Impact of operation duration on short-term and long-term prognosis in patients undergoing radical colorectal surgery

Abstract

Purpose:The objective of this study was to evaluate the impact of operation duration on short-and long-term outcomes of colorectal cancer patients following surgical resection. Methods: 6224 consecutive patients who underwent radical colorectal surgery were retrospectively assessed and were divided into short operation duration group (SOD) and long operation duration group (LOD) according to the operation duration cutoff value of 110 minutes. Results: Compared with patients in LOD group, patients in SOD group had significantly lower total costs in hospital, reduced expenses for drugs and antibiotics, shorter length of stay (LOS) in hospital and in the ICU. Moreover, 5-year overall survival (OS) and disease-free survival (DFS) for patients in the SOD group were markedly higher than for patients in the LOD group. Mutivariate regression analysis indicated that longer operation duration was associated with poor prognosis, with a hazard ratio of 1.004 (1.003, 1.005) for OS and 1.005 (1.003, 1.006) for DFS. Finally, surgeons' qualifications had meaningful correlation with operation duration (r= 0.450). Conclusions: Operation duration is an independent risk factor for patients' short-term and long-term outcome after radical colorectal surgery. Improve the surgical skills of the surgeon may shorten the operation duration, and further improve the outcome for patients.

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

“…Consistent with previous literature [2, 26], age, male gender, diabetes and obesity were found to be significantly associated with prolonged OT (≥200 min) in the multivariate analysis of the present study. Patient characteristics influence the surgical difficulty and must be carefully evaluated when planning the intervention to select the most suitable approach and procedure for the individual patient.…”

“…Consistent with previous literature [2,26], age, male gender, di- On average, the use of ICG was associated with an OT prolongation of 22 min, which is consistent with what has previously been reported [40], and may be related to the need for checking the viability of the anastomotic stumps or remaking the anastomosis in case it was not adequately performed.…”

“…Interestingly, the robotic approach was not a significant predictor of prolonged OT, although consistently longer than laparoscopy; this may remain an acceptable operation duration especially if the operating surgeon and the nursing staff are adequately trained and experienced in MIS [2]. Indeed, the type of surgical approach and the type of ileocolonic anastomosis did not significantly impact on the rate of postoperative complications, also within each category of OT.…”

“…Operation duration is one of the key operational factors influencing the surgical outcomes [1,2]. Prolonged operating time (OT) has been shown to impact upon postoperative morbidity and mortality in patients undergoing colorectal surgery, being associated with an increased risk of surgical site infections, anastomotic leakage, blood transfusion, prolonged hospital stay, reoperation, and hospital readmission [3][4][5][6][7].…”

Impact of malnutrition on the clinical evolution of very elderly patients undergoing emergency surgery for abdominal pathology

“…Considering these results, and in line with other studies [26,[36][37][38], early evaluation of the nutritional status to identify malnourishment in all elderly patients who undergo emergency abdominal surgery would be justified. Although there is as yet no single tool for performing this screening, in recent years the use of GLIM criteria has been an attempt to standardise the criteria and definition of malnutrition, and its use has been extended to older patients [39][40]. The correct identification of malnourished patients allows us to initiate interventions for these admitted patients with appropriate dietary modifications.…”