Comparison of Postoperative Outcomes Between Laparoscopic and Open Surgery for Colorectal Cancer

Neki, Kai; Eto, Ken; Kosuge, Makoto; Ohkuma, Masahisa; Noaki, Rota; Hashizume, Ryosuke; Sasaki, Shigemasa; Shirai, Yoshio; Yanaga, Katsuhiko

doi:10.21873/anticanres.11939

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…for decreasing the production of pro-inflammatory cytokines (59). They improve the nutritional level of patients, thereby improving the cachexia caused by cancer and the quality of life of patients (23).…”

Section: Discussionmentioning

confidence: 99%

“…Presently, omega-3 PUFAs are believed to play several crucial roles in the human body: (1) they inhibit arachidonic acid metabolism and thereby reduce the release of pro-inflammatory substances and thus the inflammatory response ( 58 ). They also inhibit inflammatory response by acting on cytokines related to enzymes or genes associated with the inflammatory response for decreasing the production of pro-inflammatory cytokines ( 59 ). They improve the nutritional level of patients, thereby improving the cachexia caused by cancer and the quality of life of patients ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

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Meta-analysis of omega-3 polyunsaturated fatty acids on immune functions and nutritional status of patients with colorectal cancer

et al. 2022

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This meta-analysis assessed the clinical significance of omega-3 polyunsaturated fatty acids (PUFAs) in the management of patients with colorectal cancer (CRC) after radical resection. We comprehensively searched electronic databases, such as EMBASE, PubMed, MEDLINE and Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Database (CBM), Wanfang Electronic Database, and VIP Medical Information System (VIP) from inception to 10 April 2022. Randomized controlled trials (RCTs) of omega-3 PUFAs and conventional nutrition or blank treatments were selected. The following were evaluated in the pooled analysis: immune function-related indices (IgA, IgG, IgM, CD3+, CD4+, CD8+, and ratio of CD4+/CD8+), nutritional status-related indices [total protein (TP), albumin (ALB), and prealbumin (PA)], and their corresponding 95% confidence intervals (CIs). Next, we conducted heterogeneity detection, sensitivity analysis, contour-enhanced funnel plot to detect possible publication bias, and meta-regression analysis. In all, 20 studies, including 1,613 patients (809 in the omega-3 PUFAs group and 804 in the control group), were selected in the final analysis. The results of the pooled analysis showed that omega-3 PUFAs significantly increased the humoral immune function indices, including IgA [standardized mean difference (SMD) = 0.54, 95% CI 0.10–0.99], IgM (SMD = 0.52, 95% CI 0.05–0.99), IgG (SMD = 0.65, 95% CI 0.47–0.84); T cell immune function indices, including CD3+ (SMD = 0.73, 95% CI 0.54–0.92), CD4+ (SMD = 0.76, 95% CI 0.53–0.98), and ratio of CD4+/CD8+ (SMD = 0.66, 95% CI 0.39–0.92). However, CD8+ was markedly reduced after intervention of omega-3 PUFAs (SMD = –0.28, 95% CI –0.66–0.09). In addition, pooled analysis indicated that omega-3 PUFAs markedly improved the nutritional status indicators, including TP (SMD = 0.53, 95% CI 0.17–0.88), ALB (SMD = 0.43, 95% CI 0.15–0.70), and PA (SMD = 0.46, 95% CI 0.01–0.90). The meta-regression analysis revealed that the covariates of the small sample affected the robustness and credibility of the CD4+ results. Conclusively, this study suggested that omega-3 PUFAs have the potential to be used as a valid immunonutritional therapy/support for treating patients with CRC postoperatively. This meta-analysis protocol was registered in PROSPERO (no. CRD42021288487).Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021288487], identifier [CRD42021288487].

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Meta-analysis of omega-3 polyunsaturated fatty acids on immune functions and nutritional status of patients with colorectal cancer

et al. 2022

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“…Furthermore, previous research has established that laparoscopic surgery has a protective effect on tumors in patients [49]. It demonstrates advantages in terms of reduced trauma and bleeding, less pain [50,51], earlier restoration of bowel function, and earlier resumption of normal diet [52]. Therefore, laparoscopic surgery produces more favorable results as it reduces the incidence of postoperative complications in elderly patients relative to open surgery [50,51].…”

Section: Discussionmentioning

confidence: 99%

“…It demonstrates advantages in terms of reduced trauma and bleeding, less pain [50,51], earlier restoration of bowel function, and earlier resumption of normal diet [52]. Therefore, laparoscopic surgery produces more favorable results as it reduces the incidence of postoperative complications in elderly patients relative to open surgery [50,51]. In addition, for elderly people who need long-duration laparoscopic surgery, we suggest that sufficient preparation and effective management can reduce the risks and result in safer operations [53].…”

Section: Discussionmentioning

confidence: 99%

Effects of sarcopenia, hypoalbuminemia, and laparoscopic surgery on postoperative complications in elderly patients with colorectal cancer: A prospective study

Chen¹,

Huang²,

Xu³

et al. 2020

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With the increasing number of elderly patients, the risk of diseases such as colorectal cancer (CRC) has increased. The objective of this prospective study was to explore the effects of sarcopenia, hypoalbuminemia, and laparoscopic surgery on postoperative complications among elderly patients who recently underwent colorectal surgery. Patients aged over 65 years who underwent surgery for CRC at the First Affiliated Hospital of Wenzhou Medical University were considered for this study. The demographical and clinical characteristics of these patients, as well as postoperative complications, were prospectively analyzed. The patients were divided into two groups depending on the diagnosis of sarcopenia, and the clinical variables corresponding to the two groups were compared. Further, the risk factors associated with postoperative complications were evaluated using univariate analysis and multivariate logistic regression analysis. A total of 360 patients fulfilled the inclusion criteria. Incidences of postoperative complications in the sarcopenia and non-sarcopenia groups were at 38.3% and 27.3%, respectively. In addition, sarcopenia (p=0.029) and hypoalbuminemia (p=0.010) were identified as independent risk factors, while laparoscopic surgery (p=0.023) was identified as a protective factor for postoperative complications. However, laparoscopic surgery was a protective factor for postoperative complications in the colon group only (p=0.001). Sarcopenia and hypoalbuminemia are independent risk factors that influence the probability of developing complications following CRC surgery. Laparoscopic surgery is a protective factor for postoperative complications of CRC patients, particularly colon cancer patients.

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“…Surgery is the core treatment for CRC patients [ 3 – 5 ], and favorable short-term outcomes can reduce the mental and physical stress of patients as well as lighten their financial burden simultaneously [ 6 , 7 ]. Thus, the short-term outcomes of CRC patients after radical surgery are major concerns to surgeons [ 8 ]. As reported previously, the short-term outcomes after CRC surgery are affected by many factors, including age [ 9 ], comorbidities such as liver cirrhosis [ 10 ] and diabetes [ 11 ], surgical approaches [ 12 ] and operation time [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Preoperative hypokalemia can increase complications after colorectal cancer surgery: a propensity score matching analysis

et al. 2022

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Background Whether hypokalemia can affect the short-term outcomes of CRC patients after radical surgery remains unclear. The purpose of this study was to investigate the impact of preoperative hypokalemia on the short-term outcomes for colorectal cancer (CRC) patients who underwent radical CRC surgery using propensity score matching (PSM). Methods We retrospectively enrolled consecutive CRC patients from Jan 2011 to Dec 2021 in a single-center hospital. Hypokalemia was defined as a serum potassium concentration < 3.5 mmol/L. The short-term outcomes were compared between the hypokalemia group and the normal blood potassium group. In addition, univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for overall complications. Results A total of 6183 CRC patients who underwent radical surgery were included in this study, of whom 390 (6.3%) patients were diagnosed with hypokalemia before surgery. After 1:1 ratio PSM, there were 390 patients in the hypokalemia group and in the normal potassium group. No significant difference was found between the two groups after PSM in terms of baseline information (p > 0.05). Regarding short-term outcomes, the hypokalemia group had a longer hospital stay (p = 0.028), a higher proportion of overall complications (p = 0.048) and a higher incidence of postoperative pneumonia (p = 0.008) after PSM. Moreover, hypokalemia (p = 0.036, OR = 1.291, 95% CI = 1.017–1.639) was an independent risk factor for overall complications. Conclusion Preoperative hypokalemia could increase complications after CRC surgery and prolong the hospital stay. Moreover, preoperative hypokalemia was an independent risk factor for overall complications.

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Comparison of Postoperative Outcomes Between Laparoscopic and Open Surgery for Colorectal Cancer

Abstract: LC showed more favorable results in both short-term and long-term outcomes than OC.

Cited by 7 publications

References 15 publications

Meta-analysis of omega-3 polyunsaturated fatty acids on immune functions and nutritional status of patients with colorectal cancer

Meta-analysis of omega-3 polyunsaturated fatty acids on immune functions and nutritional status of patients with colorectal cancer

Effects of sarcopenia, hypoalbuminemia, and laparoscopic surgery on postoperative complications in elderly patients with colorectal cancer: A prospective study

Preoperative hypokalemia can increase complications after colorectal cancer surgery: a propensity score matching analysis

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