The Journal of surgical research · 2025
Preoperative Localization, Margins, and Intraoperative Endoscopy in Minimally Invasive Sigmoid Colectomy: A Matched Cohort.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Lin Chang-Lin, Chiang Feng-Fan, Chen Ming-Cheng, Lin Chun-Yu, Huang Shang-Chih, Lin Ching-Shiang
Аннотация
INTRODUCTION: Preoperative localization (endoscopic tattoo or clip) is widely used in laparoscopic colorectal surgery to guide resection margins, yet its influence on long-term outcomes is uncertain. We compared minimally invasive sigmoid colectomy (MISC) performed with versus without localization.
METHODS: We retrospectively reviewed elective MISC at a single center from January 2016 to December 2019. Demographics, localization technique, operative data, hospital stay, complications, and 5-year overall survival (OS) and disease-free survival (DFS) were collected. Propensity-score matching generated two balanced cohorts.
RESULTS: Of 296 eligible patients, 99 matched pairs were analyzed. Localization yielded wider pathological margins (4.0 cm versus 3.0 cm, P < 0.001) and fewer intraoperative colonoscopies (3.0% versus 10.1%, P = 0.004). Five-year OS (89.7% versus 89.2%, P = 0.38) and DFS (82.0% versus 72.7%, P = 0.09) were similar between groups. Margin length showed limited prognostic value (OS area under the curve, 0.592; DFS area under the curve, 0.541).
CONCLUSIONS: Localization during MISC was associated with wider resection margins and a lower frequency of intraoperative colonoscopy. No statistically significant differences were observed in 5-year OS/DFS; the study was not powered to detect small survival differences.
METHODS: We retrospectively reviewed elective MISC at a single center from January 2016 to December 2019. Demographics, localization technique, operative data, hospital stay, complications, and 5-year overall survival (OS) and disease-free survival (DFS) were collected. Propensity-score matching generated two balanced cohorts.
RESULTS: Of 296 eligible patients, 99 matched pairs were analyzed. Localization yielded wider pathological margins (4.0 cm versus 3.0 cm, P < 0.001) and fewer intraoperative colonoscopies (3.0% versus 10.1%, P = 0.004). Five-year OS (89.7% versus 89.2%, P = 0.38) and DFS (82.0% versus 72.7%, P = 0.09) were similar between groups. Margin length showed limited prognostic value (OS area under the curve, 0.592; DFS area under the curve, 0.541).
CONCLUSIONS: Localization during MISC was associated with wider resection margins and a lower frequency of intraoperative colonoscopy. No statistically significant differences were observed in 5-year OS/DFS; the study was not powered to detect small survival differences.