Comparison between laparoscopic complete mesocolic excision and D2 radical operation in colon carcinoma resection: A propensity score matching analysis.

IF 1.4 4区医学 Q4 ENGINEERING, BIOMEDICAL

Technology and Health Care Pub Date : 2024-07-31 DOI:10.3233/THC-241149

Zhen Han, Yangan Liu, Ming Tan, Zhaolai Hua, Chun Dai

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引用次数: 0

Abstract

Background: Surgery remains the most effective treatment for colon cancer. However, there are still controversies regarding the tumor treatment effect, prognosis, and perioperative impact of complete mesocolic excision (CME) surgery in colon carcinoma resection.

Objective: This study aims to compare laparoscopic complete mesocolic excision (LCME) and traditional open D2 radical surgery in colon carcinoma resection through a retrospective analysis using 1:1 propensity score matching (PSM).

Methods: 98 cases undergoing LCME or open D2 colon carcinoma resection at our hospital from January 2014 to November 2021 were retrospectively collected. After excluding cases and 1:1 matching using PSM based on baseline clinical data, 86 patients were assigned in research queue. 43 patients were in each group. Two groups were compared for general clinical baseline indicators. Surgical results and postoperative adverse events of patients were also compared. Disease-free survival (DFS) rate and overall survival (OS) rate was analyzed.

Results: After 1:1 PSM matching, there was no statistically significant differences in baseline data between the LCME group and D2 group (P> 0.05). LCME was characterized by longer total duration of surgery (P< 0.001), less intraoperative bleeding volume (P< 0.001), more postoperative drainage fluid volume (P< 0.001), greater number of lymph nodes retrieved (P= 0.014). No statistically differences was observed regarding intraoperative blood transfusion, hospital stay, Clavien-Dindo complicating disease classification (all P> 0.05), 1 and 3-year DFS rate (P= 0.84) and OS rate (P⩾ 0.1).

Conclusion: LCME had a longer duration of surgery but less intraoperative bleeding volume and more postoperative drainage fluid volume and retrieved lymph nodes compared to D2 radical surgery. LCME surgery is comparable to D2 surgery in terms of postoperative prognosis, but LCME surgery shows a positive trend in the overall survival curve.

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结肠癌切除术中腹腔镜完整系膜切除术与 D2 根治术的比较：倾向评分匹配分析

背景：手术仍是结肠癌最有效的治疗方法。然而，对于结肠癌切除术中完全结肠系膜切除术（CME）的肿瘤治疗效果、预后和围手术期的影响仍存在争议：方法：回顾性收集2014年1月至2021年11月在我院接受腹腔镜完整结肠系膜切除术（LCME）和传统开腹D2根治术的98例病例。根据基线临床数据排除病例并使用倾向得分匹配法进行1:1匹配后，86名患者被分配到研究队列中。每组 43 人。两组患者的一般临床基线指标进行比较。两组患者的手术效果和术后不良反应也进行了比较。分析无病生存率（DFS）和总生存率（OS）：经过 1:1 PSM 匹配后，LCME 组与 D2 组的基线数据差异无统计学意义（P> 0.05）。LCME 组的特点是手术总时间长（P< 0.001）、术中出血量少（P< 0.001）、术后引流液量多（P< 0.001）、取淋巴结数量多（P= 0.014）。在术中输血、住院时间、Clavien-Dindo并发症分类（均P> 0.05）、1年和3年DFS率（P= 0.84）和OS率（P⩾ 0.1）方面未观察到统计学差异：结论：与D2根治术相比，LCME手术时间更长，但术中出血量更少，术后引流液量更多，取回的淋巴结也更多。就术后预后而言，LCME手术与D2手术相当，但LCME手术的总生存曲线呈正向趋势。

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

Technology and Health Care HEALTH CARE SCIENCES & SERVICES-ENGINEERING, BIOMEDICAL

CiteScore

2.10

自引率

6.20%

发文量

282

审稿时长

>12 weeks

期刊介绍： Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured. The main focus of THC is related to the overlapping areas of engineering and medicine. The following types of contributions are considered: 1.Original articles: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine. In particular, the clinical benefit deriving from the application of engineering methods and devices in clinical medicine should be demonstrated. Typically, full length original contributions have a length of 4000 words, thereby taking duly into account figures and tables. 2.Technical Notes and Short Communications: Technical Notes relate to novel technical developments with relevance for clinical medicine. In Short Communications, clinical applications are shortly described. 3.Both Technical Notes and Short Communications typically have a length of 1500 words. Reviews and Tutorials (upon invitation only): Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented. The Editorial Board is responsible for the selection of topics. 4.Minisymposia (upon invitation only): Under the leadership of a Special Editor, controversial or important issues relating to health care are highlighted and discussed by various authors. 5.Letters to the Editors: Discussions or short statements (not indexed).