Laparoscopic vs. open surgery for rectal cancer in patients with obesity: short-term outcomes and relapse-free survival across age groups.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-01-01 Epub Date: 2024-08-05 DOI:10.1007/s00595-024-02901-2

Yusuke Fujita, Koya Hida, Nobuaki Hoshino, Tomonori Akagi, Kentaro Nakajima, Masafumi Inomata, Seiichiro Yamamoto, Yoshiharu Sakai, Takeshi Naitoh, Kazutaka Obama

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Abstract

Purpose: To investigate the efficacy of laparoscopic surgery for rectal cancer in obese and older patients, who are often characterized by a higher prevalence of comorbidities and physical decline.

Methods: This large-scale multicenter retrospective cohort study included 524 patients with a body mass index of 25 or higher who underwent either open or laparoscopic surgery for stage II or III rectal cancer between 2009 and 2013. We assessed the short-term outcomes and relapse-free survival by comparing these surgical modalities. The patients were stratified into 404 non-elderly (< 70 years) and 120 elderly (≥ 70 years) patients.

Results: In both patient groups, laparoscopic surgery was associated with a significantly reduced blood loss (non-elderly: 41 vs. 545 ml; elderly: 50 vs. 445 ml) and shorter hospital stays (non-elderly: 10 vs. 19 days; elderly: 15 vs. 20 days) than open surgery. The overall complications and relapse-free survival showed no significant differences between the two surgical techniques in either age group. Additionally, the impact of the laparoscopic procedure on the relapse-free survival remained consistent between the age groups.

Conclusion: Laparoscopic surgery offers short-term benefits for patients with obesity and rectal cancer compared to open surgery, regardless of age, without influencing the long-term prognosis.

Abstract Image

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肥胖症患者直肠癌腹腔镜手术与开腹手术：不同年龄组的短期疗效和无复发生存率。

目的：研究腹腔镜手术治疗直肠癌对肥胖和高龄患者的疗效，这些患者通常具有较高的合并症发病率和体力衰退特征：这项大规模多中心回顾性队列研究纳入了 2009 年至 2013 年期间接受开腹或腹腔镜手术治疗 II 期或 III 期直肠癌的 524 名体重指数在 25 以上的患者。通过比较这两种手术方式，我们评估了短期疗效和无复发生存率。这些患者被分为404个非老年组（结果：404个非老年组的患者中，腹腔镜手术的患者占了1/3）：在这两组患者中，腹腔镜手术比开腹手术明显减少了失血量（非老年人：41毫升对545毫升；老年人：50毫升对445毫升），缩短了住院时间（非老年人：10天对19天；老年人：15天对20天）。总体并发症和无复发存活率在两个年龄组中均无明显差异。此外，腹腔镜手术对无复发存活率的影响在不同年龄组之间保持一致：结论：与开腹手术相比，腹腔镜手术为肥胖症合并直肠癌患者带来了短期益处，无论年龄大小，但不会影响长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.