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01-02-2019 | Original Article

A Comparison of Pathologic Outcomes of Open, Laparoscopic, and Robotic Resections for Rectal Cancer Using the ACS-NSQIP Proctectomy-Targeted Database: a Propensity Score Analysis

Authors: Richard Garfinkle, Maria Abou-Khalil, Sahir Bhatnagar, Nathalie Wong-Chong, Laurent Azoulay, Nancy Morin, Carol-Ann Vasilevsky, Marylise Boutros

Published in: Journal of Gastrointestinal Surgery | Issue 2/2019

Abstract

Background

There is ongoing debate regarding the benefits of minimally invasive techniques for rectal cancer surgery. The aim of this study was to compare pathologic outcomes of patients who underwent rectal cancer resection by open surgery, laparoscopy, and robotic surgery using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) proctectomy-targeted database.

Methods

All patients from the 2016 ACS-NSQIP proctectomy-targeted database who underwent elective proctectomy for rectal cancer were identified. Patients were divided into three groups based on initial operative approach: open surgery, laparoscopy, and robotic surgery. Pathologic and 30-day clinical outcomes were then compared between the groups. A propensity score analysis was performed to control for confounders, and adjusted odds ratios for pathologic outcomes were reported.

Results

A total of 578 patients were included—211 (36.5%) in the open group, 213 (36.9%) in the laparoscopic group, and 154 (26.6%) in the robotic group. Conversion to open surgery was more common among laparoscopic cases compared to robotic cases (15.0% vs. 6.5%, respectively; p = 0.011). Positive circumferential resection margin (CRM) was observed in 4.7%, 3.8%, and 5.2% (p = 0.79) of open, laparoscopic, and robotic resections, respectively. Propensity score adjusted odds ratios for positive CRM (open surgery as a reference group) were 0.70 (0.26–1.85, p = 0.47) for laparoscopy and 1.03 (0.39–2.70, p = 0.96) for robotic surgery.

Conclusions

The use of minimally invasive surgical techniques for rectal cancer surgery does not appear to confer worse pathologic outcomes.

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Title: A Comparison of Pathologic Outcomes of Open, Laparoscopic, and Robotic Resections for Rectal Cancer Using the ACS-NSQIP Proctectomy-Targeted Database: a Propensity Score Analysis
Authors: Richard Garfinkle
Maria Abou-Khalil
Sahir Bhatnagar
Nathalie Wong-Chong
Laurent Azoulay
Nancy Morin
Carol-Ann Vasilevsky
Marylise Boutros
Publication date: 01-02-2019
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 2/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-018-3974-8

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A Comparison of Pathologic Outcomes of Open, Laparoscopic, and Robotic Resections for Rectal Cancer Using the ACS-NSQIP Proctectomy-Targeted Database: a Propensity Score Analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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