Impact of operation duration on postoperative outcomes of minimally‐invasive right colectomy

Abstract

Aim: Operation time (OT) is a key operational factor influencing surgical outcomes. The present study aimed to analyse whether OT impacts on short-term outcomes of minimally-invasive right colectomies by assessing the role of surgical approach (robotic [RRC] or laparoscopic right colectomy [LRC]), and type of ileocolic anastomosis (i.e., intracorporal [IA] or extra-corporal anastomosis [EA]). Methods: This was a retrospective analysis of the Minimally-invasivE surgery for oncological Right ColectomY (MERCY) Study Group database, which included adult patients with nonmetastatic right colon adenocarcinoma operated on by oncological RRC or LRC between January 2014 and December 2020. Univariate and multivariate analyses were used. Results:The study sample was composed of 1549 patients who were divided into three groups according to the OT quartiles: (1) First quartile, <135 min (n = 386); (2) Second and third quartiles, 135-199 min (n = 731); and (3) Fourth quartile ≥200 min (n = 432). The majority (62.7%) were LRC-EA, followed by LRC-IA (24.3%), RRC-IA (11.1%), and RRC-EA (1.9%). Independent predictors of an OT ≥ 200 min included male gender, age, obesity, diabetes, use of indocyanine green fluorescence, and IA confection. An OT ≥ 200 min was significantly associated with an increased risk of postoperative noninfective complications (AOR: 1.56; 95% CI: 1.15-2.13; p = 0.004), whereas the surgical approach and the type of anastomosis had no impact on postoperative morbidity. Conclusion:Prolonged OT is independently associated with increased odds of postoperative noninfective complications in oncological minimally-invasive right colectomy.

Safety and efficacy of overlapping triangular anastomoses in complete laparoscopic colorectal resection: a systematic evaluation and Meta-analysis

“…A meta-analysis was used to evaluate the e cacy of overlapping triangulation and other anastomosis procedures. No statistically signi cant differences were found between overlapping triangular anastomosis and other anastomoses in terms of operative time, intraoperative bleeding and number of lymph nodes dissected after analysis by randomized controlled study through a multicenter study [32] ,it is suggested that different anastomosis methods have little in uence on these outcome indexes. In this study, we pooled 7 studies and found that there was no signi cant difference in operation time between overlapping triangular anastomosis and other anastomosis procedures.…”

Impact of perioperative low-molecular-weight heparin therapy on clinical events of elderly patients with prior coronary stents implanted > 12 months undergoing non-cardiac surgery: a randomized, placebo-controlled trial

“…Against this background, the present trial was designed to compare the clinical benefits and risks of discontinuing antiplatelet drugs with LMWH bridging therapy. Fourth, numerous other factors, such as functional status, comorbidity, mental health status [ 62 ], and duration of surgery [ 63 ], may have confounded the relationship between age and clinical outcomes [ 64 ]. Additionally, frailty may affect a patient’s ability to tolerate, survive, and eventually recover from surgical stress [ 65 ].…”

Risk Factors for Postoperative Complications of Laparoscopic Right Colectomy: A Post Hoc Analysis of RELARC Trial

“…A retrospective analysis of the MERCY Study Group database indicated that operative time of ≥200 minutes was significantly associated with complications. 29 Shen et al reported that operation duration was an independent risk factor for patient's short-term and long-term outcomes after radical colorectal surgery. Thus, prolonged operative time was a risk operational factor influencing postoperative complications, which reflected more complex surgical procedures.…”