Yoon Bin Jung1, Jeonghyun Kang1, Eun Jung Park2, Seung Hyuk Baik1, Kang Young Lee1. 1. 1 Department of Surgery, Yonsei University College of Medicine , Seoul, South Korea . 2. 2 Division of Colon and Rectal Surgery, Department of Surgery, Ajou University School of Medicine , Suwon, South Korea .
Abstract
BACKGROUND: The time to initiation of adjuvant chemotherapy (TIC) can be used as a recovery parameter after surgery. The effect of laparoscopic or robotic surgery on TIC has not been thoroughly studied. This study aimed to compare the impact of open, laparoscopic, and robot-assisted surgery on TIC after colon cancer surgery. MATERIALS AND METHODS: Patients who underwent curative resection for stage II or III colon cancer between January 2007 and June 2013 and who received adjuvant chemotherapy from surgeons capable of performing open, laparoscopic, and robotic surgeries were included in this study. Patient demographics, clinicopathologic variables, and TIC were compared among the three groups. Univariate and multivariate analyses were performed to identify factors affecting TIC. RESULTS: Of the 252 patients, 40, 161, and 51 patients underwent open, laparoscopic, and robotic colectomy, respectively. The postoperative complication rate was lower in the laparoscopic and robotic groups compared to the open group (P = .002). The length of hospital stay was shorter in the laparoscopic group compared with the open and robotic groups (P < .001). Multivariate analysis revealed that the operation method was the only factor affecting TIC, with laparoscopic and robotic surgery being favorable (regression coefficient -5.1, 95% confidence interval -7.6 to -2.6; P < .001). However, there was no difference in TIC between the laparoscopic and robotic group. CONCLUSIONS: Laparoscopic and robotic surgeries were associated with shorter TIC. This study demonstrates another benefit of minimally invasive surgery with regard to early initiation of adjuvant chemotherapy.
BACKGROUND: The time to initiation of adjuvant chemotherapy (TIC) can be used as a recovery parameter after surgery. The effect of laparoscopic or robotic surgery on TIC has not been thoroughly studied. This study aimed to compare the impact of open, laparoscopic, and robot-assisted surgery on TIC after colon cancer surgery. MATERIALS AND METHODS:Patients who underwent curative resection for stage II or III colon cancer between January 2007 and June 2013 and who received adjuvant chemotherapy from surgeons capable of performing open, laparoscopic, and robotic surgeries were included in this study. Patient demographics, clinicopathologic variables, and TIC were compared among the three groups. Univariate and multivariate analyses were performed to identify factors affecting TIC. RESULTS: Of the 252 patients, 40, 161, and 51 patients underwent open, laparoscopic, and robotic colectomy, respectively. The postoperative complication rate was lower in the laparoscopic and robotic groups compared to the open group (P = .002). The length of hospital stay was shorter in the laparoscopic group compared with the open and robotic groups (P < .001). Multivariate analysis revealed that the operation method was the only factor affecting TIC, with laparoscopic and robotic surgery being favorable (regression coefficient -5.1, 95% confidence interval -7.6 to -2.6; P < .001). However, there was no difference in TIC between the laparoscopic and robotic group. CONCLUSIONS: Laparoscopic and robotic surgeries were associated with shorter TIC. This study demonstrates another benefit of minimally invasive surgery with regard to early initiation of adjuvant chemotherapy.
Entities:
Keywords:
adjuvant chemotherapy; colonic neoplasm; laparoscopy; time to initiation of chemotherapy
Authors: Lawrence Lee; Nathalie Wong-Chong; Justin J Kelly; George J Nassif; Matthew R Albert; John R T Monson Journal: Surg Endosc Date: 2018-07-02 Impact factor: 4.584
Authors: Huizheng Bao; Na Xu; Zhongkun Li; Hongtao Ren; Hong Xia; Na Li; Hao Yu; Janbiao Wei; Chengyi Jiang; Lu Liu Journal: Medicine (Baltimore) Date: 2017-05 Impact factor: 1.889