Short- and long-term outcomes of laparoscopic segmental left colectomy for splenic flexure colon cancer: comparison with propensity score matching

Abstract Background Complete mesocolic excision (CME) with central vascular ligation (CVL) for colon cancer is an essential procedure for improved oncologic outcomes after surgery. Laparoscopic surgery for splenic flexure colon cancer was recently adopted due to a greater understanding of surgical anatomy and improvements in surgical techniques and innovative surgical devices. Methods We retrospectively analyzed the data of patients with splenic flexure colon cancer who underwent laparoscopic CME with CVL at our institution between January 2005 and December 2017. Results Forty-five patients (4.8%) were enrolled in this study. Laparoscopic CME with CVL was successfully performed in all patients. The median operative time was 178 min, and the median estimated blood loss was 20 g. Perioperative complications developed in 6 patients (13.3%). The median postoperative hospital stay was 9 days. According to the pathological report, the median number of harvested lymph nodes was 15, and lymph node metastasis developed in 14 patients (31.1%). No metastasis was observed at the root of the middle colic artery or the inferior mesenteric artery. The median follow-up period was 49 months. The cumulative 5-year overall survival and disease-free survival rates were 85.9% and 84.7%, respectively. The cancer-specific survival rate in stage I-III patients was 92.7%. Recurrence was observed in 5 patients (11.1%), including three patients with peritoneal dissemination and two patients with distant metastasis. Conclusions Laparoscopic CME with CVL for splenic flexure colon cancer appears to be oncologically safe and feasible based on the short- and long-term outcomes in our study. However, it is careful to introduce this procedure to necessitate the anatomical understandings and surgeon’s skill. The appropriate indications must be established with more case registries because our experience is limited.

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The Short- and Long-Term Outcomes in Elderly Patients with Hepatocellular Carcinoma after Curative Surgery: A Case-Controlled Study with Propensity Score Matching

European Surgical Research ◽

10.1159/000494733 ◽

2018 ◽

Vol 59 (5-6) ◽

pp. 380-390 ◽

Cited By ~ 2

Author(s):

Yukiyasu Okamura ◽

Teiichi Sugiura ◽

Takaaki Ito ◽

Yusuke Yamamoto ◽

Ryo Ashida ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Propensity Score ◽

Elderly Patients ◽

Propensity Score Matching ◽

Survival Rates ◽

Long Term Outcomes ◽

Propensity Matching ◽

Short And Long Term ◽

Overall Survival Rates

Background: With aging populations increasing in developed countries, the prevalence of elderly patients with hepatocellular carcinoma (HCC) is expected to rise. The aim of this study was to determine the short- and long-term outcomes of HCC surgery in elderly patients (≥75 years) using propensity score matching. Methods: The study group included 421 patients who underwent hepatectomy as their initial treatment with curative intent. The patients were divided into elderly (n = 111) and non-elderly (n = 310) groups. We applied propensity score matching – taking into consideration patient background, blood examination, and tumor factors – to minimize the effect of potential confounders. We then compared the results before and after the propensity matching. Results: Before propensity matching, the elderly group included significantly more patients with a high American Society of Anesthesiologists physical status (p < 0.001). In addition, they were taking antihypertensive drugs or an anticoagulant (both p < 0.001). The severe postoperative complications and the overall survival rates for these elderly patients were significantly poorer than for the non-elderly patients (p = 0.015 and p = 0.030, respectively). We then chose 70 patients from each group for whom the preoperative confounding factors were balanced and compared the two groups. The factors identified before matching (severe complications and overall survival rates) were no longer relevant, i.e. there were no significant differences between the two groups. Conclusion: Hepatectomy for HCC in elderly patients is justified.

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Short- and Long-term Outcomes After Laparoscopic Versus Open Emergency Resection for Colon Cancer: An Observational Propensity Score-matched Study

World Journal of Surgery ◽

10.1007/s00268-013-2146-y ◽

2013 ◽

Vol 37 (10) ◽

pp. 2458-2467 ◽

Cited By ~ 27

Author(s):

Manfred Odermatt ◽

Danilo Miskovic ◽

Najaf Siddiqi ◽

Jim Khan ◽

Amjad Parvaiz

Keyword(s):

Colon Cancer ◽

Propensity Score ◽

Long Term Outcomes ◽

Short And Long Term ◽

Matched Study ◽

Emergency Resection

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Mo1748 – Short and Long-Term Outcomes of Patients with Colon Cancer of the Splenic Flexure: A Single Institution Experience

Gastroenterology ◽

10.1016/s0016-5085(19)40742-7 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-1469

Author(s):

Esteban Calderon ◽

Shreya Shetty ◽

Patrick T. Hangge ◽

Matthew Neville ◽

Scott Kelley ◽

...

Keyword(s):

Colon Cancer ◽

Splenic Flexure ◽

Long Term Outcomes ◽

Single Institution ◽

Short And Long Term

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Effect of surgical start time on short- and long-term outcomes after minimally invasive esophagectomy: a propensity-score matching analysis

Diseases of the Esophagus ◽

10.1093/dote/doaa108 ◽

2020 ◽

Author(s):

Tao Bao ◽

Xiao-Long Zhao ◽

Kun-Kun Li ◽

Ying-Jian Wang ◽

Wei Guo

Keyword(s):

Propensity Score ◽

Minimally Invasive ◽

Propensity Score Matching ◽

Survival Rates ◽

Disease Free Survival ◽

Long Term Outcomes ◽

Start Time ◽

Short And Long Term ◽

Mckeown Esophagectomy

Summary There is growing focus on the relationship between surgical start time and postoperative outcomes. However, the extent to which the operation start time affects the surgical and oncological outcomes of patients undergoing esophagectomy has not previously been studied. The purpose of this retrospective study was to investigate the potential effect of surgical start time on the short- and long-term outcomes for patients who underwent thoracoscopic–laparoscopic McKeown esophagectomy. From September 2009 to June 2019, a total of 700 consecutive patients suffering from esophageal cancer underwent thoracoscopic–laparoscopic McKeown esophagectomy in the Department of Thoracic Surgery at Daping Hospital. Among these patients, 166 esophagectomies were performed on the same day and were classified as the first- or second-start group. Patients in the first-start group were more likely to be older than those in the second-start group: (64.73 vs. 61.28, P = 0.002). In addition, patients with diabetes mellitus were more likely to be first-start cases (8.4 vs. 1.2%). After propensity score matching (52 matched patients in first-start cases and 52 matched patients in second-start cases), these findings were no longer statistically significant. There was no difference in the incidence rate of peri- or postoperative adverse events between the first- and second-start groups. The disease-specific survival rates and disease-free survival rates were comparable between the two groups (P = 0.236 and 0.292, respectively). On the basis of the present results, a later start time does not negatively affect the short- or long-term outcomes of patients undergoing minimally invasive McKeown esophagectomy.

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