Title :

Failure to rescue following proctectomy for rectal cancer: the additional benefit of laparoscopic approach in a nationwide observational study of 44,536 patients

Author(s) :

El Amrani, Mehdi [Auteur]
Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290
Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Clement, Guillaume [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lenne, Xavier [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Turpin, Anthony [Auteur]
Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290
Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290
Service d'oncologie médicale (CHRU Lille)
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Valibouze, Caroline [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Rogosnitzky, Moshe [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Theis, Didier [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Pruvot, Francois-Rene [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Zerbib, Philippe [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]

Journal title :

Surgical Endoscopy

Abbreviated title :

Surg Endosc

Publication date :

2021-04-19

ISSN :

1432-2218

Keyword(s) :

Failure to rescue
Proctectomy
Open
Laparoscopy
Rectal cancer

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: There is growing evidence that failure to rescue (FTR) is an important factor of postoperative mortality (POM) after rectal cancer surgery and surgical approach modified post-operative outcomes. However, the ...
Show more >BACKGROUND: There is growing evidence that failure to rescue (FTR) is an important factor of postoperative mortality (POM) after rectal cancer surgery and surgical approach modified post-operative outcomes. However, the impact of laparoscopy on FTR after proctectomy for rectal cancer remains unknown. The aim of this study was to compare the rates of postoperative complications and FTR after laparoscopy vs open proctectomy for cancer. METHODS: All patients who underwent proctectomy for rectal cancer between 2012 and 2016 were included. FTR was defined as the 90-day POM rate among patients with major complications. Outcomes of patients undergoing open or laparoscopic rectal cancer surgery were compared after 1:1 propensity score matching by year of surgery, hospital volume, sex, age, Charlson score, neoadjuvant chemotherapy, tumor localization and type of anastomosis. RESULTS: Overall, 44,536 patients who underwent proctectomy were included, 7043 of whom (15.8%) developed major complications. The rates of major complications, POM and FTR were significantly higher in open compared to laparoscopic procedure (major complications: 19.2% vs 13.7%, p < 0.001; POM: 5.4% vs 2.3%, p < 0.001; FTR: 13.6% vs 8.3%, p < 0.001; respectively). After matching, open and laparoscopic groups were comparable. Multivariate analysis showed that age, Charlson score, sphincter-preserving procedure and surgical approach were predictive factors for FTR. Open proctectomy was found to be a risk factor for FTR (OR 1.342, IC95% [1.066; 1.689], p = 0.012) compared to laparoscopic procedure. CONCLUSIONS: When complications occurred, patients operated on by open proctectomy were more likely to die.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
CNRS
Inserm
Université de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
• Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290

Submission date :

2021-07-06T12:50:30Z
2024-01-30T15:19:50Z