Impact of a minimally invasive approach for colon cancer surgery on outcomes in patients with functional limitations.

IF 0.3 Q3 ONCOLOGY

Colorectal Cancer Pub Date : 2025-01-01 Epub Date: 2025-08-13 DOI:10.1080/1758194x.2025.2545749

Mario Schootman, Jun Ying, Chenghui Li, Ben Amick, Jonathan Laryea, Sonia Orcutt

{"title":"Impact of a minimally invasive approach for colon cancer surgery on outcomes in patients with functional limitations.","authors":"Mario Schootman, Jun Ying, Chenghui Li, Ben Amick, Jonathan Laryea, Sonia Orcutt","doi":"10.1080/1758194x.2025.2545749","DOIUrl":null,"url":null,"abstract":"Introduction: Patients with functional dependence have poorer outcomes after surgery for colon cancer than those who are independent. We sought to determine how much the use of minimally invasive surgery (MIS) would reduce the impact of functional dependence on discharge home, 30-day readmission, and 30-day mortality.Methods: We used the 2012-2020 American College of Surgeons' National Surgical Quality improvement Program data on patients who underwent colectomies for colon cancer. Functional dependence was either independent, partially/totally dependent, or unknown. Surgical approaches were either MIS or open. We constructed logistic regression models to analyze the data and used a counterfactual approach to assess the differences in predicted rates of outcome for open vs. MIS surgery.Results: 2.7% of 115,897 patients were partially/totally dependent. While 64.5% of all patients received MIS, among those who were partially/totally dependent only 49.7% received MIS. No difference existed in discharge destination or readmission rate by surgical approach among patients who were partially/totally dependent (p = 0.384 and p = 0.168, respectively). Using the counterfactual approach, performing MIS rather than open surgery among patients who were partially/totally dependent would lower 30-day mortality by 27.3% (relative reduction).Discussion: Optimizing MIS in patients with functional limitations should be a priority in colon cancer resection.","PeriodicalId":43638,"journal":{"name":"Colorectal Cancer","volume":"14 1","pages":""},"PeriodicalIF":0.3000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376876/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Colorectal Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/1758194x.2025.2545749","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/13 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Patients with functional dependence have poorer outcomes after surgery for colon cancer than those who are independent. We sought to determine how much the use of minimally invasive surgery (MIS) would reduce the impact of functional dependence on discharge home, 30-day readmission, and 30-day mortality.

Methods: We used the 2012-2020 American College of Surgeons' National Surgical Quality improvement Program data on patients who underwent colectomies for colon cancer. Functional dependence was either independent, partially/totally dependent, or unknown. Surgical approaches were either MIS or open. We constructed logistic regression models to analyze the data and used a counterfactual approach to assess the differences in predicted rates of outcome for open vs. MIS surgery.

Results: 2.7% of 115,897 patients were partially/totally dependent. While 64.5% of all patients received MIS, among those who were partially/totally dependent only 49.7% received MIS. No difference existed in discharge destination or readmission rate by surgical approach among patients who were partially/totally dependent (p = 0.384 and p = 0.168, respectively). Using the counterfactual approach, performing MIS rather than open surgery among patients who were partially/totally dependent would lower 30-day mortality by 27.3% (relative reduction).

Discussion: Optimizing MIS in patients with functional limitations should be a priority in colon cancer resection.

Abstract Image

查看原文本刊更多论文

微创入路结肠癌手术对功能受限患者预后的影响

功能依赖患者在结肠癌手术后的预后比独立患者差。我们试图确定微创手术（MIS）的使用能在多大程度上降低功能依赖对出院、30天再入院和30天死亡率的影响。方法：我们使用2012-2020年美国外科医师学会国家手术质量改进计划的结肠癌结肠切除术患者数据。功能依赖是独立的、部分/完全依赖的或未知的。手术入路为MIS或开放。我们构建了逻辑回归模型来分析数据，并使用反事实方法来评估开放与MIS手术预测结果率的差异。结果：115,897例患者中有2.7%部分/完全依赖。64.5%的患者接受了MIS，而部分/完全依赖的患者只有49.7%接受了MIS。部分依赖/完全依赖患者的出院目的地和手术再入院率无差异（p = 0.384和p = 0.168）。采用反事实方法，在部分/完全依赖的患者中实施MIS而不是开放手术将使30天死亡率降低27.3%（相对降低）。讨论：优化功能受限患者的MIS应优先考虑结肠癌切除术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Colorectal Cancer ONCOLOGY-

自引率

0.00%

发文量

期刊介绍： Colorectal cancer is a major cause of morbidity and mortality, particularly in the developed world. Risk factors for colorectal cancer are on the rise in many countries; populations are aging, and obesity and diabetes are increasing. National screening programs are helping to detect cancer while it is still curable; however, colorectal cancer remains the third leading cause of cancer deaths in the USA and options are still limited for those with more advanced disease. Consequently, colorectal cancer is a major research priority for government, pharmaceutical companies and non-profit organizations. Research into diagnosis and optimum treatment of the disease is progressing rapidly, with new advances reported every day. Colorectal Cancer presents reviews, analysis and commentary. on all aspects of colorectal cancer.