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Short-term results in a population based study indicate advantage for minimally invasive rectal cancer surgery versus open
Department of Surgery, SSORG Sahlgrenska University Hospital/Östra, 416 85, Göteborg, Sweden; Sunshine Coast University Hospital, Britinya, QLD, Australia.
Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Faculty of Medicine and Health Sciences, Örebro University, Örebro, Sweden.ORCID-id: 0000-0003-4939-4189
Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Faculty of Medicine and Health Sciences, Örebro University, Örebro, Sweden.ORCID-id: 0000-0002-6671-7130
Department of Surgery, SSORG Sahlgrenska University Hospital/Östra, 416 85, Göteborg, Sweden.
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2024 (Engelska)Ingår i: BMC Surgery, E-ISSN 1471-2482, Vol. 24, nr 1, artikel-id 52Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: The aim of this study was to determine if minimally invasive surgery (MIS) for rectal cancer is non-inferior to open surgery (OPEN) regarding adequacy of cancer resection in a population based setting.

METHODS: All 9,464 patients diagnosed with rectal cancer 2012-2018 who underwent curative surgery were included from the Swedish Colorectal Cancer Registry.

PRIMARY OUTCOMES: Positive circumferential resection margin (CRM < 1 mm) and positive resection margin (R1). Non-inferiority margins used were 2.4% and 4%. SECONDARY OUTCOMES: 30- and 90-day mortality, clinical anastomotic leak, re-operation < 30 days, 30- and 90-day re-admission, length of stay (LOS), distal resection margin < 1 mm and < 12 resected lymph nodes. Analyses were performed by intention-to-treat using unweighted and weighted multiple regression analyses.

RESULTS: The CRM was positive in 3.8% of the MIS group and 5.4% of the OPEN group, risk difference -1.6% (95% CI -1.623, -1.622). R1 was recorded in 2.8% of patients in the MIS group and in 4.4% of patients in the OPEN group, risk difference -1.6% (95% CI -1.649, -1.633). There were no differences between the groups in adjusted unweighted and weighted analyses. All analyses demonstrated decreased mortality and re-admissions at 30 and 90 days as well as shorter LOS following MIS.

CONCLUSIONS: In this population based setting MIS for rectal cancer was non-inferior to OPEN regarding adequacy of cancer resection with favorable short-term outcomes.

Ort, förlag, år, upplaga, sidor
BioMed Central (BMC), 2024. Vol. 24, nr 1, artikel-id 52
Nyckelord [en]
Laparoscopic surgery, Minimally invasive surgery, Rectal cancer, Robotic surgery
Nationell ämneskategori
Cancer och onkologi Kirurgi
Identifikatorer
URN: urn:nbn:se:oru:diva-111655DOI: 10.1186/s12893-024-02336-zISI: 001161245200001PubMedID: 38341534Scopus ID: 2-s2.0-85184792417OAI: oai:DiVA.org:oru-111655DiVA, id: diva2:1839469
Forskningsfinansiär
Göteborgs universitetCancerfonden, 19 0333 PjAnna-Lisa och Bror Björnssons stiftelse
Anmärkning

Open access funding provided by University of Gothenburg. This study was supported by the Swedish Cancer Society 19 0333 Pj, ALF Sahlgrenska University Hospital, ‘Agreement concerning research and education of doctors’ ALFGBG-716581, Anna-Lisa and Bror Björnsson’s Foundation. 

Tillgänglig från: 2024-02-21 Skapad: 2024-02-21 Senast uppdaterad: 2024-07-04Bibliografiskt granskad

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Matthiessen, PeterDehlaghi Jadid, Kaveh

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