TY - JOUR
T1 - Right Colon Resection for Colon Cancer
T2 - Does Surgical Approach Matter?
AU - Haskins, Ivy N.
AU - Ju, Tammy
AU - Skancke, Matthew
AU - Kuang, Xiangyu
AU - Amdur, Richard L.
AU - Brody, Fred
AU - Obias, Vincent
AU - Agarwal, Samir
N1 - Publisher Copyright:
© 2018, Mary Ann Liebert, Inc.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/10
Y1 - 2018/10
N2 - Background: Surgical resection with curative intent remains the standard of care for colon cancer. This study aims to compare the 30-day outcomes and oncologic results following open, laparoscopic, and robot-assisted right colon resection for colon cancer using the Targeted Colectomy American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Materials and Methods: All patients undergoing elective, right colon resection with primary anastomosis were identified within the targeted colectomy ACS-NSQIP database. Only patients with stage I, II, or III colon cancer were included. The association of surgical approach with oncologic results and 30-day morbidity and mortality outcomes was investigated using a variety of statistical tests. Results: A total of 3518 patients met inclusion criteria; 1024 (29.1%) underwent open surgery (OS), 2405 (63.4%) underwent laparoscopic surgery, and 89 (2.5%) underwent robotic surgery. Patients undergoing OS were significantly more likely to have positive resection margins (P <.001). Patients undergoing OS were significantly more likely to experience prolonged intubation (P =.02), deep wound infections (P =.001), wound dehiscence (P =.005), deep venous thrombosis (P =.04), bleeding requiring a blood transfusion (P <.001), a prolonged postoperative ileus (P <.001), and longer length of hospital stay (P <.001), and were more likely to die (P =.02). Conclusion: The laparoscopic approach to colon resection for colon cancer has lower 30-day morbidity compared to OS. The robotic approach is equivalent to the laparoscopic approach, and its utilization may increase in the future.
AB - Background: Surgical resection with curative intent remains the standard of care for colon cancer. This study aims to compare the 30-day outcomes and oncologic results following open, laparoscopic, and robot-assisted right colon resection for colon cancer using the Targeted Colectomy American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Materials and Methods: All patients undergoing elective, right colon resection with primary anastomosis were identified within the targeted colectomy ACS-NSQIP database. Only patients with stage I, II, or III colon cancer were included. The association of surgical approach with oncologic results and 30-day morbidity and mortality outcomes was investigated using a variety of statistical tests. Results: A total of 3518 patients met inclusion criteria; 1024 (29.1%) underwent open surgery (OS), 2405 (63.4%) underwent laparoscopic surgery, and 89 (2.5%) underwent robotic surgery. Patients undergoing OS were significantly more likely to have positive resection margins (P <.001). Patients undergoing OS were significantly more likely to experience prolonged intubation (P =.02), deep wound infections (P =.001), wound dehiscence (P =.005), deep venous thrombosis (P =.04), bleeding requiring a blood transfusion (P <.001), a prolonged postoperative ileus (P <.001), and longer length of hospital stay (P <.001), and were more likely to die (P =.02). Conclusion: The laparoscopic approach to colon resection for colon cancer has lower 30-day morbidity compared to OS. The robotic approach is equivalent to the laparoscopic approach, and its utilization may increase in the future.
KW - Colon cancer
KW - minimally invasive surgery
KW - morbidity
KW - mortality
KW - right colon resection
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U2 - 10.1089/lap.2018.0148
DO - 10.1089/lap.2018.0148
M3 - Article
C2 - 29775552
AN - SCOPUS:85054707181
VL - 28
SP - 1202
EP - 1206
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques
JF - Journal of Laparoendoscopic and Advanced Surgical Techniques
SN - 1092-6429
IS - 10
ER -