Short term results in a population based study indicate advantage for laparoscopic colon cancer surgery versus open

Petersson, Josefin; Matthiessen, Peter; Jadid, Kaveh Dehlaghi; Bock, David; Angenete, Eva

doi:10.1038/s41598-023-30448-8

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…A population-based study conducted in Sweden compared laparoscopic (LAP) and open (OPEN) surgeries for colon cancer, revealing the advantages of LAP in terms of short-term mortality, morbidity, and completeness of cancer resection. 13 This finding is consistent with our present study, which focused on laparoscopic procedures Riaz Ahmad et al and reported low mortality rates and favorable shortterm outcomes. Furthermore, laparoscopic surgery for colon cancer has been extensively researched and proven to be oncologically safe, offering various benefits such as reduced blood loss, less pain, shorter hospital stays, and improved quality of life compared to open surgery.…”

Section: Discussionsupporting

confidence: 94%

Demographic characteristics and short-term outcomes of laparoscopic colon cancer surgeries at a newly developed cancer center in Peshawar, Pakistan

Ahmad,

Jan Abbasi,

Ul Islam Nasir

et al. 2024

Pak J Med Sci

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Objective: In Pakistan, colon cancer ranks fourth in incidence, exhibiting survival rates of 90% to 14%, contingent on TNM staging and early detection. This research focuses on the demographic involvement and short-term outcomes of elective colon cancer resections at a newly established tertiary care cancer center utilizing laparoscopic procedures. Method: A retrospective analysis of elective laparoscopic colorectal resections at Shaukat Khanum Memorial Cancer Institute and Research Centre, Peshawar, from April 2021 to February 2022 was conducted. Out of 157 cases, 79 had colon cancer. Criteria included patients >18 years old with positive biopsies; consent non-providers were excluded. Statistical analysis employed descriptive statistics and cross-tabulations using SPSS-22. Results: The study encompassed biopsy-confirmed colon cancers in patients >18 years. 157 colorectal cases were performed, including 79 colon cancers. The sample comprised 61 males (77.2%) and 18 females (22.7%), mean age 42 years. Most patients (33%) were in the 36-45 age group. Majority were from KPK (69.6%), followed by Afghanistan (24%). Tumors were predominantly in the ascending colon (30.3%). Most were moderately differentiated (70.8%). Mean lymph node yield was 19.0, with 1.2% requiring open laparotomy. Post-discharge, one readmission occurred within 30 days. Mortality within 90 days was 2%, attributed to aspiration pneumonia and chemotherapy-related effects. Conclusions: Elective laparoscopic colonic surgery exhibits safety and efficacy in treating colon cancer. The study provides evidence of minimal morbidity and mortality, low readmission rates, and absence of anastomotic leaks. Hence, elective laparoscopic colonic surgery should be favored due to fewer post-operative complications and superior short-term outcomes. Larger studies on colon cancer are imperative for enhanced healthcare delivery. doi: https://doi.org/10.12669/pjms.40.5.8732 How to cite this: Ahmad R, Abbasi HJ, Nasir II, Shah MF. Demographic characteristics and short-term outcomes of laparoscopic colon cancer surgeries at a newly developed cancer center in Peshawar, Pakistan. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.8732 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 94%

Demographic characteristics and short-term outcomes of laparoscopic colon cancer surgeries at a newly developed cancer center in Peshawar, Pakistan

Ahmad,

Jan Abbasi,

Ul Islam Nasir

et al. 2024

Pak J Med Sci

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Impact of laparoscopic versus open surgery on humoral immunity in patients with colorectal cancer: a systematic review and meta-analysis

Bohne,

Grundler,

Knüttel

et al. 2023

Surg Endosc

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Background Laparoscopic surgery (LS) is hypothesized to result in milder proinflammatory reactions due to less severe operative trauma, which may contribute to the observed clinical benefits after LS. However, previous systematic reviews and meta-analyses on the impact of LS on immunocompetence are outdated, limited and heterogeneous. Therefore, the humoral response after laparoscopic and open colorectal cancer (CRC) resections was evaluated in a comprehensive systematic review and meta-analysis. Methods Included were randomized controlled trials (RCTs) measuring parameters of humoral immunity after LS compared to open surgery (OS) in adult patients with CRC of any stage. MEDLINE, Embase, Web of Science (SCI-EXPANDED), Cochrane Library, Google Scholar, ClinicalTrials.gov and ICTRP (World Health Organization) were systematically searched. Risk of bias (RoB) was assessed using the Cochrane RoB2 tool. Weighted inverse variance meta-analysis of mean differences was performed for C-reactive protein (CRP), interleukin (IL)-6, IL-8, tumour necrosis factor (TNF)α and vascular endothelial growth factor (VEGF) using the random-effects method. Methods were prospectively registered in PROSPERO (CRD42021264324). Results Twenty RCTs with 1131 participants were included. Narrative synthesis and meta-analysis up to 8 days after surgery was performed. Quantitative synthesis found concentrations to be significantly lower after LS at 0–2 h after surgery (IL-8), at 3–9 h (CRP, IL-6, IL-8, TNFα) and at postoperative day 1 (CRP, IL-6, IL-8, VEGF). At 3–9 h, IL-6 was notably lower in the LS group by 86.71 pg/ml (mean difference [MD] − 86.71 pg/ml [− 125.05, − 48.37], p < 0.00001). Combined narratively, 13 studies reported significantly lower concentrations of considered parameters in LS patients, whereas only one study reported lower inflammatory markers (for CRP and IL-6) after OS. Conclusion The increase in postoperative concentrations of several proinflammatory parameters was significantly less pronounced after LS than after OS in this meta-analysis. Overall, the summarized evidence reinforces the view of a lower induction of inflammation due to LS.

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Impact of Chronic Obstructive Pulmonary Disease on surgical outcomes of Patients with Colorectal cancer

Wang,

Zhang,

Chen

et al. 2024

Preprint

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Background: The impact of chronic obstructive pulmonary disease (COPD) on perioperative complications and prognosis in patients with colorectal cancer (CRC) is explored.Methods: Fifty-eight CRC patients with COPD and 671 CRC patients without COPD who underwent surgery for CRC in our hospital were retrospectively analyzed. Sociodemographic and clinical variables including tumor status, operative and anesthesia duration, length of hospital stay, the time of postoperative catheter removal and first defecation were compared between the two cohorts. Furthermore, postoperative intensive care unit (ICU) admission, use of mechanical ventilation, fiberoptic bronchoscopy rates, postoperative antibiotic treatment, presence of complications and cancer-specific survival (CSS) or disease-free survival (DFS) were analyzed. Finally, COX regression analysis was used to identify independent risk factors for overall survival (OS) in CRC patients.Results: COPD and Tumor-Node-Metastasis (TNM) stages were independent risk factors for the postoperative OS in patients undergoing surgery for CRC. Moreover, time of postoperative urinary catheter removal and first defecation, ICU admission, use of mechanical ventilation, and fiberoptic bronchoscopy rates were significantly higher in CRC patients with COPD than in those without COPD. Furthermore, postoperative pneumonia and septic shock were more common in patients with COPD. However, COPD was not associated with CSS or DFS in CRC patients.Conclusions: COPD is an independent risk factor for OS in CRC patients after surgery, and is correlated with more postoperative complications, but it is not associated with CSS or DFS. Thus, surgical resection is recommended for selective CRC patients with COPD under the condition of more intensive postoperative care.

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Short term results in a population based study indicate advantage for laparoscopic colon cancer surgery versus open

Cited by 3 publications

References 38 publications

Demographic characteristics and short-term outcomes of laparoscopic colon cancer surgeries at a newly developed cancer center in Peshawar, Pakistan

Demographic characteristics and short-term outcomes of laparoscopic colon cancer surgeries at a newly developed cancer center in Peshawar, Pakistan

Impact of laparoscopic versus open surgery on humoral immunity in patients with colorectal cancer: a systematic review and meta-analysis

Impact of Chronic Obstructive Pulmonary Disease on surgical outcomes of Patients with Colorectal cancer

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