TY - JOUR
T1 - Emergent colectomy for colorectal cancer
T2 - A comparative analysis of open vs. minimally invasive approach
AU - Jecius, Hunter
AU - Khurrum, Muhammad
AU - Krall, Erika
AU - Tso, Dynnika
AU - Pefok, Afang
AU - Silva, Ryan
AU - Wusterbarth, Emily
AU - Arif, Hina
AU - Hamidi, Mohammad
AU - Nfonsam, Valentine
N1 - Publisher Copyright: © 2022 Elsevier Inc.
PY - 2023/4
Y1 - 2023/4
N2 - Introduction: Emergent surgery for colorectal cancer (CRC) is associated with higher rates of morbidity and mortality and outcomes differ by surgical approach. Methods: Our study compares short-term surgical outcomes of patients undergoing emergent colectomy for CRC using the open vs minimally invasive (MIS) approach. We performed a four-year review (2012–2015) of the ACS-NSQIP Colectomy dataset and included all adult patients with CRC who underwent emergent surgical intervention. Patients were stratified into groups based on surgical approach: Open and MIS (including laparoscopic and robotic). Results: A total of 1855 (MIS: 279, Open: 1576) patients were included. Outcome measures were operative time, 30-day complications, 30-day readmission, and 30-day mortality. Multivariate Regression analysis was performed. Patients in the open group were more likely to be older (70y vs. 61y, p < 0.01), have higher ASA class, and were less likely to have received mechanical bowel preparation. On univariate analysis, patients in the MIS group had longer operative time (189 ± 41 min vs. 161 ± 69 min, p < 0.01). Patients in the open group had higher rates of mortality (6.7% vs. 3.8%, p < 0.01) and 30-day complications (28.1% vs. 16.7%, p < 0.01). On regression analysis, the open approach was independently associated with higher odds of 30-day mortality and 30-day complications. Conclusion: Given the lower overall mortality and complications, MIS colectomy may be a safer approach in the emergent treatment of patients with colorectal cancer.
AB - Introduction: Emergent surgery for colorectal cancer (CRC) is associated with higher rates of morbidity and mortality and outcomes differ by surgical approach. Methods: Our study compares short-term surgical outcomes of patients undergoing emergent colectomy for CRC using the open vs minimally invasive (MIS) approach. We performed a four-year review (2012–2015) of the ACS-NSQIP Colectomy dataset and included all adult patients with CRC who underwent emergent surgical intervention. Patients were stratified into groups based on surgical approach: Open and MIS (including laparoscopic and robotic). Results: A total of 1855 (MIS: 279, Open: 1576) patients were included. Outcome measures were operative time, 30-day complications, 30-day readmission, and 30-day mortality. Multivariate Regression analysis was performed. Patients in the open group were more likely to be older (70y vs. 61y, p < 0.01), have higher ASA class, and were less likely to have received mechanical bowel preparation. On univariate analysis, patients in the MIS group had longer operative time (189 ± 41 min vs. 161 ± 69 min, p < 0.01). Patients in the open group had higher rates of mortality (6.7% vs. 3.8%, p < 0.01) and 30-day complications (28.1% vs. 16.7%, p < 0.01). On regression analysis, the open approach was independently associated with higher odds of 30-day mortality and 30-day complications. Conclusion: Given the lower overall mortality and complications, MIS colectomy may be a safer approach in the emergent treatment of patients with colorectal cancer.
KW - Colorectal cancer
KW - Colorectal surgery
KW - Emergent colectomy
KW - Minimally invasive colectomy
KW - Open colectomy
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U2 - 10.1016/j.amjsurg.2022.10.019
DO - 10.1016/j.amjsurg.2022.10.019
M3 - Article
C2 - 36307338
SN - 0002-9610
VL - 225
SP - 724
EP - 727
JO - American journal of surgery
JF - American journal of surgery
IS - 4
ER -