Laparoscopic-assisted colorectal surgery benefits visceral obesity patients: a propensity-matched analysis

Ye, Xing-Zhao; Chen, Xiyi; Ruan, Xiuhang; Chen, Weizhe; Ma, Lan; Dong, Qian-Tong; Cai, Hui-Yang; Yu, Zhen; Chen, Xiao-Lie

doi:10.1097/meg.0000000000001423

Cited by 6 publications

(2 citation statements)

References 29 publications

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“…In the present study, patients in the LG group experienced fewer postoperative complications and shorter postoperative hospital stays than patients in the OG group. Additionally, LG turned out to be the only independent protective factor for total postoperative complications, which was similar to the results of a recent study which demonstrated that the overall incidence of complications from laparoscopic-assisted surgery was significantly lower than that from open surgery in colorectal cancer patients with VO [24]. Additionally, a previous observational study also showed that hand-assisted laparoscopic distal gastrectomy had obvious superiority over open distal gastrectomy in reducing estimated blood loss, wound length, number of analgesic injections, time to the first flatus, and postoperative hospital stay in obese patients [25].…”

Section: Discussionsupporting

confidence: 88%

Laparoscopic gastrectomy reduces adverse postoperative outcomes and decreases morbidity for gastric cancer patients with visceral obesity: a propensity score-matched analysis

Mao¹,

Chen²,

Sun³

et al. 2021

J. Cancer

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Background: Laparoscopic gastrectomy for gastric cancer shortens the recovery period without decreasing long-term survival. However, clinical evidence on whether laparoscopic radical gastrectomy reduces the surgical stress and improves the short- and long-term outcomes of obese patients with gastric cancer is lacking. We compared the short- and long-term outcomes of gastric cancer patients with visceral obesity (VO) who underwent laparoscopic gastrectomy (LG) or open gastrectomy (OG). Methods: We prospectively collected data from 578 patients who underwent radical gastrectomy in two centers between January 2014 and December 2016. The visceral fat area (VFA) was measured on the umbilicus level, and VFA ≥100 cm 2 was defined as VO. The section bias was reduced by conducting a propensity score matching analysis. The short- and long-term outcomes were further compared between patients who underwent OG and those who underwent LG. Results: Overall, 245 patients (42.61%) were classified as having VO, of whom 102 were included for further analysis after matching. There were no significant differences in clinical characteristics between the two groups in the matched cohort. The LG group had significantly fewer overall complications (P<0.001) and shorter postoperative hospital stays (P<0.001). Subgroup analysis of postoperative complications also showed that the incidence of surgical complications was lower in the LG group (P=0.002). Further survival analysis showed the LG group had significantly better long-term overall survival (P=0.017). Conclusions: Compared with open radical gastrectomy, laparoscopy would reduce the rate of postoperative complications in patients with VO, as well as prolong their overall survival.

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Section: Discussionsupporting

confidence: 88%

Laparoscopic gastrectomy reduces adverse postoperative outcomes and decreases morbidity for gastric cancer patients with visceral obesity: a propensity score-matched analysis

Mao¹,

Chen²,

Sun³

et al. 2021

J. Cancer

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“…Even more, fat overweight phenotypes represent a subpopulation at increased risk for high technical difficulties during video laparoscopic (VL) colorectal procedures, often resulting in conversion to open surgery [ 4 , 5 ]. On the other hand, VL compared with open colorectal surgery is recognized as associated with reduced postoperative pain, shorter hospital stay, less disability, and reduced pulmonary dysfunction [ 6 ]. This way, our recent report on obesity phenotypes undergoing CRC surgery further demonstrated the safe and favorable short-term outcome of the minimally invasive approach compared to the open approach when looking at the postoperative length of stay and severity of postoperative complications [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Long-Term Outcomes of Video-Laparoscopic Versus Open Surgery in Obese Patients with Colorectal Cancer: A Propensity Score Matching Study

Bizzoca

Zupo

Castellana

et al. 2022

Cancers

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Background: Minimally invasive methods in colorectal surgery offer unquestionable advantages, especially in the context of obesity. The current study addresses the lack of scientific evidence on the long-term oncologic safety of video-laparoscopic (VL) approaches in excess-weight CRC patients undergoing surgery. Methods: We retrospectively analyzed a surgical database consisting of 138 CRC patients undergoing VL (n = 87, 63%) and open CRC surgery (n = 51, 37%). To reduce selection bias, a propensity score matching was applied as a preliminary step to balance the comparison between the two surgery groups, i.e., VL and open surgery. Data from patients treated by the same surgeon were used.to minimize bias. Additional Cox regression models were run on the matched sample (N = 98) to explore the observed benefits of VL surgery in terms of overall and cancer-free survival. The nonparametric Kaplan-Meier method was used to compare the two surgical approaches and assess the likelihood of survival and cancer relapse. Results: The study sample was mostly male (N = 86, 62.3%), and VL outnumbered open surgery (63% versus 37%). Both before and after the matching, the VL-allocated group showed better overall survival (p < 0.01) with comparable cancer-free survival over more than five years of median observation time (66 months). Kaplan Meier survival probability curves corroborated the VL significant protective effect on survival (HR of 0.32; 95% CI: 0.13 to 0.81) even after adjusting for major confounding factors (age, gender, comorbidity index, BMI, tumor localization, tumor staging, tumor grading, clearance, CRM). Findings on oncologic performance by tumor relapse were comparable but lacked significance due to the small number of events observed. Conclusions: Comparing CRC surgical approaches, VL allocation showed comparable cancer-free survival but also a better performance on overall mortality than open surgery over more than five years of median observation.

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Comparison of robotic versus laparoscopic surgery for visceral obesity in mid–low rectal cancer: a propensity-matched analysis

Zhao,

Li,

Zhou

et al. 2024

J Robotic Surg

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Laparoscopic-assisted colorectal surgery benefits visceral obesity patients: a propensity-matched analysis

Cited by 6 publications

References 29 publications

Laparoscopic gastrectomy reduces adverse postoperative outcomes and decreases morbidity for gastric cancer patients with visceral obesity: a propensity score-matched analysis

Laparoscopic gastrectomy reduces adverse postoperative outcomes and decreases morbidity for gastric cancer patients with visceral obesity: a propensity score-matched analysis

Predictors of Long-Term Outcomes of Video-Laparoscopic Versus Open Surgery in Obese Patients with Colorectal Cancer: A Propensity Score Matching Study

Comparison of robotic versus laparoscopic surgery for visceral obesity in mid–low rectal cancer: a propensity-matched analysis

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