6533b860fe1ef96bd12c3ba2
RESEARCH PRODUCT
Predictors of surgical outcomes of minimally invasive right colectomy: the MERCY study
Nicola De’angelisGianmaria Casoni PattaciniDes C. WinterFilippo AisoniGiorgio BianchiPaolo CarcoforoValerio CelentanoFederico CoccoliniSalomone Di SaverioAlice FrontaliChristine DenetDavid FuksPietro GenovaMario GuerrieriMiquel KraftZaher LakkisCéphise AntonotJeanne VertierBertrand Le RoyRenato Micelli LupinacciAleix Martínez-perezGiovanni Domenico De PalmaMarco MiloneLorenzo OrciSebastiano BartolettiLauren O’connellMonica OrtenziJean-christophe PaquetOrnella PerrottoRoberto PetriAntonio SantangeloStefano ScabiniRaffaele De RosaValeria ToniniAlain ValverdeEnrico AndolfiFrancesca PecchiniGianluca PellinoAlessia UrbaniLaura VidalAngelo RestivoSimona DeiddaLuigi ZorcoloFrederic RisEloy EspinMicaela Piccolisubject
Colonic NeoplasmAnastomosisAnastomosis SurgicalOperative TimeGastroenterologyRight colectomyIntracorporeal anastomosisRobotic surgeryIntracorporeal anastomosiColon cancerCohort StudiesTreatment OutcomeRobotic Surgical ProceduresRetrospective StudieMinimally invasive surgerySurgicalColonic NeoplasmsColon cancer; Intracorporeal anastomosis; Laparoscopy; Minimally invasive surgery; Right colectomy; Robotic surgery; Anastomosis Surgical; Cohort Studies; Colectomy; Humans; Operative Time; Retrospective Studies; Treatment Outcome; Colonic Neoplasms; Laparoscopy; Robotic Surgical ProceduresHumansLaparoscopyCohort StudieColectomyHumanRetrospective Studiesdescription
PURPOSE: The optimal approach for minimally invasive (MIS) right colectomy remains under debate. This study aimed to describe surgical trends in the treatment of nonmetastatic right colon cancer and to identify predictors of short-term surgical outcomes. METHODS: A retrospective multicenter cohort study of Minimally-invasivE surgery for oncologic Right ColectomY (MERCY) was conducted on patients who underwent laparoscopic or robotic right colectomy between 2014 and 2020. Classification tree approach was used to describe the extracorporeal (EA) or intracorporeal (IA) anastomosis choice. Mixed-model regressions were used to identify patient- and surgery-related factors predictive of postoperative outcomes. A questionnaire was used to evaluate the surgeons' perspectives. RESULTS: The MERCY database comprised 1870 patients; 87.2% underwent laparoscopy, and 68.1% received an EA. A clear surgical trend was noted, with an increasing rate of IA and robotic procedures after 2017. EA represented 41% of anastomoses in centers equipped with a robotic surgical system. Mixed-model regressions (on 1088 patients) showed that age, sex, BMI, comorbidity, robotics, IA, and conversion to open surgery were predictors of surgical outcomes. In particular, IA was a predictor of a shorter time to regular diet and fewer surgical site infections. Based on the questionnaire, IA was the preferred over EA by 72% of surgeons. CONCLUSION: MIS continues to evolve, with an increasing number of IA being performed in the recent years and when using a robotic surgical system. Understanding the role of predictors of surgical outcomes may help surgeons personalize decision-making among the different MIS options to manage right colon cancer.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2022-03-19 |