scholarly journals Laparoscopic Surgery vs. Open Surgery for Older Patients with Rectal Cancer: A Comparative Study of Propensity Score

2021 ◽  
Author(s):  
Qiang Li ◽  
Hong Gao ◽  
Jin-Zhong Wang ◽  
Yu-Bing Zhu
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Propensity Score ◽  
Blood Loss ◽  
Older Patients ◽  
Open Surgery ◽  
Postoperative Hospital Stay ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery

Abstract Background The purpose of this study was to compare the efficacy of laparoscopic surgery to open rectal cancer surgery in patients aged 70 years and older. Methods Consecutive patients (≥70 years old) who underwent rectal cancer surgery were retrospectively selected. Based on the covariates (age, gender, body mass index (BMI), ASA, TNM staging), the propensity score was calculated for paired comparison. The Tumor Distance from the Anal Verge (TDAV), history of abdominal surgery, combined diseases, time of operation, amount of blood loss, anastomosis method, postoperative hospital stay, time to first exhaust, time to first oral diet, postoperative complications, postoperative 30-day mortality and postoperative pathological staging of two groups were collected. Results Shorter operating time, higher intraoperative blood loss, slower intestinal function, longer time to first exhaust, longer postoperative hospital stay, higher incidence of postoperative complications (no statistical difference), and shorter duration of analgesics were observed in the OS group (all P<0.05). The sphincter preserving rate was basically the same in the two groups. For low rectal cancer with TDAV < 5 cm, more patients tended to choose LS (P=0.051); for middle rectal cancer with TDAV of 5-10 cm, more patients tended to choose OS (P=0.032). There was no significant difference in postoperative survival rate between the two groups. Conclusions In older patients, laparoscopic rectal cancer surgery led to less trauma, and a faster recovery compared to open surgery, with significant short-term advantages and no significant long-term advantages. For low rectal cancer, the advantage of LS was more prominent.

scholarly journals The efficacy of ileostomy after laparoscopic rectal cancer surgery: a meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yu Mu ◽  
Linxian Zhao ◽  
Hongyu He ◽  
Huimin Zhao ◽  
Jiannan Li
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Meta Analysis ◽  
Operation Time ◽  
Postoperative Hospital Stay ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Anastomotic Leakage Rate ◽  
Protective Ileostomy ◽  
Clinically Significant

Abstract Background Protective ileostomy is always applied to avoid clinically significant anastomotic leakage and other postoperative complications for patients receiving laparoscopic rectal cancer surgery. However, whether it is necessary to perform the ileostomy is still controversial. This meta-analysis aims to analyze the efficacy of ileostomy on laparoscopic rectal cancer surgery. Methods Cochrane Library, EMBASE, Web of Science, and PubMed were applied for systematic search of all relevant literature, updated to May 07, 2021. Studies compared patients with and without ileostomy for laparoscopic rectal cancer surgery. We applied Review Manager software to perform this meta-analysis. The quality of the non-randomized controlled trials was assessed using the Newcastle-Ottawa scale (NOS), and the randomized studies were assessed using the Jadad scale. Results We collected a total of 1203 references, and seven studies were included using the research methods. The clinically significant anastomotic leakage rate was significantly lower in ileostomy group (27/567, 4.76%) than that in non-ileostomy group (54/525, 10.29%) (RR = 0.47, 95% CI 0.30–0.73, P for overall effect = 0.0009, P for heterogeneity = 0.18, I2 = 32%). However, the postoperative hospital stay, reoperation, wound infection, and operation time showed no significant difference between the ileostomy and non-ileostomy groups. Conclusion The results demonstrated that protective ileostomy could decrease the clinically significant anastomotic leakage rate for patients undergoing laparoscopic rectal cancer surgery. However, ileostomy has no effect on postoperative hospital stay, reoperation, wound infection, and operation time. The efficacy of ileostomy after laparoscopic rectal cancer surgery: a meta-analysis.

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 Rectal cancer surgery in older people does not increase postoperative complications - a retrospective analysis

2014 ◽  
Vol 12 (1) ◽  
pp. 355 ◽  
Author(s):  
Jagdeep Singh ◽  
Anton Stift ◽  
Sarah Brus ◽  
Katharina Kosma ◽  
Martina Mittlböck ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Postoperative Complications ◽  
Older People ◽  
Retrospective Analysis ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery

scholarly journals Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery

2008 ◽  
Vol 14 (8) ◽  
pp. 1248 ◽  
Author(s):  
Varut Lohsiriwat ◽  
Darin Lohsiriwat ◽  
Wiroon Boonnuch ◽  
Vitoon Chinswangwatanakul ◽  
Thawatchai Akaraviputh ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Cancer Surgery ◽  
Major Risk Factor ◽  
Rectal Cancer Surgery

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.

Comparison of Clinical Efficacy and Complications Between Laparoscopic Versus Open Surgery for Low Rectal Cancer

2019 ◽  
Vol 22 (3) ◽  
pp. 179-186 ◽  
Author(s):  
Jian Dai ◽  
Zhou Yu
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Hospital Stay ◽  
Complication Rate ◽  
Open Surgery ◽  
Operation Time ◽  
Lower Rectal Cancer ◽  
Surgery Group ◽  
Stay Time

Aim: To compare the surgical outcomes of laparoscopic surgery for lower rectal cancer with open surgery. Methods: The multiple databases including PubMed, Springer, EMBASE, EMBASE, OVID were adopted to search for the relevant studies, and full-text articles involving the comparison of unilateral and bilateral PVP surgery were reviewed. Review Manager 5.0 was adopted to estimate the effects of the results among the selected articles. Forest plots, sensitivity analysis and bias analysis for the articles included were also conducted. Results: Finally, 1186 patients were included in the 10 studies, which eventually satisfied the eligibility criteria, and laparoscopic and open surgery group were 646 and 540, respectively. The meta-analysis suggested that there was no significant difference of the operation time between laparoscopic and open surgery group, while the time to solid intake, hospital stay time, blood loss and complication rate of laparoscopic group are much less than those of open surgery. Conclusion: Although both these two punctures provide similar operation time, we encourage the use of the laparoscopic surgery as the preferred surgical technique for treatment of lower rectal cancer due to less time to solid intake, hospital stay time, blood loss and lower complication rate.

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