Safety and Efficacy of Laparoscopic Surgery versus Open Surgery in Elderly Patients with Colon Cancer: A Propensity Score Matching Cohort Study.

IF 1.2 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2022-01-01 DOI:10.1159/000529223

Chao Wang, Lin Gan, Kewei Jiang, Zhidong Gao, Yingjiang Ye

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引用次数: 0

Abstract

Introduction: The safety of laparoscopic surgery (LS) and its effect on survival have not been sufficiently assessed in elderly colon cancer patients.

Methods: Clinicopathologic data of patients aged ≥75 years who underwent colectomy for primary colon cancer, between January 2018 and June 2021, were reviewed. Patients were divided into the LS and open surgery (OS) groups according to the intention-to-treat principle and were compared using propensity score matching. The primary outcomes were differences in surgical safety and 3-year survival.

Results: There were 98 patients with a median age of 82 years and 85 patients with a median age of 80 years assigned to the OS and LS groups, respectively. Propensity score matching revealed that LS did not prolong the operative time (190 vs. 180 min, p = 0.209) and was linked to less intraoperative blood loss (50 vs. 100 mL, p = 0.039) and shorter postoperative hospital stay (8 vs. 10 days, p = 0.005), compared to OS. In addition, LS was not accompanied by more stress response when the variations exhibited in laboratory tests and the Barthel index pre- and postsurgery were considered. There were no significant differences in the adjusted 3-year overall survival (86.0% vs. 81.2%, p = 0.795) and disease-free survival (86.6% vs. 87.9%, p = 0.356) between the groups.

Conclusion: LS enhanced postoperative recovery without increasing surgical risks, compared to OS, in colon cancer patients aged ≥75 years. Furthermore, no significant differences in the 3-year adjusted survival were observed between the groups.

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老年结肠癌患者腹腔镜手术与开放手术的安全性和有效性:一项倾向评分匹配队列研究

腹腔镜手术(LS)的安全性及其对老年结肠癌患者生存的影响尚未得到充分的评估。方法:回顾2018年1月至2021年6月期间年龄≥75岁的原发性结肠癌结肠切除术患者的临床病理资料。根据意向治疗原则将患者分为LS组和开放手术(OS)组，采用倾向评分匹配进行比较。主要结局是手术安全性和3年生存率的差异。结果:OS组和LS组分别有98例患者，中位年龄82岁和85例患者，中位年龄80岁。倾向评分匹配显示，与OS相比，LS不会延长手术时间(190 vs 180 min, p = 0.209)，术中出血量更少(50 vs 100 mL, p = 0.039)，术后住院时间更短(8 vs 10天，p = 0.005)。此外，考虑到实验室测试和Barthel指数在术前和术后所表现出的变化，LS并不伴有更多的应激反应。两组间调整后的3年总生存率(86.0% vs. 81.2%， p = 0.795)和无病生存率(86.6% vs. 87.9%， p = 0.356)无显著差异。结论:在年龄≥75岁的结肠癌患者中，与OS相比，LS可提高术后恢复，但不增加手术风险。此外，3年调整生存率在两组间无显著差异。

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

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.