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Hirano Y, Hiranuma C, Hattori M, Douden K, Yamaguchi S. Single-port laparoscopic colectomy in elderly patients with colon cancer: A propensity score-matched comparison with younger patients. Asian J Endosc Surg 2020; 13:175-179. [PMID: 31250557 DOI: 10.1111/ases.12719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/26/2019] [Accepted: 05/06/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study aims to evaluate the safety and feasibility of single-port laparoscopic colectomy (SPLC) in elderly patients with colon cancer. METHODS During the study period, 344 patients underwent SPLC in our hospital. Among them, 87 patients were aged 80 years and older, and 257 patients were younger than 80 years. After 1:1 propensity-score matching, 87 elderly patients were compared with 87 young patients. RESULTS Short-term clinical outcomes after SPLC were equivalent between the two groups, although the elderly group had a higher ASA score and more postoperative complications. The 5-year overall survival rates were 64.6% in the elderly group and 66.8% in control group. The 5-year cancer-specific survival rates were 78.0% in the elderly group and 70.9% in control group. There were no significant differences between the groups. CONCLUSION Our results indicated that SPLC is technically feasible for operative teams that have adequately standardized the procedure, and it is oncologically safe in elderly patients with colon cancer.
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Affiliation(s)
- Yasumitsu Hirano
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan.,Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan
| | | | | | - Kenji Douden
- Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
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Hoshino N, Fukui Y, Hida K, Sakai Y. Short-term outcomes of laparoscopic surgery for colorectal cancer in the elderly versus non-elderly: a systematic review and meta-analysis. Int J Colorectal Dis 2019; 34:377-386. [PMID: 30649570 DOI: 10.1007/s00384-019-03234-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE Laparoscopic surgery for colorectal cancer has spread globally. The usefulness of laparoscopic surgery for elderly patients was initially indicated by comparison with open surgery. However, whether the procedure is safe for elderly as well as non-elderly patients with colorectal cancer remains unclear. METHODS In this review, patients aged ≥ 75 were defined as elderly. We conducted literature searches using PubMed, Scopus, and the Cochrane Central Register of Clinical Trials. Two authors independently reviewed resultant articles to identify relevant observational studies. Data synthesis was performed with a random-effects model. Heterogeneity was investigated by using forest plots and I2 statistics. Risk of bias of included studies was assessed by the Risk of Bias Assessment Tool for Nonrandomized Studies. Publication bias was assessed by funnel plots. RESULTS Twenty-two studies were included. The incidence of overall complications was slightly higher in elderly patients than in non-elderly patients, with statistical significance (risk ratio (RR) 1.20, 95% confidence interval (CI) 1.08-1.34). There was no difference between them in the incidence of anastomotic leakage (RR 1.24, 95% CI 0.86-1.80) and mortality (risk difference 0.00, 95% CI - 0.01 to 0.01). CONCLUSIONS Laparoscopic surgery for colorectal cancer is mostly safe for elderly patients as well as non-elderly patients. Preoperative comorbidities or poor physical capacity should be cared for in the elderly.
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Affiliation(s)
- Nobuaki Hoshino
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Yudai Fukui
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Koya Hida
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yoshiharu Sakai
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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Nishizawa Y, Hata T, Takemasa I, Yamasaki M, Akasaka H, Sugimoto K, Tamai K, Takahashi H, Haraguchi N, Nishimura J, Matsuda C, Mizushima T, Ikenaga M, Yamamoto H, Murata K, Rakugi H, Doki Y, Mori M. Clinical benefits of single-incision laparoscopic surgery for postoperative delirium in elderly colon cancer patients. Surg Endosc 2017; 32:1434-1440. [DOI: 10.1007/s00464-017-5827-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 08/15/2017] [Indexed: 11/29/2022]
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Tokuoka M, Ide Y, Takeda M, Hirose H, Hashimoto Y, Matsuyama J, Yokoyama S, Fukushima Y, Sasaki Y. Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients. Oncol Lett 2016; 12:1465-1470. [PMID: 27446454 DOI: 10.3892/ol.2016.4802] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 03/22/2016] [Indexed: 12/18/2022] Open
Abstract
The safety of single-incision laparoscopic surgery (SLS) in elderly patients with colorectal cancer has not been established. The aim of the current study was to compare the outcomes of SLS and multi-port laparoscopic surgery (MLS) and to assess the feasibility of SLS in colorectal cancer patients aged ≥70 years. A retrospective case-control study of colon cancer patients undergoing elective surgical intervention between 2011 and 2014 was conducted. A total of 129 patients with colon cancer underwent surgery and were included in the analysis. Data regarding patient demographics, surgical variables, oncological outcomes and short-term outcomes were evaluated for statistical significance to compare MLS (n=79) and SLS (n=50) in colon cancer patients. No significant differences were observed in patient characteristics. No case required re-admission within 30 days post surgery. The mean surgery times were similar for the MLS and SLS groups when cases with left and right hemicolectomies were combined (207.7 and 215.9 min, respectively; P=0.47). In addition, overall perioperative outcomes, including blood loss, number of lymph nodes harvested, size of the surgical margin and complications, were similar between these groups. Thus, we suggest that SLS can be performed safely in elderly patients with colon cancer.
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Affiliation(s)
- Masayoshi Tokuoka
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Yoshihito Ide
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Mitsunobu Takeda
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Hajime Hirose
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Yasuji Hashimoto
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Jin Matsuyama
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Shigekazu Yokoyama
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Yukio Fukushima
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
| | - Yo Sasaki
- Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581-0069, Japan
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Suzuki O, Nakamura F, Kashimura N, Nakamura T, Takada M, Ambo Y. A case-matched comparison of single-incision versus multiport laparoscopic right colectomy for colon cancer. Surg Today 2015; 46:297-302. [PMID: 25805710 DOI: 10.1007/s00595-015-1154-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 03/03/2015] [Indexed: 01/26/2023]
Abstract
PURPOSE To minimize the parietal trauma associated with multiple surgical access sites, single-incision laparoscopic surgery for colectomy has been emerging with the improvements in instrumentation and surgical techniques. The purpose of this study was to compare the clinicopathological outcomes between single-incision laparoscopic right colectomy (SILC) and multiport laparoscopic right colectomy (MLC) for right colon cancer. METHODS Thirty-five consecutive patients undergoing SILC from a prospective single-institution database were case matched according to demographic data to an equivalent number of patients who underwent MLC. RESULTS The SILC patients had decreased scores for maximal pain assessed by a visual analog scale on postoperative days 1 and 3, and used fewer postoperative systemic narcotics. The median length of the hospital stay for the SILC patients was significantly shorter compared with the MLC patients. The postoperative morbidity rates were similar between the groups. The oncological findings were not significantly different between the groups. CONCLUSION SILC is a feasible and safe alternative to conventional MLC for patients with right colon cancer.
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Affiliation(s)
- On Suzuki
- Department of Surgery, Teine-Keijinkai Hospital, 1-jo 12-chome, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan. .,Department of Gastroenterological Surgery, IMS Sapporo Digestive Disease Center General Hospital, 2-jo Nishi 1-chome, Hachiken, Nishi-ku, Sapporo, Hokkaido, 063-0842, Japan.
| | - Fumitaka Nakamura
- Department of Surgery, Teine-Keijinkai Hospital, 1-jo 12-chome, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan
| | - Nobuichi Kashimura
- Department of Surgery, Teine-Keijinkai Hospital, 1-jo 12-chome, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan
| | - Toru Nakamura
- Department of Surgery, Teine-Keijinkai Hospital, 1-jo 12-chome, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan
| | - Minoru Takada
- Department of Surgery, Teine-Keijinkai Hospital, 1-jo 12-chome, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan
| | - Yoshiyasu Ambo
- Department of Surgery, Teine-Keijinkai Hospital, 1-jo 12-chome, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan
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