The Risk Factors for Perioperative Serum Albumin Variation in Pediatric Patients Undergoing Major Gastroenterology Surgery

Background: The albumin, a negative acute-phase protein, is important for perioperative morbidity, even in patients with normal preoperative levels. This study intend to determine the perioperative factors related with the postoperative reduction in serum albumin (ΔALB) and its influence on perioperative outcome in a pediatric general surgical cohort.Methods: This single-center retrospective review included 939 pediatric patients who underwent major gastroenterology surgery from August 2010 to August 2019. The patients were dichotomized into a high ΔALB group (≥14.6%) and a low ΔALB group (<14.6%) based on the mean value of ΔALB (14.6%). the independent risk factors for ΔALB, were explored using the propensity score matching to minimize potential selection bias and subjected to method multivariable logistic regression model. Furthermore, in 366 matched patients, the influences of operating time on perioperative outcomes were analyzed.Results: Among the 996 patients reviewed, 939 patient records were enrolled in the final analysis. Controlling for other factors, multivariable analysis showed that a high CRP on POD 3 or 4 [odds ratio (OR) = 2.36 (95% CI, 1.51–3.86); p = 0.007], a longer operating time [OR = 1.18 (95% CI, 1.00–1.53); p = 0.014), and the presence of Charcot's triad [OR = 1.73 (95% CI, 1.05–2.83); p = 0.031] were factors that predicted a high ΔALB level. A high ΔALB level was also related with gastrointestinal functional recovery delay, reflected by the postoperative defecation (p = 0.013) and bowel movement (p = 0.019) delay and the high occurrence of postoperative complications (16.1 vs. 10.9%, OR, 1.57; 95% CI, 1.02–2.41, P = 0.0026).Conclusions: The high ΔALB level was correlated with postoperative outcome. To obtain a safe recovery and discharge after a major abdominal operation, the above risk factors for ΔALB could be addressed in the perioperative period.

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Factors affecting perioperative serum albumin variation and short term complications in pediatric patients undergoing major gastroenterology surgery

10.21203/rs.2.24434/v2 ◽

2020 ◽

Author(s):

Qingshuang Liu ◽

Kai Gao ◽

Xiaomin Sun ◽

Chunbao Guo

Keyword(s):

Risk Factors ◽

Serum Albumin ◽

Pediatric Population ◽

Operating Time ◽

Length Of Hospital Stay ◽

Postoperative Recovery ◽

Perioperative Outcomes ◽

Perioperative Morbidity ◽

Charcot’S Triad ◽

The Mean

Abstract Background: Albumin is considered a negative acute-phase protein because its concentration decreases during injury and sepsis. The decrease in serum albumin might be important for perioperative morbidity, even in patients with normal preoperative levels in pediatric population. We here intend to determine the perioperative factors associated with the reduction in serum albumin within 2 postoperative days compared with the preoperative level (∆ALB) and its influence on the perioperative outcome in a pediatric general surgical cohort. Methods: This single-center retrospective review included 939 patients who underwent Roux-en-Y hepaticojejunostomy between August 2010 and Aug 2019. Based on the mean valure of ∆ALB (14.6%), patients were separated into two groups, including a high ∆ALB group (≥14.6%) and a low ∆ALB group (<14.6%). Multivariable logistic regression analyses were performed to determine the independent risk factors for the reduction in serum albumin. Propensity score matching was performed to adjust for any potential selection bios for the two groups. In 366 matched patients, influences of operating time on perioperative outcomes, including postoperative recovery, complications measurement, and length of hospital stay between the two groups were analyzed. Results: For all 996 patients reviewed, 939 patient records were enrolled into the final analysis. Controlling for other factors, multivariate analysis showed that the high CRP on POD 3 or 4 (odds ratio[OR] =2.36 [95% CI, 1.51-3.86]; p =0.007), presence of Charcot's triad (OR=1.73[95% CI, 1.05-2.83]; p = 0.031), the longer operating time (OR=1.18[95% CI, 1.00 -1.53]; p=0.014) were factors that predicted the high ∆ALB level. The high ∆ALB level was associated with postoperative gastrointestinal functional recovery, reflected by the first defecation (p= 0.013) and first bowel movement (p=0.019) and the high occurrence of postoperative complications (16.1% vs 10.9%, OR, 1.57; 95 %CI, 1.02-2.41, P=0.0026). The mean length of postoperative stay was longer than that of patients with ∆ALB < 14.0% group, although no statistic significant was stained (p=0.057). Conclusions: We showed that change in albumins was associated with postoperative outcomes. The risk factors for ∆ALB could be intervened in the perioperative period to permit patients gain a safe recovery and discharge after major abdominal operations.

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Factors affecting perioperative ∆ALB and short term complications in pediatric patients undergoing major gastroenterology surgery

10.21203/rs.2.24434/v1 ◽

2020 ◽

Author(s):

Kai Gao ◽

Qingshuang Liu ◽

chunbao guo

Keyword(s):

Risk Factors ◽

Serum Albumin ◽

Pediatric Population ◽

Operating Time ◽

Length Of Hospital Stay ◽

Final Analysis ◽

Postoperative Recovery ◽

Perioperative Outcomes ◽

Perioperative Morbidity ◽

Charcot’S Triad

Abstract Background: Albumin is considered a negative acute-phase protein because its concentration decreases during injury and sepsis. The decrease in serum albumin might be important for perioperative morbidity, even in patients with normal preoperative levels in pediatric population. We here intend to determine the perioperative factors associated with the reduction in serum albumin within 2 postoperative days compared with the preoperative level (∆ALB) and its influence on the perioperative outcome in a pediatric general surgical cohort. Methods: This single-center retrospective review included 939 patients who underwent Roux-en-Y hepaticojejunostomy between August 2010 and Aug 2019. Based on the median ∆ALB (14.6%), patients were separated into two groups, including a high ∆ALB group (≥14.6%) and a low ∆ALB group (<14.6%). Multivariable logistic regression analyses were performed to determine the independent risk factors for the reduction in serum albumin. Propensity score matching was performed to adjust for any potential selection bios for the two groups. In 366 matched patients, influences of operating time on perioperative outcomes, including postoperative recovery, complications measurement, length of hospital stay between the two groups were analyzed. Results: For all 996 patients reviewed, 939 patient records were enrolled into the final analysis. Controlling for other factors, multivariate analysis showed that the high CRP on POD 3 or 4 (OR =2.36 [95% CI, 1.51-3.86]; p =0.007), presence of Charcot's triad (OR=1.73[95% CI, 1.05-2.83]; p = 0.031), the longer operating time (OR=1.18[95% CI, 1.00 -1.53]; p=0.014) were factors that predicted the high ∆ALB level. The high ∆ALB level was associated with postoperative gastrointestinal functional recovery, reflected by the first defecation (p= 0.013) and first bowel movement (p=0.019) and the high occurrence of postoperative complications (16.1% vs 10.9%, RR, 1.57; 95 %CI, 1.02-2.41, P=0.0026). The mean length of postoperative stay was longer than that of patients with ∆ALB < 14.0% group, although no statistic significant was stained (p=0.057). Conclusions: We showed that change in albumins was associated with postoperative outcomes. The risk factors for ∆ALB could be intervened in the perioperative period to permit patients gain a safe recovery and discharge after major abdominal operations

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Factors affecting perioperative serum albumin variation and short-term complications in pediatric patients undergoing major gastroenterology surgery

10.21203/rs.2.24434/v3 ◽

2020 ◽

Author(s):

Qingshuang Liu ◽

Kai Gao ◽

Xiaomin Sun ◽

chunbao guo

Keyword(s):

Risk Factors ◽

Serum Albumin ◽

Pediatric Population ◽

Operating Time ◽

Multivariable Analysis ◽

Postoperative Recovery ◽

Perioperative Outcomes ◽

Charcot’S Triad ◽

Significant Difference ◽

The Mean

Abstract Background: Albumin is considered a negative acute-phase protein because its concentration decreases during injury and sepsis. The decrease in serum albumin may be important for perioperative morbidity, even in patients with normal preoperative levels in the pediatric population. Here, we intend to determine the perioperative factors associated with the reduction in serum albumin within 2 postoperative days compared with the preoperative level (∆ALB) and its influence on perioperative outcome in a pediatric general surgical cohort.Methods: This single-center retrospective review included 939 patients who underwent Roux-en-Y hepaticojejunostomy between August 2010 and August 2019. Based on the mean value of ∆ALB (14.6%), patients were separated into two groups, a high ∆ALB group (≥14.6%) and a low ∆ALB group (<14.6%). Multivariable logistic regression analyses were performed to determine the independent risk factors for a reduction in serum albumin. Propensity score matching was performed to adjust for any potential selection bias for the two groups. In 366 matched patients, the influences of operating time on perioperative outcomes, including postoperative recovery, complications measurement, and length of hospital stay between the two groups were analyzed.Results: Among the 996 patients reviewed, 939 patient records were enrolled in the final analysis. Controlling for other factors, multivariable analysis showed that a high CRP on POD 3 or 4 (odds ratio [OR] =2.36 [95% CI, 1.51-3.86]; p =0.007), the presence of Charcot's triad (OR=1.73 [95% CI, 1.05-2.83]; p = 0.031), and a longer operating time (OR=1.18 [95% CI, 1.00 -1.53]; p=0.014) were factors that predicted a high ∆ALB level. A high ∆ALB level was associated with postoperative gastrointestinal functional recovery, reflected by the first defecation (p= 0.013) and first bowel movement (p=0.019) and the high occurrence of postoperative complications (16.1% vs 10.9%, OR, 1.57; 95% CI, 1.02-2.41, P=0.0026). The mean length of postoperative stay of patients in the high ∆ALB group was longer than that of patients in the ∆ALB < 14.0% group, although no statistically significant difference was observed (p=0.057). Conclusions: We showed that a change in albumin level was associated with postoperative outcome. The risk factors for ∆ALB could be addressed in the perioperative period to permit patients to obtain a safe recovery and discharge after a major abdominal operation.

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The risk factors related to operative duration and its relationship with clinical outcome in pediatric patients undergone Roux-en-Y hepaticojejunostomy

10.21203/rs.3.rs-19847/v1 ◽

2020 ◽

Author(s):

Ang Li ◽

Kai Gao ◽

Qingshuang Liu ◽

Jingyu Chen ◽

Chunbao Guo

Keyword(s):

Risk Factors ◽

Clinical Outcome ◽

Hospital Stay ◽

Pediatric Patients ◽

Operating Time ◽

Postoperative Recovery ◽

Perioperative Outcomes ◽

Operative Duration ◽

Long Time ◽

Short Time

Abstract Background: The operative duration might be important for perioperative morbidity and the involvement has not been fully characterized in pediatric patients. We here determined the perioperative variables in association with operative duration and its influence on the clinical outcome in the pediatric patients.Methods: We retrospectively reviewed 701 patients who underwent elective choledochal cysts followed by Roux-en-Y hepaticojejunostomy between August 2010 and Aug 2019. Based on the median operating time (165 min), patients were separated into two groups, including a long-time group (>165 min) and a short-time group (<165 min). The independent risk factors for the operative time were determined usng the multivariable logistic regression analyses. To adjust for any potential selection bios, propensity score matching was performed for the long-time and short-time groups. In the 192 matched patients, perioperative outcomes, including postoperative recovery, complications measurement, and length of hospital stay were analyzed.Results: The operating time was often increased by excision difficulty caused by the lager choledochal cyst size (OR=1.56; 95% CI, 1.09-2.23; p<0.001), the greater BMI(OR=1.02; 95% CI, 1.00-1.15; p=0.018), older age (OR=1.17; 95% CI, 1.02-1.39; p=0.012) under multivariate analysis. The long-time surgical duration was associated with delay for gastrointestinal functional recovery, measured with the first defecation (p=0.027) and first bowel movement (p=0.019). Moreover, a significant decrease in serum albumin were presented in the long-time group compared with the short time group (p=0.0035). The total length of postoperative hospital stay was longer in patients with long-time group (7.51±2.03 days) than patients with short-time group (6.72±1.54 days, p = 0.006).Conclusions: Our data demonstrated that short operating time was associated with favorable postoperative results. The influencing factors for operating time could be ameliorated in the perioperative period to gain a better outcome after major abdominal operations.

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Risk factors for unplanned removal of central venous catheters in hospitalized children with hematological and oncological disorders

10.22541/au.160645869.93914774/v1 ◽

2020 ◽

Author(s):

Moe Miyagishima ◽

Hamada Motoharu ◽

Yuji Hirayama ◽

Hideki Muramatsu ◽

Takahisa Tainaka ◽

...

Keyword(s):

Risk Factors ◽

Cumulative Incidence ◽

Pediatric Patients ◽

Cohort Analysis ◽

Multivariable Analysis ◽

Central Line ◽

Central Venous Catheters ◽

Central Venous ◽

Subdistribution Hazard ◽

Significant Difference

Background: Central venous catheters (CVCs) have been essential devices for the treatment of children with hematological and oncological disorders. Only few studies investigated the complications and selections of different types of CVCs in these pediatric patients. This study aimed to compare risk factors for unplanned removal of two commonly used CVCs, i.e., peripherally inserted central catheters (PICCs) and tunneled CVCs, and propose better device selection for the patient. Procedure: This retrospective, single center cohort analysis was conducted on pediatric patients with hematological and oncological disorders inserted with either a PICC or a tunneled CVC. Results: Between January 1, 2013, and December 31, 2015, 89 patients inserted with tunneled CVCs (total 21,395 catheter-days) and 84 with PICCs (total 9,177 catheter-days) were followed up until the catheter removal. The median duration of catheterization was 88 days in PICCs and 186 days in tunneled CVCs (p = 1.24×10-9). PICCs at the 3-month cumulative incidence of catheter occlusion (5.2% vs. 0%, p = 4.08×10-3) and total unplanned removal (29.0% vs 7.0%, p = 0.0316) were significantly higher, whereas no significant difference was observed in the cumulative incidence of central line-associated bloodstream infection (11.8% vs. 2.3%, p = 0.664). Multivariable analysis identified younger age (<2 years) (subdistribution hazard ratio [SHR], 2.29; 95% confidence interval [CI], 1.27–4.14) and PICCs (SHR, 2.73; 95% CI, 1.48–5.02) were independent risk factors for unplanned removal. Conclusion: Our results suggest that tunnel CVCs would be a preferred device for children with hematological and oncological disorders requiring long-term, intensive treatment.

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Predicting Persistent Opioid Use, Abuse, and Toxicity Among Cancer Survivors

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djz200 ◽

2019 ◽

Vol 112 (7) ◽

pp. 720-727 ◽

Cited By ~ 6

Author(s):

Lucas K Vitzthum ◽

Paul Riviere ◽

Paige Sheridan ◽

Vinit Nalawade ◽

Rishi Deka ◽

...

Keyword(s):

Risk Factors ◽

At Risk ◽

Cancer Survivors ◽

Critical Role ◽

Multivariable Analysis ◽

Area Under The Curve ◽

Opioid Abuse ◽

Opioid Use ◽

Multivariable Logistic Regression Model ◽

Patients At Risk

Abstract Background Although opioids play a critical role in the management of cancer pain, the ongoing opioid epidemic has raised concerns regarding their persistent use and abuse. We lack data-driven tools in oncology to understand the risk of adverse opioid-related outcomes. This project seeks to identify clinical risk factors and create a risk score to help identify patients at risk of persistent opioid use and abuse. Methods Within a cohort of 106 732 military veteran cancer survivors diagnosed between 2000 and 2015, we determined rates of persistent posttreatment opioid use, diagnoses of opioid abuse or dependence, and admissions for opioid toxicity. A multivariable logistic regression model was used to identify patient, cancer, and treatment risk factors associated with adverse opioid-related outcomes. Predictive risk models were developed and validated using a least absolute shrinkage and selection operator regression technique. Results The rate of persistent opioid use in cancer survivors was 8.3% (95% CI = 8.1% to 8.4%); the rate of opioid abuse or dependence was 2.9% (95% CI = 2.8% to 3.0%); and the rate of opioid-related admissions was 2.1% (95% CI = 2.0% to 2.2%). On multivariable analysis, several patient, demographic, and cancer and treatment factors were associated with risk of persistent opioid use. Predictive models showed a high level of discrimination when identifying individuals at risk of adverse opioid-related outcomes including persistent opioid use (area under the curve [AUC] = 0.85), future diagnoses of opioid abuse or dependence (AUC = 0.87), and admission for opioid abuse or toxicity (AUC = 0.78). Conclusion This study demonstrates the potential to predict adverse opioid-related outcomes among cancer survivors. With further validation, personalized risk-stratification approaches could guide management when prescribing opioids in cancer patients.

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Clinical characteristics and COVID-19 outcomes in a regional cohort of pediatric patients with rheumatic diseases

10.1101/2021.05.19.21257450 ◽

2021 ◽

Author(s):

Daniel Clemente ◽

Clara Udaondo ◽

Jaime de Inocencio ◽

Juan Carlos Nieto ◽

Pilar Galan del Rio ◽

...

Keyword(s):

Risk Factors ◽

Hospital Admission ◽

Rheumatic Diseases ◽

Pediatric Patients ◽

Musculoskeletal Diseases ◽

Severe Disease ◽

Tertiary Hospital ◽

Multivariable Logistic Regression Model ◽

Symptomatic Disease ◽

Moderate Disease

Background: This study aimed to assess the baseline characteristics and clinical outcomes of coronavirus disease 2019 (COVID-19) in pediatric patients with rheumatic and musculoskeletal diseases (RMD) and identify the risk factors associated with symptomatic or severe disease defined as hospital admission, intensive care admission or death. Methods: An observational longitudinal study was conducted during the first year of pandemic SARS-CoV-2 (1st March 2020 to 1st March 2021). All pediatric patients attended at the rheumatology outpatient clinic of six tertiary hospital in Madrid, Spain, with a medical diagnosis of RMD and COVID-19 were included. Main outcomes were symptomatic disease and hospital admission. The covariates were sociodemographic, clinical, and treatments. We ran a multivariable logistic regression model to assess risk factors for outcomes. Results: The study population included 77 pediatric patients. Mean age was 11.88 (4.04) years Of these, 30 patients were asymptomatic, 41 had a mild or moderate disease and other 6 patients (7.79%) required hospital admission related to COVID-19. The median length of stay was 5 (2-20) days and there was no death. Previous comorbidities increased the risk for symptomatic disease and hospital admission. Compared with outpatients, the factor independently associated with hospital admission was the use of glucocorticoids (OR 1.08; p=0.00). No statistically significant findings for symptomatic COVID-19 were found in the final model. Conclusion: Our data found no differences in COVID-19 outcomes between children-onset rheumatic diseases. Our results suggest that associated comorbidities and being in treatment with glucocorticoids increase the risk of hospital admission.

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Clinical characteristics and COVID-19 outcomes in a regional cohort of pediatric patients with rheumatic diseases

Pediatric Rheumatology ◽

10.1186/s12969-021-00648-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Daniel Clemente ◽

Clara Udaondo ◽

Jaime de Inocencio ◽

Juan Carlos Nieto ◽

Pilar Galán del Río ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Hospital Admission ◽

Clinical Characteristics ◽

Pediatric Patients ◽

Musculoskeletal Diseases ◽

Severe Disease ◽

Significant Risk ◽

Multivariable Logistic Regression Model ◽

Symptomatic Disease

Abstract Background This study aimed to assess the baseline characteristics and clinical outcomes of coronavirus disease 2019 (COVID-19) in pediatric patients with rheumatic and musculoskeletal diseases (RMD) and identify the risk factors associated with symptomatic or severe disease defined as hospital admission, intensive care admission or death. Methods An observational longitudinal study was conducted during the first year of the SARS-CoV-2 pandemic (March 2020–March 2021). All pediatric patients attended at the rheumatology outpatient clinics of six tertiary referral hospitals in Madrid, Spain, with a diagnosis of RMD and COVID-19 were included. Main outcomes were symptomatic disease and hospital admission. The covariates were sociodemographic and clinical characteristics and treatment regimens. We ran a multivariable logistic regression model to assess associated factors for outcomes. Results The study population included 77 pediatric patients. Mean age was 11.88 (4.04) years Of these, 30 patients (38.96%) were asymptomatic, 41 (53.25%) had a mild-moderate COVID-19 and 6 patients (7.79%) required hospital admission. The median length of hospital admission was 5 (2–20) days, one patient required intensive care and there were no deaths. Previous comorbidities increased the risk for symptomatic disease and hospital admission. Compared with outpatients, the factor independently associated with hospital admission was previous use of glucocorticoids (OR 3.51; p = 0.00). No statistically significant risk factors for symptomatic COVID-19 were found in the final model. Conclusion No differences in COVID-19 outcomes according to childhood-onset rheumatic disease types were found. Results suggest that associated comorbidities and treatment with glucocorticoids increase the risk of hospital admission.

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Risk factors for unplanned removal of central venous catheters in hospitalized children with hematological and oncological disorders

10.21203/rs.3.rs-269055/v1 ◽

2021 ◽

Author(s):

Moe Miyagishima ◽

Motoharu Hamada ◽

Yuji Hirayama ◽

Hideki Muramatsu ◽

Takahisa Tainaka ◽

...

Keyword(s):

Risk Factors ◽

Cumulative Incidence ◽

Pediatric Patients ◽

Cohort Analysis ◽

Multivariable Analysis ◽

Central Line ◽

Central Venous Catheters ◽

Central Venous ◽

Subdistribution Hazard ◽

Significant Difference

Abstract ObjectiveCentral venous catheters (CVCs) have been essential devices for the treatment of children with hematological and oncological disorders. Only few studies investigated the complications and selections of different types of CVCs in these pediatric patients. This study aimed to compare risk factors for unplanned removal of two commonly used CVCs, i.e., peripherally inserted central catheters (PICCs) and tunneled CVCs, and propose better device selection for the patient.MethodsThis retrospective, single center cohort analysis was conducted on pediatric patients with hematological and oncological disorders inserted with either a PICC or a tunneled CVC.ResultsBetween January 1, 2013, and December 31, 2015, 89 patients inserted with tunneled CVCs (total 21,395 catheter-days) and 84 with PICCs (total 9,177 catheter-days) were followed up until the catheter removal. The median duration of catheterization was 88 days in PICCs and 186 days in tunneled CVCs (p = 1.24×10-9). PICCs at the 3-month cumulative incidence of catheter occlusion (5.2% vs. 0%, p = 4.08×10-3) and total unplanned removal (29.0% vs 7.0%, p = 0.0316) were significantly higher, whereas no significant difference was observed in the cumulative incidence of central line-associated bloodstream infection (11.8% vs. 2.3%, p = 0.664). Multivariable analysis identified younger age (<2 years) (subdistribution hazard ratio [SHR], 2.29; 95% confidence interval [CI], 1.27–4.14) and PICCs (SHR, 2.73; 95% CI, 1.48–5.02) were independent risk factors for unplanned removal.ConclusionOur results suggest that tunnel CVCs would be a preferred device for children with hematological and oncological disorders requiring long-term, intensive treatment.

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Risk Factors Related to Operative Duration and Their Relationship With Clinical Outcomes in Pediatric Patients Undergoing Roux-en-Y Hepaticojejunostomy

Frontiers in Pediatrics ◽

10.3389/fped.2020.590420 ◽

2020 ◽

Vol 8 ◽

Author(s):

Yongjun Zhou ◽

Yunfei Zhang ◽

Hongjie Guo ◽

Chao Zheng ◽

Chunbao Guo

Keyword(s):

Risk Factors ◽

Clinical Outcomes ◽

Pediatric Patients ◽

Operative Time ◽

Short Operative Time ◽

Perioperative Morbidity ◽

Operative Duration ◽

Independent Risk Factors ◽

Surgical Duration ◽

Median Operative Time

Background: Operative duration might be important for perioperative morbidity, and its involvement has not been fully characterized in pediatric patients. We identified perioperative variables associated with operative duration and determined their influence on clinical outcomes in pediatric patients.Methods: We retrospectively reviewed 701 patients who underwent elective removal of choledochal cysts followed by Roux-en-Y hepaticojejunostomy. The patients were separated into the long operative time group (>165 min) and short operative time group (<165 min) based on the median operative time (165 min). Propensity score matching was performed to adjust for any potential selection bias. The independent risk factors for operative time were determined using multivariable logistic regression analyses.Results: The operative time was often increased by excision difficulty caused by a larger choledochal cyst size (OR = 1.56; 95% CI, 1.09–2.23; p < 0.001), a greater BMI (OR = 1.02; 95% CI, 1.00–1.15; p = 0.018), and older age (OR = 1.17; 95% CI, 1.02–1.39; p = 0.012) in the multivariate analysis. A long surgical duration was associated with delayed gastrointestinal functional recovery, as measured using the time to first defecation (p = 0.027) and first bowel movement (p = 0.019). Significantly lower levels of serum albumin were found in the long operative time group than in the short operative time group (p = 0.0035). The total length of postoperative hospital stay was longer in patients in the long operative time group (7.51 ± 2.03 days) than in those in the short operative time group (6.72 ± 1.54 days, p = 0.006).Conclusions: Our data demonstrated that a short operative time was associated with favorable postoperative results. The influencing factors of operative time should be ameliorated to achieve better outcomes.

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