scholarly journals Comparative Quality of Laparoscopic and Open Cholecystectomy in the Elderly Using Propensity Score Matching Analysis

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Kazuaki Kuwabara ◽  
Shinya Matsuda ◽  
Koichi Benjamin Ishikawa ◽  
Hiromasa Horiguchi ◽  
Kenji Fujimori
Keyword(s):  
Postoperative Complications ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Open Cholecystectomy ◽  
Severe Disease ◽  
The Elderly ◽  
Propensity Score Matching Analysis ◽  
Safe Technique

The safety of laparoscopic cholecystectomy (LC) in patients ≥65 years of age requires further investigation of postoperative outcomes before it becomes more widely accepted as a safe technique. The advantages of using LC versus open cholecystectomy (OC) in elderly patients were analyzed using propensity score matching. The demographics, cholecystitis severity, comorbidities, complications, and admission and discharge Barthel Index (BI) scores of patients with benign gallbladder diseases were analyzed. Outcomes were analyzed by age, length of stay (LOS), total charges (TCs), BI improvement, and postoperative complications. OC, which was indicated in severe disease cases, increased hospital resource use and caused more complications than LC, but did not improve BI. Advanced age and OC resulted in greater LOS and TCs and was the best indicator of BI deterioration. Whenever possible, surgeons should use LC in elderly patients to minimize postoperative complications and allow them to regain a good quality of life.

scholarly journals Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ke-Min Jin ◽  
Kun Wang ◽  
Quan Bao ◽  
Hong-Wei Wang ◽  
Bao-Cai Xing
Keyword(s):  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Disease Free Survival ◽  
The Elderly ◽  
Multivariate Regression Analysis ◽  
Cancer Specific Survival ◽  
Younger Patients ◽  
Propensity Score Matching Analysis ◽  
American Society

Abstract Background Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients. Methods From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥ 70 years of age) were matched to 128 younger patients (< 70 years of age) to obtain two balanced groups with regard to demographic, therapeutic, and prognostic factors. Results There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score III and comorbidities and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p < 0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175 ml vs. 200 ml, p = 0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p = 0.020), and a higher readmission rate (4.7% vs.0%, p = 0.036). The EG also had longer disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p > 0.05). Old age was not an independent factor for DFS, OS, and CSS by Cox multivariate regression analysis (p > 0.05). Conclusions Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS, and CSS.

scholarly journals Liver Resection for Colorectal Liver-limited Metastases in Elderly Patients: A Propensity Score Matching Analysis

2020 ◽  
Author(s):  
Ke-Min Jin ◽  
Kun Wang ◽  
Quan Bao ◽  
Hong-Wei Wang ◽  
Bao-Cai Xing
Keyword(s):  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Disease Free Survival ◽  
The Elderly ◽  
Multivariate Regression Analysis ◽  
Cancer Specific Survival ◽  
Younger Patients ◽  
Propensity Score Matching Analysis ◽  
American Society

Abstract Background: Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients.Methods: From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥70 years of age) were matched to 128 younger patients (＜70 years of age) to obtain two balanced groups with regards to demographic, therapeutic and prognostic factors.Results: There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score Ⅲ and comorbidities, and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p<0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175ml vs. 200ml, p=0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p=0.020) and a higher readmission rate (4.7% vs.0%, p=0.036). The EG also had longer disease-free survival (DFS), overall survival (OS) and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p>0.05). Old age was not an independent factor for DFS, OS and CSS by Cox multivariate regression analysis (p>0.05).Conclusions: Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS and CSS.

scholarly journals Liver Resection for Colorectal Liver-limited Metastases in Elderly Patients: A Propensity Score Matching Analysis

2020 ◽  
Author(s):  
Ke-Min Jin ◽  
Kun Wang ◽  
Quan Bao ◽  
Hong-Wei Wang ◽  
Bao-Cai Xing
Keyword(s):  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Disease Free Survival ◽  
The Elderly ◽  
Multivariate Regression Analysis ◽  
Cancer Specific Survival ◽  
Younger Patients ◽  
Propensity Score Matching Analysis ◽  
American Society

Abstract Background: Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients.Methods: From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥ 70 years of age) were matched to 128 younger patients (༜70 years of age) to obtain two balanced groups with regards to demographic, therapeutic and prognostic factors.Results: There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score Ⅲ and comorbidities, and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p < 0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175 ml vs. 200 ml, p = 0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p = 0.020) and a higher readmission rate (4.7% vs.0%, p = 0.036). The EG also had longer disease-free survival (DFS), overall survival (OS) and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p > 0.05). Old age was not an independent factor for DFS, OS and CSS by Cox multivariate regression analysis (p > 0.05).Conclusions: Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS and CSS.

scholarly journals Liver Resection for Colorectal Liver-limited Metastases in Elderly Patients: A Propensity Score Matching Analysis

2020 ◽  
Author(s):  
Ke-Min Jin ◽  
Kun Wang ◽  
Quan Bao ◽  
Hong-Wei Wang ◽  
Bao-Cai Xing
Keyword(s):  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Disease Free Survival ◽  
The Elderly ◽  
Multivariate Regression Analysis ◽  
Cancer Specific Survival ◽  
Younger Patients ◽  
Propensity Score Matching Analysis ◽  
American Society

Abstract Background: Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients. Methods: From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥70 years of age) were matched to 128 younger patients (＜70 years of age) to obtain two balanced groups with regards to demographic, therapeutic and prognostic factors.Results: There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score Ⅲ and comorbidities, and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p<0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175ml vs. 200ml, p=0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p=0.020) and a higher readmission rate (4.7% vs.0%, p=0.036). The EG also had longer disease-free survival (DFS), overall survival (OS) and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p>0.05). Old age was not an independent factor for DFS, OS and CSS by Cox multivariate regression analysis (p>0.05). Conclusions: Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS and CSS.

scholarly journals Short-term outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma in elderly patients: A propensity score matching analysis

2020 ◽  
Author(s):  
Kazuteru Monden ◽  
Hiroshi Sadamori ◽  
Masayoshi Hioki ◽  
Satoshi Ohno ◽  
Norihisa Takakura
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Oral Intake ◽  
Short Term ◽  
Open Liver Resection ◽  
Propensity Score Matching Analysis ◽  
Baseline Characteristics

Abstract The number of elderly patients with hepatocellular carcinoma (HCC) requiring surgical treatment has been continuously increasing. This study aimed to examine the safety and feasibility of laparoscopic liver resection (LLR) versus open liver resection (OLR) for HCC in elderly patients at our institution in Japan.Between 2010 and 2018, LLR and OLR were performed in 80 and 138 elderly patients (>70 years) who were diagnosed with HCC, respectively. Propensity score matching (PSM) analysis with covariates of baseline characteristics was applied. Intra- and postoperative data were evaluated in both groups.After PSM, 56 patients who underwent LLR and OLR, respectively, were compared. No significant differences in demographic, clinical data, and operative times were observed. Blood loss (OLR: 327 mL; LLR: 50 mL; P< 0.001), length of postoperative hospital stay (OLR: 12 days; LLR: 7 days; P< 0.001), and time to start oral intake (OLR: 2 days; LLR: 1 day; P< 0.001) were significantly lower and shorter in the LLR group than in the OLR group. The incidence of complications over Clavien-Dindo class IIIa was similar between both groups.Our results suggest that advanced age alone is not a contraindication, and LLR can be a treatment option for elderly patients with HCC.

scholarly journals Short-Term Outcomes of Laparoscopic Versus Open Liver Resection for Hepatocellular Carcinoma in Elderly Patients: A Propensity Score Matching Analysis

2021 ◽  
Author(s):  
Kazuteru Monden ◽  
Hiroshi Sadamori ◽  
Masayoshi Hioki ◽  
Satoshi Ohno ◽  
Norihisa Takakura
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Oral Intake ◽  
Short Term ◽  
Open Liver Resection ◽  
Propensity Score Matching Analysis ◽  
Baseline Characteristics

Abstract BackgroundThe number of elderly patients with hepatocellular carcinoma (HCC) requiring surgical treatment has been continuously increasing. This study aimed to examine the safety and feasibility of laparoscopic liver resection (LLR) versus open liver resection (OLR) for HCC in elderly patients at our institution in Japan.MethodsBetween 2010 and 2018, LLR and OLR were performed in 80 and 138 elderly patients (aged > 70 years) who were diagnosed with HCC, respectively. Propensity score matching (PSM) analysis with covariates of baseline characteristics was applied. Intra- and postoperative data were evaluated in both groups.ResultsAfter PSM, 56 patients who underwent LLR and OLR, respectively, were compared. No significant differences in demographic, clinical data, and operative times were observed. Blood loss (OLR: 327 mL, LLR: 50 mL [P < 0.001]), length of postoperative hospital stay (OLR: 12 days, LLR: 7 days [P < 0.001]), and time to start oral intake (OLR: 2 days, LLR: 1 day [P < 0.001]) were significantly lower and shorter in the LLR group than in the OLR group. The incidence of complications over Clavien-Dindo class IIIa was similar between both groups.ConclusionsOur results suggest that advanced age alone is not a contraindication, and LLR can be a treatment option for elderly patients with HCC.Trial registration: retrospectively registered

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