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Differences in effectiveness and use of laparoscopic surgery in locally advanced colon cancer patients
Journal article   Open access   Peer reviewed

Differences in effectiveness and use of laparoscopic surgery in locally advanced colon cancer patients

M Schootman, Matthew Mutch, T Loux, J M Eberth and N O Davidson
Scientific reports, v 11(1), pp 10022-10022
11 May 2021
DOI: https://doi.org/10.1038/s41598-021-89554-0
PMID: 33976338
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1038/s41598-021-89554-0View
Published, Version of Record (VoR) Open

Abstract

Patients with locally advanced colon cancer have worse outcomes. Guidelines of various organizations are conflicting about the use of laparoscopic colectomy (LC) in locally advanced colon cancer. We determined whether patient outcomes of LC and open colectomy (OC) for locally advanced (T4) colon cancer are comparable in all colon cancer patients, T4a versus T4b patients, obese versus non-obese patients, and tumors located in the ascending, descending, and transverse colon. We used data from the 2013-2015 American College of Surgeons' National Surgical Quality Improvement Program. Patients were diagnosed with nonmetastatic pT4 colon cancer, with or without obstruction, and underwent LC (n = 563) or OC (n = 807). We used a composite outcome score (mortality, readmission, re-operation, wound infection, bleeding transfusion, and prolonged postoperative ileus); length of stay; and length of operation. Patients undergoing LC exhibited a composite outcome score that was 9.5% lower (95% CI - 15.4; - 3.5) versus those undergoing OC. LC patients experienced a 11.3% reduction in postoperative ileus (95% CI - 16.0; - 6.5) and an average of 2 days shorter length of stay (95% CI - 2.9; - 1.0). Patients undergoing LC were in the operating room an average of 13.5 min longer (95% CI 1.5; 25.6). We found no evidence for treatment heterogeneity across subgroups (p > 0.05). Patients with locally advanced colon cancer who receive LC had better overall outcomes and shorter lengths of stay compared with OC patients. LC was equally effective in obese/nonobese patients, in T4a/T4b patients, and regardless of the location of the tumor.

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11 citations in Web of Science
10 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Surgery
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