to verify these findings.

scholarly journals Impact of Previous Abdominal Surgery on Robotic-Assisted Rectal Surgery in Patients with Rectal Cancer Undergoing Preoperative Chemoradiotherapy: A Propensity Score Matching Study

2020 ◽  
Author(s):  
Ching-Wen Huang ◽  
Wei-Chih Su ◽  
Tsung-Kun Chang ◽  
Cheng-Jen Ma ◽  
Tzu-Chieh Yin ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Propensity Score ◽  
Abdominal Surgery ◽  
Propensity Score Matching ◽  
Rectal Surgery ◽  
Perioperative Outcomes ◽  
Group Differences ◽  
Complication Rates ◽  
Robotic Assisted ◽  
Previous Abdominal Surgery

Abstract Background: The application of minimally invasive surgery in patients with colorectal cancer (CRC) and a history of previous abdominal surgery (PAS) remains controversial. This retrospective study with propensity score matching (PSM) investigated the impact of PAS on robotic-assisted rectal surgery outcomes in patients with rectal cancer undergoing preoperative concurrent chemoradiotherapy (CCRT).Methods: In total, 203 patients with rectal cancer who underwent preoperative CCRT and robotic-assisted rectal surgery between May 2013 and December 2019 were enrolled. Patients were categorized into PAS and non-PAS groups based on the PAS history. The PSM caliper matching method with 1-to-3 match was used to match PAS patients with non-PAS.Results: Of the 203 enrolled patients, 35 were PAS patients 168 were non-PAS patients. After PSM, 32 PAS patients and 96 non-PAS patients were included for analysis. No significant between-group differences were noted in the perioperative outcomes, including median console time [165 min (PAS) vs 175 min (noon-PAS), P = 0.4542)] and median operation time [275 min (PAS) vs 290 min (non-PAS), P = 0.5943)] after PSM. Postoperative recovery and overall complication rates were also similar (all P > 0.05). Moreover, the between-group differences in pathological or short-term oncological outcomes were also nonsignificant (all P > 0.05). No 30-day postoperative deaths were observed in either group.Conclusion: The current results indicate that robotic-assisted surgery is safe and feasible for PAS patients with rectal cancer undergoing preoperative CCRT. However, future prospective randomized clinical trials are required to verify these findings.

scholarly journals Impact of Previous Abdominal Surgery on Robotic-assisted Rectal Surgery in Patients With Rectal Cancer Undergoing Preoperative Chemoradiotherapy: A Propensity Score Matching Study

2020 ◽  
Author(s):  
Ching-Wen Huang ◽  
Wei-Chih Su ◽  
Tsung-Kun Chang ◽  
Cheng-Jen Ma ◽  
Tzu-Chieh Yin ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Propensity Score ◽  
Abdominal Surgery ◽  
Propensity Score Matching ◽  
Rectal Surgery ◽  
Perioperative Outcomes ◽  
Group Differences ◽  
Complication Rates ◽  
Robotic Assisted ◽  
Previous Abdominal Surgery

Abstract Background: The application of minimally invasive surgery in patients with colorectal cancer (CRC) and a history of previous abdominal surgery (PAS) remains controversial. This retrospective study with propensity score matching (PSM) investigated the impact of PAS on robotic-assisted rectal surgery outcomes in patients with rectal cancer undergoing preoperative concurrent chemoradiotherapy (CCRT).Methods: In total, 203 patients with rectal cancer who underwent preoperative CCRT and robotic-assisted rectal surgery between May 2013 and December 2019 were enrolled. Patients were categorized into PAS and non-PAS groups based on the PAS history. The PSM caliper matching method with 1-to-3 match was used to match PAS patients with non-PAS.Results: Of the 203 enrolled patients, 35 were PAS patients 168 were non-PAS patients. After PSM, 32 PAS patients and 96 non-PAS patients were included for analysis. No significant between-group differences were noted in the perioperative outcomes, including median console time [165 min (PAS) vs 175 min (noon-PAS), P = 0.4542)] and median operation time [275 min (PAS) vs 290 min (non-PAS), P = 0.5943)] after PSM. Postoperative recovery and overall complication rates were also similar (all P > 0.05). Moreover, the between-group differences in pathological or short-term oncological outcomes were also nonsignificant (all P > 0.05). No 30-day postoperative deaths were observed in either group.Conclusion: The current results indicate that robotic-assisted surgery is safe and feasible for PAS patients with rectal cancer undergoing preoperative CCRT. However, future prospective randomized clinical trials are required to verify these findings.

scholarly journals Neoadjuvant Chemotherapy Versus Direct Surgery for Locally Advanced Gastric Cancer With Serosal Invasion (cT4NxM0): A Propensity Score-Matched Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Wei Xu ◽  
Lingquan Wang ◽  
Chao Yan ◽  
Changyu He ◽  
Sheng Lu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Advanced Gastric Cancer ◽  
Propensity Score Matching ◽  
Locally Advanced ◽  
Perioperative Outcomes ◽  
Serosal Invasion ◽  
D2 Gastrectomy ◽  
Locally Advanced Gastric Cancer

BackgroundFor locally advanced gastric cancer (LAGC) with serosal invasion (cT4NxM0), adjuvant chemotherapy (AC) after D2 gastrectomy is the standard therapy in Asia. However, perioperative chemotherapy (PCT) combined with D2 gastrectomy is mostly suggested in Europe and America. As a part of PCT, the value of neoadjuvant chemotherapy (NAC) is unclear. We investigated whether NAC could further improve survival and other outcomes for these patients.MethodsPatients with cT4NxM0 gastric cancer who underwent D2 gastrectomy were analyzed. The patients were divided into two groups based on whether they received NAC: the neoadjuvant chemotherapy (NAC) and direct surgery (S) groups. After propensity score matching (1:1 ratio), survival and perioperative outcomes were analyzed between the two groups.ResultsA total of 902 patients met all the eligibility criteria and were enrolled. After propensity score matching, 221 matched pairs of patients were identified. The median overall survival (OS) and disease-free survival (DFS) of all patients were 75.10 and 43.67 months, respectively. The median OS of patients in the NAC and S groups were undefined and 29.80 months, respectively (P<0.0001). The median DFS of patients in the NAC and S groups were undefined and 22.60 months (P<0.0001). There were no significant differences in the radical degrees of operation between the two groups (P=0.07). However, there were significant differences in postoperative hospital stay (P<0.001) and complications (P=0.037) between the two groups.ConclusionThis study suggested NAC can further improve prognosis and prevent recurrence in LAGC (cT4NxM0) patients. NAC is feasible and safe for LAGC (cT4NxM0) patients, and does not increase the risk of perioperative surgery.

Prognosis of anal canal adenocarcinoma versus lower rectal adenocarcinoma in Japan: a propensity score matching study

Surgery Today ◽  
2021 ◽  
Author(s):  
Yasumitsu Saiki ◽  
Kazutaka Yamada ◽  
Masafumi Tanaka ◽  
Mitsuko Fukunaga ◽  
Yasue Irei ◽  
...  
Keyword(s):  
Propensity Score ◽  
Anal Canal ◽  
Propensity Score Matching ◽  
Rectal Adenocarcinoma

scholarly journals The Effect of Neoadjuvant Therapies for Patients with Locally Advanced Gastric Cancer: A Propensity Score Matching Study

2021 ◽  
Vol 12 (2) ◽  
pp. 379-386
Author(s):  
Tongbo Wang ◽  
Yingtai Chen ◽  
Lulu Zhao ◽  
Hong Zhou ◽  
Chaorui Wu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Advanced Gastric Cancer ◽  
Propensity Score Matching ◽  
Locally Advanced ◽  
Locally Advanced Gastric Cancer

scholarly journals Evolution and trends in the adoption of laparoscopic liver resection in Singapore: Analysis of 300 cases

2021 ◽  
Vol 50 (10) ◽  
pp. 742-750
Author(s):  
Brian K Goh ◽  
Zhongkai Wang ◽  
Ye-Xin Koh ◽  
Kai-Inn Lim
Keyword(s):  
Liver Resection ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Laparoscopic Liver Resection ◽  
Conversion Rate ◽  
Perioperative Outcomes ◽  
Transfusion Rate ◽  
Open Conversion ◽  
Previous Abdominal Surgery ◽  
Surgeon Experience

ABSTRACT Introduction: The introduction of laparoscopic surgery has changed abdominal surgery. We evaluated the evolution and changing trends associated with adoption of laparoscopic liver resection (LLR) and the experience of a surgeon without prior LLR experience. Methods: A retrospective review of 310 patients who underwent LLR performed by a single surgeon from 2011 to 2020 was conducted. Exclusion criteria were patients who underwent laparoscopic liver surgeries such as excision biopsy, local ablation, drainage of abscesses and deroofing of liver cysts. There were 300 cases and the cohort was divided into 5 groups of 60 patients. Results: There were 288 patients who underwent a totally minimally invasive approach, including 28 robotic-assisted procedures. Open conversion occurred for 13 (4.3%) patients; the conversion rate decreased significantly from 10% in the initial period to 3.3% subsequently. There were 83 (27.7%) major resections and 131 (43.7%) resections were performed for tumours in the difficult posterosuperior location. There were 152 (50.7%) patients with previous abdominal surgery, including 52 (17.3%) repeat liver resections for recurrent tumours, and 60 patients had other concomitant operations. According to the Iwate criteria, 135 (44.7%) were graded as high/expert difficulty. Major morbidity (>grade 3a) occurred in 12 (4.0%) patients and there was no 30-day mortality. Comparison across the 5 patient groups demonstrated a significant trend towards older patients, higher American Society of Anesthesiologists (ASA) score, increasing frequency of LLR with previous abdominal surgery, increasing frequency of portal hypertension and huge tumours, decreasing blood loss and decreasing transfusion rate across the study period. Surgeon experience (≤60 cases) and Institut Mutualiste Montsouris (IMM) high grade resections were independent predictors of open conversion. Open conversion was associated with worse perioperative outcomes such as increased blood loss, transfusion rate, morbidity and length of stay. Conclusion: LLR can be safely adopted for resections of all difficulty grades, including major resections and for tumours located in the difficult posterosuperior segments, with a low open conversion rate. Keywords: Laparoscopic hepatectomy, laparoscopic liver resection, robotic hepatectomy, robotic liver resection, Singapore

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