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Abe S, Nozawa H, Sasaki K, Murono K, Emoto S, Yokoyama Y, Matsuzaki H, Nagai Y, Shinagawa T, Sonoda H, Ishihara S. Minimally invasive versus open multivisceral resection for rectal cancer clinically invading adjacent organs: a propensity score-matched analysis. Surg Endosc 2024:10.1007/s00464-024-10844-5. [PMID: 38658387 DOI: 10.1007/s00464-024-10844-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Minimally invasive surgery (MIS), such as laparoscopic and robotic surgery for rectal cancer, is performed worldwide. However, limited information is available on the advantages of MIS over open surgery for multivisceral resection for cases clinically invading adjacent organs. PATIENTS AND METHODS This was a retrospective propensity score-matching study of consecutive clinical T4b rectal cancer patients who underwent curative intent surgery between 2006 and 2021 at the University of Tokyo Hospital. RESULTS Sixty-nine patients who underwent multivisceral resection were analyzed. Thirty-three patients underwent MIS (the MIS group), while 36 underwent open surgery (the open group). Twenty-three patients were matched to each group. Conversion was required in 2 patients who underwent MIS (8.7%). R0 resection was achieved in 87.0% and 91.3% of patients in the MIS and open groups, respectively. The MIS group had significantly less blood loss (170 vs. 1130 mL; p < 0.0001), fewer Clavien-Dindo grade ≥ 2 postoperative complications (30.4% vs. 65.2%; p = 0.0170), and a shorter postoperative hospital stay (20 vs. 26 days; p = 0.0269) than the open group. The 3-year cancer-specific survival rate, relapse-free survival rate, and cumulative incidence of local recurrence were 75.7, 35.9, and 13.9%, respectively, in the MIS group and 84.5, 45.4, and 27.1%, respectively, in the open group, which were not significantly different (p = 0.8462, 0.4344, and 0.2976, respectively). CONCLUSION MIS had several short-term advantages over open surgery, such as lower complication rates, faster recovery, and a shorter hospital stay, in rectal cancer patients who underwent multivisceral resection.
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Affiliation(s)
- Shinya Abe
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| | - Hiroaki Nozawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Kazuhito Sasaki
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Koji Murono
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Shigenobu Emoto
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Yuichiro Yokoyama
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Hiroyuki Matsuzaki
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Yuzo Nagai
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Takahide Shinagawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Hirofumi Sonoda
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
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Kohjimoto Y, Yamashita S, Iwagami S, Muraoka S, Wakamiya T, Hara I. hinotori TM vs. da Vinci ®: propensity score-matched analysis of surgical outcomes of robot-assisted radical prostatectomy. J Robot Surg 2024; 18:130. [PMID: 38498237 DOI: 10.1007/s11701-024-01877-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/20/2024] [Indexed: 03/20/2024]
Abstract
hinotori™ is a recently developed surgical robot system. The present study aims to compare intraoperative and postoperative outcomes of robot-assisted radical prostatectomy (RARP) by the hinotori™ system compared with those of the longer-established da Vinci® system. This study includes 100 consecutive patients who underwent RARP by da Vinci® and 60 patients who underwent RARP by hinotori™. To minimize imbalances of patient demographics between the two groups, 1:1 propensity score-matching was performed, and 43 patients each were assigned to the da Vinci® and hinotori™ groups after matching. In the propensity score-matched cohort, we could not find significant differences in patient demographics between the two groups. Surgical outcomes, operative time, and console time in the hinotori™ group were significantly longer than those in the da Vinci® group. Meanwhile, we could not find significant differences in other outcomes between the two groups, such as estimated blood loss, intraoperative complications, major postoperative complications (Clavien-Dindo grade 3 or 4) or length of hospital stay after surgery. The rate of positive cancer margin in the hinotori™ group was higher than that in the da Vinci® group, but significant difference could not be found between the two groups. Moreover, we could not find significant differences in urinary continence rates after surgery between the da Vinci® and hinotori™ groups. Our results suggest that the hinotori™ surgical robot system could provide comparable surgical outcomes to that of the da Vinci® system for patients undergoing RARP.
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Affiliation(s)
- Yasuo Kohjimoto
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Shimpei Yamashita
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
| | - Sohei Iwagami
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Satoshi Muraoka
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Takahito Wakamiya
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Isao Hara
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
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Yanagisawa T, Tatematsu N, Horiuchi M, Migitaka S, Yasuda S, Itatsu K, Kubota T, Sugiura H. Prolonged preoperative sedentary time is a risk factor for postoperative ileus in patients with colorectal cancer: a propensity score-matched retrospective study. Support Care Cancer 2023; 32:54. [PMID: 38129532 DOI: 10.1007/s00520-023-08271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE This study aimed to investigate the association between prolonged preoperative sedentary time (ST) and postoperative ileus (POI) after adjusting for confounders in patients with colorectal cancer (CRC). METHODS This single-center retrospective study enrolled 155 consecutive patients who underwent surgery for primary CRC. A diagnosis of POI was made by the surgeons if the Clavien-Dindo classification (CD) grade is ≥ 2 within 30 days after surgery. Preoperative ST was assessed using the International Physical Activity Questionnaire usual week short version (Japanese version). Patients were classified into two groups (ST < 6 h/day and ST ≥ 6 h/day) based on results from the questionnaire, and data were analyzed using a propensity score-matching strategy to adjust for confounders. In addition, receiver operating characteristic (ROC) curve analysis was performed to identify the optimal cutoff value of preoperative ST for predicting POI. RESULTS Of the 155 patients, 134 were included in the analysis. POI occurred in 16 (11.9%) patients of overall patients and 11 (12.5%) of the 88 matched patients. The logistic regression analysis after propensity score-matching showed that prolonged preoperative ST (ST ≥ 6 h/day) was associated with POI (odds ratio 5.40 (95% confidence interval: 1.09 - 26.60), p = 0.038). The ROC curve analysis indicated that the optimal cutoff value of preoperative ST for predicting POI was 6 h/day. CONCLUSION Prolonged preoperative ST is a risk factor for POI in patients with CRC. Therefore, reducing preoperative ST may play an important role in preventing POI.
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Affiliation(s)
- Takuya Yanagisawa
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Noriatsu Tatematsu
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-Ku, Nagoya, Aichi, 461-8673, Japan.
| | - Mioko Horiuchi
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Saki Migitaka
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Shotaro Yasuda
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Keita Itatsu
- Department of Surgery, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Tomoyuki Kubota
- Department of Breast Surgery, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Hideshi Sugiura
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-Ku, Nagoya, Aichi, 461-8673, Japan
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Motoyama D, Matsushita Y, Watanabe H, Tamura K, Otsuka A, Fujisawa M, Miyake H. Perioperative outcomes of robot-assisted partial nephrectomy using hinotori versus da Vinci surgical robot system: a propensity score-matched analysis. J Robot Surg 2023; 17:2435-2440. [PMID: 37462888 DOI: 10.1007/s11701-023-01614-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/13/2023] [Indexed: 09/10/2023]
Abstract
The purpose of this study was to evaluate perioperative outcomes of robot-assisted partial nephrectomy (RAPN) using hinotori, a recently developed robot-assisted surgical platform, by comparing them with those using da Vinci. This study included 303 and 40 consecutive patients who underwent RAPN using da Vinci and hinotori, respectively. To adjust potential baseline parameters between da Vinci and hinotori groups, 1:2 propensity score-matching was performed, and perioperative outcomes in these two groups were comprehensively evaluated. Propensity score-matched analysis generated two groups, consisting of 74 and 37 patients undergoing RAPN using da Vinci and hinotori, respectively, and no significant differences in major baseline parameters were noted between the two groups. RAPN could be completed without conversion to nephrectomy or open surgery in all patients. There were no significant differences in major perioperative outcomes between da Vinci and hinotori groups, including the operative time, time using the robotic system and warm ischemia time. No patient in either group was diagnosed with a positive surgical margin or experienced perioperative complications, corresponding to Clavien-Dindo 3 ≤ . There were no significant differences in the achievements of trifecta and margin, ischemia and complications outcomes between the two groups, and changes in the estimated glomerular filtration rate 1 and 28 days after RAPN were also similar between them. In conclusion, these findings showed that the hinotori platform could facilitate similar perioperative outcomes in patients undergoing RAPN in comparison with the existing robotic system, da Vinci.
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Affiliation(s)
- Daisuke Motoyama
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
- Department of Developed Studies for Advanced Robotic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
| | - Yuto Matsushita
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
| | - Hiromitsu Watanabe
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
| | - Keita Tamura
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
| | - Atsushi Otsuka
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
| | - Masato Fujisawa
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideaki Miyake
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan.
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Jeong JY, Seo SH, Kim KH, An MS, Baik H, Kang SH, Oh SH. Doxifluridine versus Tegafur/Gimeracil/Oteracil (S-1) as adjuvant chemotherapy for patients with gastric cancer after gastrectomy: A propensity score-matched analysis. Asian J Surg 2023; 46:3656-3662. [PMID: 37002050 DOI: 10.1016/j.asjsur.2023.03.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Doxifluridine (DF), an oral 5-FU prodrug, has been used for various solid cancers due to its efficacy and low toxicity. We aim to evaluate the effect of DF as adjuvant monotherapy in advanced gastric cancer. METHODS We retrospectively reviewed the clinical data of 263 patients with advanced gastric cancer who underwent curative gastrectomy between January 2010 and December 2013 at our institute. Since previous randomized control trials have confirmed the efficacy of S-1 as adjuvant chemotherapy in advanced gastric cancer, we analyzed the oncologic effect and patient compliance of the DF group compared to the S-1 group. After propensity score matching, 48 patients were included in each group. RESULTS There was no significant difference in 5-year overall survival (OS) and 5-year disease-free survival (DFS) between DF and S-1 groups (5-year OS; 77.1% vs 75.0%; p = 0.729, 5-year DFS; 76.6% vs 73.9%; p = 0.748). The completion rates of the DF and S-1 groups were 60.4% and 72.9%, respectively (p = 0.194). The mean relative dose intensity of the DF and S-1 groups were 76.2% and 84.2%, respectively (p = 0.195). After multivariate analysis, the chemotherapy regimen was not a risk factor for OS and DFS, whereas relative dose intensity and pathologic stage were independent prognostic factors. CONCLUSION There was no significant difference in the oncologic effect and patient compliance between DF and S-1 groups. DF could be an alternative option for adjuvant chemotherapy in advanced gastric cancer. In addition, we confirmed that relative dose intensity is an important independent prognostic factor for survival.
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Affiliation(s)
- Ji Yoon Jeong
- Department of Surgery, Busan Paik Hospital, Inje University, Republic of Korea
| | - Sang Hyuk Seo
- Department of Surgery, Busan Paik Hospital, Inje University, Republic of Korea
| | - Kwang Hee Kim
- Department of Surgery, Busan Paik Hospital, Inje University, Republic of Korea.
| | - Min Sung An
- Department of Surgery, Busan Paik Hospital, Inje University, Republic of Korea
| | - HyungJoo Baik
- Department of Surgery, Busan Paik Hospital, Inje University, Republic of Korea
| | - Sang Hyun Kang
- Department of Surgery, Busan Paik Hospital, Inje University, Republic of Korea
| | - Sang Hoon Oh
- Department of Surgery, Busan Paik Hospital, Inje University, Republic of Korea
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Hua J, Lia Z, Ma C, Zhang X, Li Q, Duan X, Xiao T, Geng X. Risk factors analysis and establishment of predictive nomogram of extranodal B-cell lymphoma of mucosal-associated lymphoid tissue. Cancer Radiother 2023; 27:126-135. [PMID: 36894407 DOI: 10.1016/j.canrad.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/05/2022] [Accepted: 08/09/2022] [Indexed: 03/09/2023]
Abstract
PURPOSE The role of radiation therapy in mucosa-associated lymphoid tissue (MALT) lymphoma is poorly defined. The objective of this study was to explore the factors associated with the performance of radiotherapy and to assess its prognostic impact in patients with MALT lymphoma. PATIENTS AND METHODS Patients with MALT lymphoma diagnosed between 1992 and 2017 were identified in the US Surveillance, Epidemiology, and End Results database (SEER). Factors associated with the delivery of radiotherapy were assessed by chi-square test. Overall survival (OS) and lymphoma-specific survival (LSS) were compared between patients with and without radiotherapy, using Cox proportional hazard regression models, in patients with early stage as well as those with advanced stage. RESULTS Of the 10,344 patients identified with a diagnosis of MALT lymphoma, 33.6% had received radiotherapy; this rate was 38.9% for stage I/II patients and 12.0% for stage III/IV patients, respectively. Older patients and those who already received primary surgery or chemotherapy had a significantly lower rate of receiving radiotherapy, regardless of lymphoma stage. After univariate and multivariate analysis, radiotherapy was associated with improved OS and LSS in patients with stage I/II (HR=0.71 [0.65-0.78]) and (HR=0.66 [0.59-0.74]), respectively, but not in patients with stage III/IV (HR=1.01 [0.80-1.26]) and (HR=0.93 [0.67-1.29]). The nomogram built from the significant prognostic factors associated with overall survival of stage I/II patients had a good concordance (C-index=0.749±0.002). CONCLUSION This cohort study shows that radiotherapy is significantly associated with a better prognosis in patients with early but not advanced MALT lymphoma. Prospective studies are needed to confirm the prognostic impact of radiotherapy in patients with MALT lymphoma.
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Affiliation(s)
- J Hua
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - Z Lia
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - C Ma
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Zhang
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - Q Li
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Duan
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - T Xiao
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Geng
- Department of Radiotherapy, Liaocheng People's Hospital, 252000 Shan Dong, China.
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Liu Z, Zhang X, Lv P, Wu B, Bai S. Functional, oncological outcomes and safety of laparoscopic partial nephrectomy versus open partial nephrectomy in localized renal cell carcinoma patients with high anatomical complexity. Surg Endosc 2022; 36:7629-7637. [PMID: 35411462 DOI: 10.1007/s00464-022-09225-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/26/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Partial nephrectomy (PN) is the main treatment strategy for localized renal cell carcinoma (RCC). However, for RCC with high anatomical complexity, PN remains a challenge for urologists. Therefore, this study aimed to evaluate the functional oncological outcomes and safety of laparoscopic partial nephrectomy (LPN) versus open partial nephrectomy (OPN) in localized RCC patients with highly anatomical complexity (R.E.N.A.L. score ≥ 10). PATIENTS AND METHODS We retrospectively studied 575 patients who underwent PN at our center between January 2007 and December 2017. After propensity score-matching (PSM), 137 patients treated with LPN and 54 patients treated with OPN were balanced into 97 and 44 pairs. Patient demographics, and extensive perioperative and prognostic data were recorded and compared. RESULTS In the matched group, the OPN group had significantly less eGFR loss than the LPN group (2.57 ml/min/1.73 m2 vs. 31.59 ml/min/1.73 m2, P < 0.001). The recurrence-free survival (P = 0.287), overall survival (P = 0.296), cancer-specific survival (P = 0.664), and cardiocerebrovascular disease-specific survival (P = 0.341) were equivalent between groups. The rates of minor (P = 0.621) and major (P = 0.647) complications were also similar between groups. CONCLUSIONS This PSM cohort study showed that OPN resulted in better renal function preservation than LPN in localized RCC patients with high anatomical complexity, and had comparable oncological and safety outcomes after long-term follow-up. These findings may help improve clinical decision-making for localized RCC patients with high anatomical complexity.
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Affiliation(s)
- Zeqi Liu
- Department of Urology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning, 110004, People's Republic of China
| | - Xuanyu Zhang
- Department of Urology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning, 110004, People's Republic of China
| | - Peng Lv
- Department of Urology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning, 110004, People's Republic of China
| | - Bin Wu
- Department of Urology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning, 110004, People's Republic of China
| | - Song Bai
- Department of Urology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning, 110004, People's Republic of China.
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Ma R, Lu D, Wang B, Zhai X, Xia A, An L, Shi G, Cai Y, Lu Y, Pang S, Chen F, Xu H. Complete Cytoreductive Surgery vs. Debulking Surgery for pseudomyxoma peritonei of appendiceal origin: A propensity score-matched study based on a single-center experience. Eur J Surg Oncol 2021; 47:2369-2376. [PMID: 34034942 DOI: 10.1016/j.ejso.2021.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/07/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study aimed to report the prognostic predictors and compare the long-term outcomes of complete cytoreductive surgery (CCRS) vs. debulking surgery (DS) in patients with pseudomyxoma peritonei (PMP) of appendiceal origin. METHODS A retrospective analysis of 1008 consecutive patients with PMP undergoing primary surgery from January 2008 to December 2019 was performed. A propensity score-matched (PSM) analysis (1:1) was performed, and oncologic outcomes were compared between the CCRS and DS groups. RESULTS Out of 1008 patients, 258 patients were excluded. Baseline characteristics differed significantly between the CCRS and DS groups (total n = 750). After PSM, 106 patients were selected from each group and the baseline characteristics were matched between groups. There were significant differences between groups in operative time, the incidence of major complications (P = 0.017), and the numbers of organs removed. The median follow-up was 28 (1-131) months. Median overall survival (OS) for the 212 patients was 52.0 months (95% CI 40.2-63.8), and 10-year OS was 39.0%. Median OS could not be calculated for the CCRS group; in the DS group, this value was 41 months (P = 0.010). The 10-year OS rate was 54.2% in the CCRS group and 31.2% in the DS group. Multivariate analyses identified CCRS (P = 0.012) and histopathologic subtype (P < 0.001) as independent prognostic factors for OS. CONCLUSIONS In this matched-pair analysis of patients with appendiceal PMP, CCRS was safe and associated with better prognosis than DS. The completeness of cytoreduction and histopathologic subtype were two independent prognostic factors for OS.
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Affiliation(s)
- Ruiqing Ma
- Department of Myxoma, Aerospace Center Hospital, Beijing, China
| | - Dongmei Lu
- Department of Health Management, Aerospace Center Hospital, Beijing, China
| | - Bing Wang
- Department of Myxoma, Aerospace Center Hospital, Beijing, China
| | - Xichao Zhai
- Department of Myxoma, Aerospace Center Hospital, Beijing, China
| | - Ao Xia
- Department of Myxoma, Aerospace Center Hospital, Beijing, China
| | - Lubiao An
- Department of Myxoma, Aerospace Center Hospital, Beijing, China
| | - Guanjun Shi
- Department of Myxoma, Aerospace Center Hospital, Beijing, China
| | - Ying Cai
- Department of Myxoma, Aerospace Center Hospital, Beijing, China
| | - Yiyan Lu
- Department of Pathology, Aerospace Center Hospital, Beijing, China
| | - Shaojun Pang
- Department of Myxoma, Aerospace Center Hospital, Beijing, China
| | - Feng Chen
- Department of Myxoma, Aerospace Center Hospital, Beijing, China.
| | - Hongbin Xu
- Department of Myxoma, Aerospace Center Hospital, Beijing, China.
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Sutter W, Duceau B, Vignac M, Bonnet G, Carlier A, Roussel R, Trimaille A, Pommier T, Guilleminot P, Sagnard A, Pastier J, Weizman O, Giordano G, Cellier J, Geneste L, Panagides V, Marsou W, Deney A, Karsenty C, Attou S, Delmotte T, Ribeyrolles S, Chemaly P, Gautier A, Fauvel C, Chaumont C, Mika D, Pezel T, Cohen A, Potier L; Critical COVID-19 France Investigators. Association of diabetes and outcomes in patients with COVID-19: Propensity score-matched analyses from a French retrospective cohort. Diabetes Metab 2021; 47:101222. [PMID: 33388386 DOI: 10.1016/j.diabet.2020.101222] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 01/05/2023]
Abstract
Background Our study aimed to compare the clinical outcomes of patients with and without diabetes admitted to hospital with COVID-19. Methods This retrospective multicentre cohort study comprised 24 tertiary medical centres in France, and included 2851 patients (675 with diabetes) hospitalized for COVID-19 between 26 February and 20 April 2020. A propensity score-matching (PSM) method (1:1 matching including patients’ characteristics, medical history, vital statistics and laboratory results) was used to compare patients with and without diabetes (n = 603 per group). The primary outcome was admission to an intensive care unit (ICU) and/or in-hospital death. Results After PSM, all baseline characteristics were well balanced between those with and without diabetes: mean age was 71.2 years; 61.8% were male; and mean BMI was 29 kg/m2. A history of cardiovascular, chronic kidney and chronic obstructive pulmonary diseases were found in 32.8%, 22.1% and 6.4% of participants, respectively. The risk of experiencing the primary outcome was similar in patients with or without diabetes [hazard ratio (HR): 1.16, 95% confidence interval (CI): 0.95–1.41; P = 0.14], and was 1.29 (95% CI: 0.97–1.69) for in-hospital death, 1.26 (95% CI: 0.9–1.72) for death with no transfer to an ICU and 1.14 (95% CI: 0.88–1.47) with transfer to an ICU. Conclusion In this retrospective study cohort of patients hospitalized for COVID-19, diabetes was not significantly associated with a higher risk of severe outcomes after PSM. Trial registration number NCT04344327.
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Sueda T, Tei M, Nishida K, Yoshikawa Y, Matsumura T, Koga C, Wakasugi M, Miyagaki H, Kawabata R, Tsujie M, Hasegawa J. Oncological outcomes following laparoscopic surgery for pathological T4 colon cancer: a propensity score-matched analysis. Surg Today 2021; 51:404-14. [PMID: 32767131 DOI: 10.1007/s00595-020-02106-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
Abstract
PURPOSES Whether laparoscopic colectomy (LC) is safe and effective for patients with locally advanced T4 colon cancer remains controversial. This study aimed to compare the oncological outcomes of LC and open colectomy (OC) for patients with pathological (p) T4 colon cancer. METHODS We retrospectively analyzed 151 consecutive patients with pT4M0 colon cancer who underwent curative surgery between 2010 and 2017 using a propensity score-matched analysis. RESULTS After propensity score-matching, we enrolled 100 patients (n = 50 in each group). Median follow-up was 43.5 months. The conversion rate to laparotomy in this study was 5.5% for the entire patient cohort and 6.0% for the matched cohort. Compared to the OC group, the LC group showed reductions in estimated blood loss and length of postsurgical stay. Clavien-Dindo classification grade ≥ II and all-grade complication rates were significantly lower in the LC group than in the OC group. R0 resection was achieved in all patients with LC. No significant differences were found between the groups in terms of overall, cancer-specific, recurrence-free survival, or incidence of local recurrence among the entire patient cohort and matched cohort. CONCLUSIONS The oncological outcomes were similar between the LC and OC groups. LC offers a safe, feasible option for patients with pT4 colon cancer.
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Cai X, Zhang M, Liang C, Xu Y, Yu W. Delayed gastric emptying after Pancreaticoduodenectomy: a propensity score-matched analysis and clinical Nomogram study. BMC Surg 2020; 20:149. [PMID: 32646466 PMCID: PMC7346444 DOI: 10.1186/s12893-020-00809-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/29/2020] [Indexed: 01/08/2023] Open
Abstract
Background Delayed gastric emptying (DGE) is a common and frustrating complication of pancreaticoduodenectomy (PD). Studies suggest that surgical methods and other clinical characteristics may affect the occurrence of DGE. Nevertheless, the results of such studies are conflicting. The objective of this work was to perform a propensity score matching analysis to compare the differences between pylorus-preserving pancreaticoduodenectomy (PPPD) and pylorus-removing pancreaticoduodenectomy (PrPD) and to develop and validate a nomogram to predict the probability of severe DGE (SDGE). Methods This retrospective study enrolled patients who underwent PD at our institution from December 2009 to December 2018. Propensity score matching was applied at a ratio of 1:1 to compare PPPD and PrPD groups. We compared incidence of complications, DGE, lengths of hospital stay, hospitalization costs, and mortality. Univariate and multivariate logistic regression analysis were performed to identify potential risk factors of severe DGE. Finally, a nomogram was developed and validated to predict severe DGE. Results The PPPD group had a significantly higher rate of postoperative pancreatic fistula (29.9% versus 17.4%, P < 0.05) and less blood loss (463.7 ml versus 694.9 ml, P < 0.05). After propensity score matching, the PPPD group had a significantly higher rate of postoperative DGE (19.2% versus 3.8%, P < 0.05), especially severe DGE (17.3% versus 0%) than the PrPD group. There were no significant differences in terms of lengths of hospital stay, hospitalization costs or mortality between the groups. Surgical method, biliary leakage, abdominal infection, and diabetes were independent risk factors for SDGE. The nomogram predicted SDGE with a training C - index of 0.798 and a validation C - index of 0.721. Conclusion PPPD increases the risk of DGE than PrPD, especially SDGE. Our prediction nomogram gives good prediction of SDGE after pancreaticoduodenectomy.
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Affiliation(s)
- Xianlei Cai
- Department of Gastrointestinal Surgery, Ningbo Medical Center Lihuili Hospital, 57 Xingning Road, 315000, Ningbo, PR China
| | - Miaozun Zhang
- Department of Gastrointestinal Surgery, Ningbo Medical Center Lihuili Hospital, 57 Xingning Road, 315000, Ningbo, PR China
| | - Chao Liang
- Department of Gastrointestinal Surgery, Ningbo Medical Center Lihuili Hospital, 57 Xingning Road, 315000, Ningbo, PR China
| | - Yuan Xu
- Department of Gastrointestinal Surgery, Ningbo Medical Center Lihuili Hospital, 57 Xingning Road, 315000, Ningbo, PR China
| | - Weiming Yu
- Department of Gastrointestinal Surgery, Ningbo Medical Center Lihuili Hospital, 57 Xingning Road, 315000, Ningbo, PR China.
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Cunningham AJ, McClellan KV, Dewey E, Krishnaswami S, Butler MW, Nolt D, Fialkowski E, Haag MC, Hamilton NA. Perioperative neutropenia is not an independent risk factor for infectious complications of central venous line placement in children: A propensity score-matched analysis. J Pediatr Surg 2020; 55:1339-1343. [PMID: 31515110 DOI: 10.1016/j.jpedsurg.2019.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/08/2019] [Accepted: 08/07/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The infectious risk of central venous line (CVL) placement in children with neutropenia (absolute neutrophil count [ANC] <500/mm3) is not well defined. This study aims to investigate the early (≤30 days) and late (>30 days) infectious complications of CVLs placed in pediatric patients with and without neutropenia. METHODS A retrospective review was conducted of all CVLs placed by pediatric surgeons at two institutions from 2010 to 2017. Multivariable logistic regression was performed to identify risk factors for line infection. Propensity score-matched cohorts of patients with and without neutropenia were compared in a 1:1 ratio. Wilcoxon rank-sum, Chi-square, Fisher's exact, and log-rank tests were also performed. RESULTS Review identified 1,102 CVLs placed in 937 patients. Fifty-four patients were neutropenic at the time of placement. Multivariable analysis demonstrated tunneled catheters and subclavian access as associated with line infection. The propensity score-matched cohort included 94 patients, 47 from each group. Demographic and preoperative data were similar between the groups (p > 0.05). Patients with neutropenia were no more likely to develop early (4.3% vs. 2.1%, p = 1.000) or late (19.1% vs. 17.0%, p = 1.000) infectious complications than patients without neutropenia, with similar median time to infection (141 vs. 222 days, p = 0.370). CONCLUSION A policy of selective CVL placement in neutropenic patients with standardized postoperative line maintenance is safe. Future directions include defining criteria by which neutropenic patients could be prospectively selected for safe CVL placement. LEVEL OF EVIDENCE II - Retrospective cohort study.
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Affiliation(s)
- Aaron J Cunningham
- Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
| | | | - Elizabeth Dewey
- Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Sanjay Krishnaswami
- Division of Pediatric Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Marilyn W Butler
- Division of Pediatric Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Dawn Nolt
- Division of Pediatric Infectious Diseases, Oregon Health & Science University, Portland, OR, USA
| | - Elizabeth Fialkowski
- Division of Pediatric Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Meredith C Haag
- School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Nicholas A Hamilton
- Division of Pediatric Surgery, Oregon Health & Science University, Portland, OR, USA
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13
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Han DH, Choi SH, Kang CM, Lee WJ. Propensity score-matching analysis for single-site robotic cholecystectomy versus single-incision laparoscopic cholecystectomy: A retrospective cohort study. Int J Surg 2020; 78:138-142. [PMID: 32334076 DOI: 10.1016/j.ijsu.2020.04.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/06/2020] [Accepted: 04/15/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Although the single-site robotic cholecystectomy(SSRC) has been performed with expectation of overcoming the limitation of single-incision laparoscopic cholecystectomy(SILC), there exists a lack of comparison studies involving SILC and SSRC. This study aimed to analyze surgical outcomes of single-site robotic cholecystectomy and single-incision laparoscopic cholecystectomy by propensity score-matching analysis. MATERIALS AND METHODS From March 2009 to August 2015, 290 consecutive patients underwent SSRC or SILC at Severance Hospital, Seoul, Korea. Potential confounding factors for operative outcomes were adjusted by propensity score-matching analysis. One hundred four patients from each group were evaluated for perioperative outcomes and compared for a retrospective cohort study. RESULTS There was no difference in potential cofounders such as gender, age, body mass index (BMI), and perioperative cholecystitis-related symptoms between two groups after propensity score-matching. However, mean operation time was shorter (56.69 ± 13.65 vs. 101.57 ± 27.05 min; p < 0.001) and median bleeding amount during surgery was less (0 (0-50) vs. 0 (0-100) mL; p < 0.001) in the SILC group. There was no significant difference between the two groups regarding conversion to conventional multiport cholecystectomy. Bile leakage due to perforation of the gallbladder during surgery was more common in the SILC group (6.7% vs. 17.3%; p = 0.019). Moreover, bile spillage rate was significantly increased in conjunction with a higher BMI in the SILC group, whereas BMI did not affect the bile leakage rate in the SSRC group. CONCLUSIONS SSRC is not superior to SILC except regarding bile spillage incidence. However, the technical stability and clinically undetected advantages of SSRC are expected to prompt surgeons to perform this more reliable procedure.
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Affiliation(s)
- Dai Hoon Han
- Department of HBP Surgery, Yonsei University College of Medicine, Seoul, South Korea; Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, South Korea
| | - Sung Hoon Choi
- Department of Surgery, CHA Bundang Medical Center, CHA, Seongnam, South Korea
| | - Chang Moo Kang
- Department of HBP Surgery, Yonsei University College of Medicine, Seoul, South Korea; Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, South Korea.
| | - Woo Jung Lee
- Department of HBP Surgery, Yonsei University College of Medicine, Seoul, South Korea; Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, South Korea
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14
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Sueda T, Tei M, Yoshikawa Y, Furukawa H, Matsumura T, Koga C, Wakasugi M, Miyagaki H, Kawabata R, Tsujie M, Hasegawa J. Prognostic impact of postoperative intra-abdominal infections after elective colorectal cancer resection on survival and local recurrence: a propensity score-matched analysis. Int J Colorectal Dis 2020; 35:413-422. [PMID: 31897647 DOI: 10.1007/s00384-019-03493-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE Several authors have reported an association between anastomotic leak and/or intra-abdominal abscess and oncological survival and recurrence. However, no reports have investigated whether combining anastomotic leak/intra-abdominal abscess and positive drainage culture influences long-term oncological outcomes. Therefore, we defined these complications as postoperative intra-abdominal infections. The present study aimed to evaluate the prognostic impact of postoperative intra-abdominal infections on long-term oncological outcomes after curative stage I-III colorectal cancer surgery. METHODS We performed a retrospective analysis of 755 consecutive patients with stage I-III colorectal cancer undergoing curative surgery between 2010 and 2015 by performing a propensity score-matched analysis to reduce selection bias. RESULTS Of the 755 patients, 62 were matched for postoperative intra-abdominal infections analyses. The median follow-up was 48 months. Compared with the non-infections group, the postoperative intra-abdominal infections group had a significantly shorter local recurrence-free survival (P = 0.01 prior to matching, and P = 0.05 after matching). No significant difference was found between the groups in terms of overall, cancer-specific free, recurrence-free, or distant recurrence-free survival. However, multivariate analyses identified postoperative intra-abdominal infections as an independent prognostic factor for local recurrence-free survival (P = 0.04 prior to matching, and P = 0.03 after matching). CONCLUSIONS In this matched-pair analysis comparing stage I-III colorectal cancer patients with and without postoperative intra-abdominal infections, postoperative intra-abdominal infections were associated with poor local recurrence-free survival, but not overall, cancer-specific free, recurrence-free, or distant recurrence-free survival.
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Affiliation(s)
- Toshinori Sueda
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan.
| | - Mitsuyoshi Tei
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan
| | - Yukihiro Yoshikawa
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan
| | - Haruna Furukawa
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan
| | - Tae Matsumura
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan
| | - Chikato Koga
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan
| | - Masaki Wakasugi
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan
| | - Hiromichi Miyagaki
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan
| | - Ryohei Kawabata
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan
| | - Masanori Tsujie
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan
| | - Junichi Hasegawa
- Department of Gastroenterological Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan
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15
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Dohi O, Yoshida N, Terasaki K, Azuma Y, Ishida T, Kitae H, Matsumura S, Ogita K, Takayama S, Mizuno N, Nakano T, Hirose R, Inoue K, Kamada K, Uchiyama K, Ishikawa T, Takagi T, Kishimoto M, Konishi H, Naito Y, Itoh Y. Efficacy of Clutch Cutter for Standardizing Endoscopic Submucosal Dissection for Early Gastric Cancer: A Propensity Score-Matched Analysis. Digestion 2020; 100:201-209. [PMID: 30522097 DOI: 10.1159/000495287] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/09/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS The purpose of this study was to evaluate the safety and efficacy of gastric endoscopic submucosal dissection (ESD) using the Clutch Cutter (CC), a scissor-type knife, compared with those of procedures using conventional devices. METHODS This single-center retrospective study evaluated 237 patients with early gastric cancer: 83 who underwent ESD using the CC group and 154 who underwent ESD using the insulated-tip knife 2 (IT2 group). Clinicopathological features and technical outcomes were compared between the 2 groups using a propensity score-matched analysis. RESULTS In 61 pairs of matched patients, there was no significant difference in R0 resection, perforation, or postoperative bleeding between the CC and IT2 groups. Comparisons between the 2 groups showed similar treatment outcomes for an expert endoscopist. Nevertheless, there were significant differences between the 2 groups for nonexperts in terms of self-completion (61.7 and 24.5%, respectively, p < 0.001), mean procedure times (45 and 61 min, respectively, p = 0.002), and mean numbers of intraoperative bleeding points and bleeding points requiring hemostatic forceps (3 and 0 vs. 8 and 3, respectively, p < 0.001). CONCLUSION Better self-completion rates and shorter procedure times were noted for gastric ESD using the CC by nonexperts than for that using IT2, probably due to hemostatic efficacy.
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Affiliation(s)
- Osamu Dohi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan,
| | - Naohisa Yoshida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kei Terasaki
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuka Azuma
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tsugitaka Ishida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroaki Kitae
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinya Matsumura
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuyuki Ogita
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shun Takayama
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naoki Mizuno
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takahiro Nakano
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryohei Hirose
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ken Inoue
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuhiro Kamada
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuhiko Uchiyama
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takeshi Ishikawa
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomohisa Takagi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mitsuo Kishimoto
- Department of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hideyuki Konishi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuji Naito
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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16
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Pirruccio K, Sloan M, Sheth NP. Trends in obesity prevalence among total hip arthroplasty patients and the effect on surgical outcomes, 2008-2016. J Orthop 2019; 16:347-52. [PMID: 31007457 DOI: 10.1016/j.jor.2019.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/25/2019] [Indexed: 02/08/2023] Open
Abstract
Introduction The prevalence of obesity continues to rise in parallel with demand for total hip arthroplasty (THA). This study aims to report obesity trends in primary THA and its effects on procedure outcomes in the United States, stratifying based on Body Mass Index (BMI). Methods Primary THA procedures were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2008-2016). Patient demographic (including BMI), primary outcomes (death; serious morbidity), and secondary outcome variables were analyzed. Using BMI comparison groups (Obese: BMI > 30 [O]; Morbidly Obese: BMI > 40 [MO]) for case populations, univariate, propensity score-matched, and multivariate logistic regression analyses were performed. Results The prevalence of obesity increased among primary THA (2008: 546/1200 [45.5%], 2016: 16,078/34,137 [47.1%]) cases. Data on 135,013 primary THA cases were analyzed. Propensity score-matched analyses demonstrated that both serious morbidity (O: OR = 0.73, p < 0.001; MO: OR = 0.84, p = 0.001) and frequency of discharges home (O: OR = 0.90, p < 0.001; MO: OR = 0.71, p < 0.001) were significantly reduced. Instead, long operative times (O: OR = 1.30, p < 0.001; MO: OR = 1.53, p < 0.001), readmission (O: OR = 1.27, p < 0.001; MO: OR = 1.49, p < 0.001), and reoperation (O: OR = 1.44, p < 0.001, MO: OR = 1.96, p < 0.001) were all significantly increased in both obese and morbidly obese cases. Death (OR = 0.29; p = 0.016) was decreased in the MO cohort, while length of stay (OR = 1.19, p = 0.004) was increased in the MO cohort. Conclusion Both obese and morbidly obese primary THA patient populations were associated with variably increased complication risks; morbidly obese patients had higher complication rates relative to obese patients. Orthopaedic surgeons should continue to consider obesity as a risk factor for THA complications. However, given similar functional outcomes and satisfaction levels as non-obese patients, denying patients THA surgery based on BMI alone may merit reconsideration.
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Liu GY, Lv X, Wu YS, Mao MJ, Ye YF, Yu YH, Liang H, Yang J, Ke LR, Qiu WZ, Huang XJ, Li WZ, Guo X, Xiang YQ, Xia WX. Effect of induction chemotherapy with cisplatin, fluorouracil, with or without taxane on locoregionally advanced nasopharyngeal carcinoma: a retrospective, propensity score-matched analysis. Cancer Commun (Lond) 2018; 38:21. [PMID: 29764487 PMCID: PMC5993041 DOI: 10.1186/s40880-018-0283-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 01/23/2018] [Indexed: 01/19/2023] Open
Abstract
Background Available data in the literature comparing different induction chemotherapy (IC) regimens on locoregionally advanced nasopharyngeal carcinoma (NPC) are scarce. The purpose of the present study was to evaluate the outcomes of locoregionally advanced NPC patients who were treated with taxane, cisplatin and 5-fluorouracil (TPF) or cisplatin and 5-fluorouracil (PF) as IC followed by concurrent chemoradiotherapy (CCRT). Methods In total, 1879 patients with locoregionally advanced NPC treated with IC and CCRT from a prospectively maintained database were included in the present observational study. We compared overall survival (OS), disease-specific survival (DSS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival, using the propensity score method. Results In total, 1256 patients received TPF or PF as IC backbone. The TPF group showed significantly better OS (hazard ratio [HR], 0.660; 95% confidence interval [CI] 0.442–0.986; P = 0.042), DSS (HR, 0.624; 95% CI 0.411–0.947; P = 0.027) and DMFS (HR, 0.589; 95% CI 0.406–0.855; P = 0.005) compared with the PF group in multivariable analyses. Propensity score matching identified 294 patients in each cohort and confirmed that TPF was associated with significantly improved 5-year OS (88.1% vs. 80.7%; P = 0.042), DSS (88.5% vs. 80.7%; P = 0.021) and DMFS (87.9% vs. 78.6%; P = 0.012) rates compared with the PF group. There were no significant differences in locoregional relapse-free survival before or after matching. Conclusions In our study, IC with the TPF regimen combined with CCRT showed improved long-term survival for the patients with locoregionally advanced NPC compared with the PF regimen. However, a prospective randomized clinical trial to validate these findings is necessary.
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Affiliation(s)
- Guo-Ying Liu
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | - Xing Lv
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | - Yi-Shan Wu
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | - Min-Jie Mao
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yan-Fang Ye
- The Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ya-Hui Yu
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | - Hu Liang
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | - Jing Yang
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Liang-Ru Ke
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | - Wen-Ze Qiu
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | - Xin-Jun Huang
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | - Wang-Zhong Li
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | - Xiang Guo
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China
| | - Yan-Qun Xiang
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China. .,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.
| | - Wei-Xiong Xia
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China. .,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.
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Nakamura M, Wakabayashi G, Miyasaka Y, Tanaka M, Morikawa T, Unno M, Tajima H, Kumamoto Y, Satoi S, Kwon M, Toyama H, Ku Y, Yoshitomi H, Nara S, Shimada K, Yokoyama T, Miyagawa S, Toyama Y, Yanaga K, Fujii T, Kodera Y, Tomiyama Y, Miyata H, Takahara T, Beppu T, Yamaue H, Miyazaki M, Takada T. Multicenter comparative study of laparoscopic and open distal pancreatectomy using propensity score-matching. J Hepatobiliary Pancreat Sci 2015; 22:731-6. [PMID: 26087943 DOI: 10.1002/jhbp.268] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 05/17/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Laparoscopic distal pancreatectomy has been shown to be associated with favorable postoperative outcomes using meta-analysis. However, there have been no randomized controlled studies yet. This study aimed to compare laparoscopic and open distal pancreatectomy using propensity score-matching. METHODS We retrospectively collected perioperative data of 2,266 patients who underwent distal pancreatectomy in 69 institutes from 2006-2013 in Japan. Among them, 2,010 patients were enrolled in this study and divided into two groups, laparoscopic distal pancreatectomy and open distal pancreatectomy. Perioperative outcomes were compared between the groups using unmatched and propensity matched analysis. RESULTS After propensity score-matching, laparoscopic distal pancreatectomy was associated with favorable perioperative outcomes compared with open distal pancreatectomy, including higher rate of preservation of spleen and splenic vessels (P < 0.001); lower rates of intraoperative transfusion (P = 0.020), clinical grade of pancreatic fistula (International Study Group on Pancreatic Fistula grade B and C; P < 0.001), and morbidity (P < 0.001); and shorter hospital stay (P = 0.001), but a longer operative time (P < 0.001). CONCLUSIONS Laparoscopic distal pancreatectomy was associated with more favorable perioperative outcomes than open distal pancreatectomy.
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Affiliation(s)
- Masafumi Nakamura
- Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan.,Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Go Wakabayashi
- Department of Surgery, Iwate Medical University School of Medicine, Morioka, Japan
| | - Yoshihiro Miyasaka
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masao Tanaka
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Morikawa
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Michiaki Unno
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Tajima
- Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yusuke Kumamoto
- Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Sohei Satoi
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - Masanori Kwon
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - Hirochika Toyama
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yonson Ku
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideyuki Yoshitomi
- Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Nara
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuaki Shimada
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Takahide Yokoyama
- First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shinichi Miyagawa
- First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoichi Toyama
- The Jikei University School of Medicine, Tokyo, Japan
| | | | - Tsutomu Fujii
- Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | | - Yasuyuki Tomiyama
- Department of Hepatology and Pancreatology, Kawasaki Medical School, Kurashiki, Japan
| | - Hiroaki Miyata
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeshi Takahara
- Department of Surgery, Iwate Medical University School of Medicine, Morioka, Japan
| | - Toru Beppu
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masaru Miyazaki
- Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tadahiro Takada
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
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Cansino JM, Lopez-Melendo J, Pablo-Romero MDP, Sánchez-Braza A. An economic evaluation of public programs for internationalization: the case of the Diagnostic Program in Spain. Eval Program Plann 2013; 41:38-46. [PMID: 23920021 DOI: 10.1016/j.evalprogplan.2013.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 06/04/2013] [Accepted: 07/10/2013] [Indexed: 06/02/2023]
Abstract
This paper evaluates the Diagnostic Program in Spain which is a publicly funded program to promote internationalization of companies located in Andalusia (south of Spain). The methodology used is the propensity score-matching. The treatment group consists of companies which participated in the Program until 2008. The control group has companies which planned to participate in the Program but had not done so up to that date. The response variable measures the ratio of export to total sales for each company. Four covariates have been taken into account: activity, location, sales and number of employees. The analysis leads to the conclusion that the companies that participated in the Program improved their ratio of exports to total sales by about 10 percentage points.
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Affiliation(s)
- José M Cansino
- Department of Economic Analysis and Political Economy, Facultad de CC, Economicas y Empresariales, Universidad de Sevilla, Ramon y Cajal, 1, 41018 Sevilla, Spain.
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