Open versus minimally invasive sphincter-sparing surgery for rectal cancer: a single-center retrospective cohort study in Peru

Abstract

Objective: The study aimed to describe and compare minimally invasive surgery (MIS) and open surgery for rectal cancer in Peru. Material and methods: A retrospective single-center analysis was performed for all patients who underwent sphincter- sparing surgery for non-metastatic rectal cancer at Instituto Nacional de Enfermedades Neoplásicas in Peru between January 2016 and December 2020. Clinical, perioperative, pathological, and survival outcomes were compared between both groups. A propensity score matching method was used to minimize bias. Results: 162 patients were included in the final analysis. 124 had open surgery and 38 had MIS. Patients, clinical tumour, pathological characteristics, and perioperative were similar between groups after matching. Similar circumferential resection margin (CRM) with optimal quality of the mesorectum (p=1.000) but higher number of lymph nodes resected in open surgery group (p=0.741) was described. The leakage rate was slightly higher in the MIS group (p=0.358) with 10.5%, while the postoperative hospital stay was longer in the open surgery group after matching (p=0.001; OR 95% 5.2 CI: 1.8-15.6). The estimated recurrence-free survival (RFS) and overall survival (OS) at 3 years in open surgery and MIS was 71.8% (95% CI; 0.58-0.89) and 70% (95% CI; 0.56-0.88) (p=0.431) and 77.7% (95% CI; 0.64-0.94) and 88.9% (95% CI; 0.79-0.99) (p=0.5), respectively. Conclusions: Shorter postoperative hospital stay in the minimally invasive surgery group was reported. RFS, OS, and re lar between both groups. This approach is for non-metastatic rectal cancer in referral centers in Peru.

Risk factors of anastomotic leak in colorectal cancer: a multicentric study in a Latin American country

“…To date the current trend is to perform minimally invasive surgery for colorectal cancer patients, however, this is not the case in developing countries like Peru where most of the cases are still performed with an open approach [ 8 , 10 ]. A meta-analysis by Song et al [ 45 ] concluded that laparoscopic surgery is superior to open in terms of estimated blood loss, hospital stay, postoperative mortality and complications.…”

“…To date, there is scarce literature regarding this complication and its risk factors in a developing country and Latin population where a high percentage of the surgeries are open instead of laparoscopic, and most of the hospitals do not have enhanced recovery after surgery (ERAS) protocols. For instance, open surgery was the standard of care in the public health system at the beginning of the last decade; despite, there is trend to adopt the laparoscopic approach, there is still around 50%–80% of the cases open during the last 5 years [ 7 – 10 ]. Hence, our purpose is to identify the pre-, intra- and post-operative risk factors associated with AL from three national hospitals in the capital of Peru to allow the surgeons to make decisions on a daily basis and provide individualised surgical treatment to patients with colorectal cancer.…”

Lymph node ratio predicts overall survival in patients with stage II non-small cell lung cancer: a population-based SEER analysis

“…To avoid interference with these conditions, we used the LNR to assess patient prognosis. The LNR has an important predictive role in patient prognosis and has been validated in colon, esophageal, gastric, bladder, and breast cancers [11][12][13][14][15]. However, in NSCLC, the role of LNR has not been proven.…”

“…The LNR has an important predictive role in patient prognosis and has been validated in colon, breast, gastric, esophageal and bladder cancers. This study aims to explore whether the LNR is helpful for predicting the prognosis of patients with stage II NSCLC and whether it can play an important role in the treatment plan [11][12][13][14][15].…”