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Unsorted and grouped surgeries. Unsorted surgeries: 1 ¼ right hemicolectomy, 2 ¼ extended right hemicolectomy, 3 ¼ extended left hemicolectomy, 4 ¼ left hemicolectomy, 5 ¼ sigmoidectomy, 6 ¼ anterior resection, 7 ¼ low anterior resection, 8 ¼ ultra-low anterior resection with coloanal anastomosis, 9 ¼ abdominoperineal resection. Sorted surgeries: 1 ¼ sigmoidectomy, 2 ¼ right hemicolectomy, extended right hemicolectomy, extended left hemicolectomy, left hemicolectomy and anterior resection, 3 ¼ low anterior resection, 4 ¼ ultra-low anterior resection with coloanal anastomosis and abdominoperineal resection.
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Objective
Laparoscopic surgery is an alternative procedure for colorectal cancers. However, high-level supporting evidence has been derived from high-volume centers in developed countries. During the early phase of applying the laparoscopic approach, we evaluated the procedure’s short-term outcomes in our regional middle-volume hospital in a develo...
Contexts in source publication
Context 1
... volume represented the bulkiness of the tumor and was calculated from three tumor diameters derived from the histological results. Because the type of operation varied widely, we decided to group and arrange the procedures into four orders of surgical difficulty. This decision was based on the operative time and theoretically compatible results. Fig. 1 shows the plots of the operative times according to each operation with its locally-weighted scatterplot smoothing (LOWESS) line. After grouping and sorting, the fittingline appeared to be better related to the linear correlation. The details of the sorted surgeries are shown in Fig. 1 and Table ...
Context 2
... on the operative time and theoretically compatible results. Fig. 1 shows the plots of the operative times according to each operation with its locally-weighted scatterplot smoothing (LOWESS) line. After grouping and sorting, the fittingline appeared to be better related to the linear correlation. The details of the sorted surgeries are shown in Fig. 1 and Table ...
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Background:
We assessed whether a postoperative bilateral, ultrasound-guided, posterior transversus abdominis plane (TAP) block could reduce 24 h rescue tramadol requirement compared with placebo in patients undergoing elective laparoscopic colorectal cancer surgery.
Methods:
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Citations
... Considering the QoL of patients, laparoscopic surgery (LS) is better for the patient, as a shorter recovery time is needed, and it causes less severe symptoms [16,22,[65][66][67][68][69][70]. Open surgery is more likely to require a stoma, which has a direct negative impact on patients' QoL [12]. ...
Introduction:
Quality of life is a topic increasingly being addressed by researchers. Due to the increasing incidence of colorectal cancer, this issue is particularly relevant. Despite the increasing number of publications on this topic each year, it still requires further research. The aim of this study was to analyze the available literature from the past 10 years, addressing the topic of QoL in patients with colorectal cancer which has been treated surgically.
Material and methods:
This review is based on 93 articles published between 2012 and 2022. It analyzes the impact of socioeconomic factors, the location and stage of the tumor, stoma and the method of surgical treatment on patients' QoL and sexual functioning.
Results:
CRC has a negative impact on patients' financial status, social functioning, pain and physical functioning. Patients with stage II or III cancer have an overall lower QoL than patients with stage I. The more proximally the lesion is located to the sphincters, the greater the negative impact on the QoL. There was a significant difference in favor of laparoscopic surgery compared with open surgery. In patients with a stoma, the QoL is lower compared with patients with preserved gastrointestinal tract continuity. The more time has passed since surgery, the more the presence of a stoma has a negative impact on QoL. Surgery for CRC negatively affects patients' sex lives, especially in younger people and among men.
Conclusions:
This study may contribute to the identification of the factors that affect the QoL of patients with surgically treated colorectal cancer. This will allow even more effective and complete treatment, facilitating patients' return to normal physical, mental and social functioning.
... Similar results were also reported in a recent case series study which showed that the laparoscopic group had more harvested mesenteric lymph nodes [5.0 nodes, 95% confidence interval [CI]: 1.8e8.1; p-value: <0.01] with comparable margin status [p-value: 0.66] [36] . However, in a Danish nationwide propensity score matched database study, laparoscopic resection was associated with a higher probability of good resection quality [defined as resection performed either in the mesocolic plane accompanied by R0 resection, or by a resection performed in the intramesocolic plane accompanied by R0 resection. ...
Background: Although widely performed the usefulness of Laparoscopic surgery for rectosigmoid and upper rectal cancer resection compared with open surgery has not been established sufficiently. The aim of this study was to compare the short-term, oncologic, outcomes of laparoscopic and open resection for recto-sigmoid and / or upper rectal cancer in the same time period.Patients and Methods: This prospective study included 50 patients with recto- sigmoid and upper rectal cancer diseases, admitted to Al Azhar New Damietta University hospital and Damietta cancer Institute surgery departments between December 2016 and December 2018. Patients were randomly divided into two groups: [Group 1: "25 patients"] subjected to laparoscopic interventions, and [Group 2: "25 patients]" subjected to open surgery. Data were collected and Short-term outcomes and long-term prognosis were analyzed.Results: The mean operative time was significantly increased in the LR group than OR group [LR 198.88± 18.7, OR 183.4± 20.5 minutes, p =0.01] as well as the hospital stay [LR 8.8± 2, OR 7.4± 2.9 days, p =0.013]. However, LR group was quicker to recover in term of mobilizing early, recovery of bowel function, and early toleration of diet and fluid and this difference was only statistically significant for oral fluid but not for diet [p= 0.078; 0.17 respectively]. There was no significant difference between both groups in tumor characteristics as locations, gross tumor morphology, staging, and distance to the distal margin. Also, both groups had comparable intraoperative and post-operative adverse events.Conclusion: Laparoscopic surgery for rectosigmoid cancer and rectal cancer offers numerous advantages beyond aesthetics aspects and is possible and safe with comparable oncological clearance to open surgery and might be considered an option of care when both approaches are suitable.
... The complications were similar between LR and OR in this study, except for less blood loss with LR, supported by the general principle of LR (4-8) and by a previous meta-analysis (53) and a cohort study (54). A recent study showed that LR and OR was safe both in elderly and non-elderly patients (55). ...
Background: The prognosis of middle-aged patients with CRC treated by laparoscopic resection (LR) is unclear. This study aimed to evaluate the survival outcomes of LR compared with open resection (OR) for patients with CRC and 45-65 years of age.
Methods: This retrospective cohort study used the data from a database of all consecutive colorectal resections performed between January 2009 and December 2017. Propensity score matching (PSM) was done to handle the selection bias based on age, gender, body mass index (BMI), tumor location, AJCC stage, and admission year. Univariate and multivariate COX regression model was used to identify risk factors of overall survival (OS) and progression-free survival (PFS).
Results: After PSM, 217 patients were included in each group. There were no differences in OS and PFS between the two groups (all P>0.05). There was less blood loss for LR (P<0.001), but the other complications were similar between the two groups. The multivariate analysis showed that high histological grade (hazard ratio [HR]=2.262, 95%CI: 1.334-3.836, P=0.002), stage III (HR=1.744, 95%CI: 2.360-25.406, P=0.001), stage IV (HR=47.905, 95%CI: 14.430-159.033, P<0.001), and adjuvant therapy (HR=0.547, 95%CI: 0.358-0.838, P=0.006) were independently associated with OS. High preoperative CEA (HR=1.585, 95%CI: 1.049-2.394, P=0.029), high histological grade (HR=2.128, 95%CI: 1.272-3.558, P=0.004), stage III (HR=5.562, 95%CI: 1.980-15.624, P=0.001), and stage IV (HR=26.338, 95%CI: 9.090-76.315, P<0.001), were independently associated with OS. LR was not associated with OS and PFS.
Conclusions: In middle-aged patients with CRC, OR and LR have similar survival outcomes and complications.
Background:
The prognosis of middle-aged patients with colorectal cancer (CRC) treated by laparoscopic resection (LR) is unclear. This study aimed to evaluate the survival outcomes of LR compared with open resection (OR) for middle-aged patients with CRC.
Patients and methods:
This retrospective cohort study used the data from a database of all consecutive colorectal resections performed between January 2009 and December 2017. Propensity score matching (PSM) was performed to handle the selection bias based on age, gender, body mass index, tumour location, AJCC stage and admission year. Univariate and multivariate COX regression model was used to identify risk factors of overall survival (OS) and disease-free survival (DFS).
Results:
After PSM, 154 patients were included in each group. Compared with the OR group in the total cohort, there were better survival outcomes in the LR group for 5-year OS and 5-year DFS (both P < 0.001). These differences were observed for Stage II and III diseases and for all CRC, irrespective of location. The multivariate analysis showed that tumour ≥5 cm (hazard ratio [HR] = 1.750, 95% confidence interval [CI]: 1.026-2.986, P = 0.040), Stage III (HR = 14.092, 95% CI: 1.894-104.848, P = 0.010) and LR (HR = 0.300, 95% CI: 0.160-0.560, P < 0.001) were independently associated with OS. Pre-operative carcinoembryonic antigen ≥5 ng/ml (HR = 3.954, 95% CI: 1.363-11.473, P = 0.011), Stage III (HR = 6.206, 95% CI: 1.470-26.200, P = 0.013) and LR (HR = 0.341, 95% CI: 0.178-0.653, P = 0.001) were independently associated with DFS.
Conclusions:
In middle-aged patients with CRC, LR achieves better survival than OR. Complications are similar, except for less blood loss and shorter post-surgical hospital stay with LR.
The study objective was to evaluate the impact of medical hospital volume on short-term colorectal cancer treatment results.
Materials and methods. The retrospective study included 93 patients with colorectal cancer operated on by one surgeon at two medical centers in Moscow from 2018 to 2020: 32 patients of the first group were operated in tertiary medical center (N.I. Pirogov National Medical and Surgical Center) and 61 of the second group – in regional low volume hospital (Centrosoyuz Hospital). The endpoints of the study were the short-term outcomes: surgery duration, blood loss, postoperative hospital stay, intra- and postoperative complications, lymph node harvested and the quality of specimen.
Results. Surgery duration as well as blood loss in two groups were similar (258 min vs 240 min, p = 0.47 and 100 ml and 100 ml, p = 0.89, accordingly). Hospital stay after surgery was significantly less in the first group (9 days vs 16 days, p <0.01). The frequency of postoperative complications of type I–II according to the Clavien–Dindo classification was higher in the first group (6/8 vs 1/8, p <0.05) but reoperations performed more in the second group due to III Clavien–Dindo complications (2/8 vs 7/8, p = 0.012). Grade 2–3 rectal cancer specimen quality was 94.7 % vs 77.8 %, p = 0.13 and harvested lymph nodes >12 was 71.9 % vs 78.7 %, p = 0.485 in first and second group, respectively.
Conclusion. Hospital volume does not affect rectal cancer specimen quality, surgery duration and blood loss, if the surgical interventions are performed by one experienced surgeon but associated with the incidence of postoperative complications and the length of stay.
