Keep Them on the Table: Outcomes Are Improved After Minimally Invasive Colectomy Despite Longer Operative Times in Patients With High-Risk Colon Cancer
BACKGROUND:
For high-risk patients, traditional surgical dogma advises open operations, with short operative times, to “get them off the table” instead of longer minimally invasive surgery approaches.
OBJECTIVE:
The aim of this study was to compare postoperative outcomes in patients with high-risk colon cancer undergoing elective longer minimally invasive surgery operations compared with shorter open operations.
DESIGN:
Retrospective comparative cohort study.
SETTINGS:
Interventions were performed in hospitals participating in the national surgical database.
PATIENTS:
The National Surgical Quality Improvement Program database was used to identify patients with colon cancer with ASA class 3 to 4 undergoing right and sigmoid colectomy between 2012 and 2017.
MAIN OUTCOME MEASURES:
Thirty-day postoperative outcomes were compared between short open and long minimally invasive groups.
RESULTS:
A total of 3775 patients were identified as having undergone long minimally invasive right colectomy and short open right colectomy (33% open, 67% minimally invasive surgery), and 1042 patients were identified as having undergone long minimally invasive sigmoid colectomy and short open sigmoid colectomy (36% open, 64% minimally invasive). Patients undergoing long minimally invasive right colectomy had significantly lower rates of overall morbidity, severe adverse events, mortality, superficial surgical site infections, and wound disruptions, a...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Outcomes Source Type: research
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