scholarly journals Laparoscopic surgery for patients with colorectal cancer produces better short‐term outcomes with similar survival outcomes in elderly patients compared to open surgery

2016 ◽  
Vol 5 (6) ◽  
pp. 1047-1054 ◽  
Author(s):  
Soo Yun Moon ◽  
Sohee Kim ◽  
Soo Young Lee ◽  
Eon Chul Han ◽  
Sung‐Bum Kang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Open Surgery ◽  
Survival Outcomes ◽  
Short Term ◽  
Similar Survival

Economic evaluation of laparoscopic surgery for colorectal cancer

2007 ◽  
Vol 23 (4) ◽  
pp. 464-472 ◽  
Author(s):  
Robyn M. de Verteuil ◽  
Rodolfo A. Hernández ◽  
Luke Vale ◽  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Laparoscopic Surgery ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Open Surgery ◽  
Disease Free Survival ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Short Term

Objectives: The aim of this study was to assess the cost-effectiveness of laparoscopic surgery compared with open surgery for the treatment of colorectal cancer.Methods: A Markov model was developed to model cost-effectiveness over 25 years. Data on the clinical effectiveness of laparoscopic and open surgery for colorectal cancer were obtained from a systematic review of the literature. Data on costs came from a systematic review of economic evaluations and from published sources. The outcomes of the model were presented as the incremental cost per life-year gained and using cost-effectiveness acceptability curves to illustrate the likelihood that a treatment was cost-effective at various threshold values for society's willingness to pay for an additional life-year.Results: Laparoscopic surgery was on average £300 more costly and slightly less effective than open surgery and had a 30 percent chance of being cost-effective if society is willing to pay £30,000 for a life-year. One interpretation of the available data suggests equal survival and disease-free survival. Making this assumption, laparoscopic surgery had a greater chance of being considered cost-effective. Presenting the results as incremental cost per quality-adjusted life-year (QALY) made no difference to the results, as utility data were poor. Evidence suggests short-term benefits after laparoscopic repair. This benefit would have to be at least 0.01 of a QALY for laparoscopic surgery to be considered cost-effective.Conclusions: Laparoscopic surgery is likely to be associated with short-term quality of life benefits, similar long-term outcomes, and an additional £300 per patient. A judgment is required as to whether the short-term benefits are worth this extra cost.

Short-term clinical outcomes from a randomized controlled trial to evaluate laparoscopic and open surgery for stage II-III colorectal cancer: Japan Clinical Oncology Group study JCOG 0404 (NCT00147134).

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 538-538
Author(s):  
Seiichiro Yamamoto ◽  
Masafumi Inomata ◽  
Seigo Kitano ◽  
Hiroshi Katayama ◽  
Junki Mizusawa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Laparoscopic Surgery ◽  
Open Surgery ◽  
Controlled Trial ◽  
Short Term ◽  
Primary Analysis ◽  
Eligibility Criteria ◽  
Minimization Method ◽  
Term Survival

538 Background: The benefits of laparoscopic surgery (LAP) in comparison with open surgery (OP) have been suggested; however, the long-term survival after LAP for advanced colorectal cancer (CRC) requiring complete mesocolic excision is still unclear. We conducted a study to confirm the non-inferiority of LAP to OP in terms of overall survival with less frequent post-operative morbidity. The primary analysis is planned in 2014, and short-term outcomes including post-operative complications are presented here. Methods: Only accredited surgeons from 30 Japanese institutions participated. Eligibility criteria included histologically proven CRC; tumor located in the cecum, ascending, sigmoid or rectosigmoid colon; T3 or deeper lesion without involvement of other organs; N0–2 and M0; tumor size =<8 cm; patient age 20-75 years. Patients were randomized preoperatively by the minimization method. Patients with pathological stage III received adjuvant chemotherapy with fluorouracil plus leucovorin. The primary endpoint is overall survival, and the planned sample size was 1050. Results: A total of 1057 patients were randomized (OP: 528, LAP: 529) between October 2004 and March 2009. Patients assigned to LAP had less blood loss than those assigned to OP (median 30 ml vs 85 ml, p<0.001), although LAP lasted 52 minutes longer than OP (p<0.001). Radicality of resection, as assessed by the number of resected lymph nodes, did not differ between the two groups. LAP was associated with earlier recovery of bowel function (p<0.001), and with a shorter hospital stay (p<0.0001) than OP. Morbidity and mortality until discharge did not differ between the two groups, except for fewer wound-related complications in LAP (p=0.007). Conclusions: Short-term clinical benefits of LAP were demonstrated, and laparoscopic surgery for advanced CRC can be performed safely by experienced surgeons. If the non-inferiority of LAP in overall survival is demonstrated in the primary analysis planned in 2014, LAP will be the new standard surgical procedure for CRC.

Midterm follow-up of a randomized trial of open surgery versus laparoscopic surgery in elderly patients with colorectal cancer

2017 ◽  
Vol 31 (10) ◽  
pp. 3890-3897 ◽  
Author(s):  
Atsushi Ishibe ◽  
Mitsuyoshi Ota ◽  
Shoichi Fujii ◽  
Yusuke Suwa ◽  
Shinsuke Suzuki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Randomized Trial ◽  
Open Surgery ◽  
Surgery In Elderly

scholarly journals One-Stage Total Laparoscopic Treatment for Colorectal Cancer With Synchronous Metastasis. Is It Safe and Feasible?

2021 ◽  
Vol 8 ◽  
Author(s):  
Giuseppe Sena ◽  
Arcangelo Picciariello ◽  
Fabio Marino ◽  
Marta Goglia ◽  
Aldo Rocca ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Hospital Stay ◽  
Open Surgery ◽  
Disease Free Survival ◽  
Long Term Outcomes ◽  
Short Term ◽  
One Stage

Liver is the main target organ for colorectal cancer (CRC) metastases. It is estimated that ~25% of CRC patients have synchronous metastases at diagnosis, and about 60% of CRC patients will develop metastases during the follow up. Although several teams have performed simultaneous laparoscopic resections (SLR) of liver and colorectal lesions, the feasibility and safety of this approach is still widely debated and few studies on this topic are present in the literature. The purpose of this literature review is to understand the state of the art of SLR and to clarify the potential benefits and limitations of this approach. Several studies have shown that SLR can be performed safely and with short-term outcomes similarly to the separated procedures. Simultaneous laparoscopic colorectal and hepatic resections combine the advantages of one stage surgery with those of laparoscopic surgery. Several reports compared the short-term outcomes of one stage laparoscopic resection with open resections and showed a similar or inferior amount of blood loss, a similar or lower complication rate, and a significant reduction of hospital stay for laparoscopic surgery respect to open surgery but much longer operating times for the laparoscopic technique. Few retrospective studies compared long term outcomes of laparoscopic one stage surgery with the outcomes of open one stage surgery and did not identify any differences about disease free survival and the overall survival. In conclusion, hepatic and colorectal SLR are a safe and effective approach characterized by less intraoperative blood loss, faster recovery of intestinal function, and shorter length of postoperative hospital stay. Moreover, laparoscopic approach is associated to lower rates of surgical complications without significant differences in the long-term outcomes compared to the open surgery.

scholarly journals Advantage of laparoscopy surgery for elderly colorectal cancer patients without compromising oncologic outcome

2020 ◽  
Author(s):  
Yih Jong Chern ◽  
Hsin-Yuan Hung ◽  
Jeng-Fu You ◽  
Yu-Jen Hsu ◽  
Jy-Ming Chiang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Open Surgery ◽  
Medical Center ◽  
Postoperative Mortality ◽  
Long Term Outcomes ◽  
Postoperative Stay ◽  
Conversion Rates

Abstract Background: Laparoscopic surgery has achieved good results in elderly patients with colorectal cancer (CRC). In this study, we compared the short-term and long-term outcomes of open surgery and laparoscopic surgery in CRC patients aged above 75 years at a single tertiary medical center.Methods: Between January 2009 and December 2015, we studied 967 patients who underwent curative resection for primary colorectal adenocarcinoma without distant metastasis in a single institution. Of the enrolled subjects, 305 underwent laparoscopic surgery, and 662 received open laparotomy surgery.Results: Compared to the patients who received open surgery, those received laparoscopic surgery had prominent shorter postoperative stay (10.3 vs. 13.5 days p < 0.001) and similar postoperative mortality (p = 0.082) and morbidity (p = 0.354). In the laparoscopy cohort, 6 of 305 patients were converted to open surgery and 1 died. The long-term overall survival, cancer-specific survival and recurrence rate were all similar between both cohorts in each stage.Conclusions: Laparoscopic surgery is suitable for elderly patients due to shorter postoperative stay, similar long-term outcomes with open surgery and acceptably low conversion rates. For long-term overall and oncological outcome, the results of laparoscopic surgery were similar to that of open surgery in each TNM stage.

scholarly journals Decreasing Postoperative Pulmonary Complication Following Laparoscopic Surgery in Elderly Individuals with Colorectal Cancer: A Competing Risk Analysis in a Propensity Score–Weighted Cohort Study

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 131
Author(s):  
Yih-Jong Chern ◽  
Jeng-Fu You ◽  
Ching-Chung Cheng ◽  
Jing-Rong Jhuang ◽  
Chien-Yuh Yeh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Risk Analysis ◽  
Elderly Patients ◽  
Open Surgery ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
Long Term Outcomes ◽  
Laparoscopy Group

Advanced age is a risk factor for major abdominal surgery due to a decline in physical function and increased comorbidities. Although laparoscopic surgery provides good results in most patients with colorectal cancer (CRC), its effect on elderly patients remains unclear. This study aimed to compare the short- and long-term outcomes between open and laparoscopic surgeries in elderly patients with CRC. Total 1350 patients aged ≥75 years who underwent curative resection for stage I–III primary CRC were enrolled retrospectively and were divided into open surgery (846 patients) and laparoscopy (504 patients) groups. After propensity score weighting to balance an uneven distribution, a competing risk analysis was used to analyze the short-term and long-term outcomes. Postoperative mortality rates were lower in the laparoscopy group, especially due to pulmonary complications. Postoperative hospital stay was significantly shorter in the laparoscopy group than in the open surgery group. Overall survival, disease-free survival, and competing risk analysis showed no significant differences between the two groups. Laparoscopic surgery for elderly patients with CRC significantly decreased pulmonary-related postoperative morbidity and mortality in this large cohort study. Laparoscopic surgery is a favorable method for elderly patients with CRC than open surgery in terms of less hospital stay and similar oncological outcomes.

scholarly journals Advantage of Laparoscopy Surgery for Elderly Colorectal Cancer Patients without Compromising Oncologic Outcome

2020 ◽  
Author(s):  
Yih Jong Chern ◽  
Hsin-Yuan Hung ◽  
Jeng-Fu You ◽  
Yu-Jen Hsu ◽  
Jy-Ming Chiang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Open Surgery ◽  
Medical Center ◽  
Postoperative Mortality ◽  
Long Term Outcomes ◽  
Postoperative Stay ◽  
Conversion Rates

Abstract Backgrounds: Laparoscopic surgery has achieved good results in elderly patients with colorectal cancer (CRC). In this study, we compared the short-term and long-term outcomes of open surgery and laparoscopic surgery in CRC patients aged above 75 years at a single tertiary medical center.Methods: Between January 2009 and December 2015, we studied 967 patients who underwent curative resection for primary colorectal adenocarcinoma without distant metastasis in a single institution. Of the enrolled subjects, 305 underwent laparoscopic surgery, and 662 received open laparotomy surgery.Results: Compared to the patients who received open surgery, those received laparoscopic surgery had prominent shorter postoperative stay (10.3 vs. 13.5 days p < 0.001) and similar postoperative mortality (p = 0.082) and morbidity (p = 0.354). In the laparoscopy cohort, 6 of 305 patients were converted to open surgery and 1 died. The long-term overall survival, cancer-specific survival and recurrence rate were all similar between both cohorts in each stage.Conclusions: Laparoscopic surgery is suitable for elderly patients due to shorter postoperative stay, similar long-term outcomes with open surgery and acceptably low conversion rates. For long-term overall and oncological outcome, the results of laparoscopic surgery were similar to that of open surgery in each TNM stage.

scholarly journals Advantage of laparoscopy surgery for elderly colorectal cancer patients without compromising oncologic outcome

2020 ◽  
Author(s):  
Yih Jong Chern ◽  
Hsin-Yuan Hung ◽  
Jeng-Fu You ◽  
Yu-Jen Hsu ◽  
Jy-Ming Chiang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Open Surgery ◽  
Medical Center ◽  
Long Term Outcomes ◽  
Cancer Specific Survival ◽  
Postoperative Stay ◽  
Conversion Rates

Abstract Background: Laparoscopic surgery has achieved significant results in elderly patients with colorectal cancer (CRC). In this study, we compared the short-term and long-term outcomes of open surgery and laparoscopic surgery in patients with CRC aged above 75 years at a single tertiary medical center.Methods: We analyzed 967 patients who underwent curative resection for primary colorectal adenocarcinoma without distant metastasis between January 2009 and December 2015, in a single institution. Of the enrolled patients, 305 underwent laparoscopic surgery, and 662 received open laparotomy surgery.Results: Compared to the patients who underwent open surgery, those who received laparoscopic surgery had significantly shorter postoperative stay (10.3 vs. 13.5 days p < 0.001) and similar postoperative morbidity (p = 0.354) and mortality (p = 0.082). In the laparoscopy cohort, six of 305 patients were converted to open surgery and one died. The long-term overall survival, cancer-specific survival, and recurrence rate were similar between both cohorts in each stage.Conclusions: Laparoscopic surgery is suitable for elderly patients owing to shorter postoperative stay, similar long-term outcomes with open surgery, and acceptable low conversion rates. For long-term overall and oncological outcomes, the results of laparoscopic surgery were similar to that of open surgery in each TNM stage.

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