Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2025
The impact of surgical case order on short- and long-term outcomes in patients undergoing laparoscopic gastrectomy: a propensity matched study.
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Shao Min, Chen Jun-Yu, Zhong Qing, Jiang Yi-Ming, Qiu Tao-Yuan, Zheng Li-Na, Chen Qi-Yue, Xie Jian-Wei, Li Ping, Huang Chang-Ming, Zheng Chao-Hui
Аннотация
BACKGROUND: Whether the surgical case order is an important factor affecting the short- and long-term outcomes of patients with gastric cancer (GC) has always been a concern. This study aimed to compare the short- and long-term outcomes of different surgical case orders.
METHODS: This study included patients who underwent laparoscopy-assisted radical gastrectomy at the Union Hospital of Fujian Medical University between January 2016 and December 2017. Overall, 1235 patients (number 1 group [n = 497], number 2 group [n = 426], and other group [n = 312]) were included in the propensity score matching (PSM; 1:1:1).
RESULTS: After PSM, there were no significant differences in clinicopathologic characteristics between the number 1 group, the number 2 group, and the other group. The operative time in the other group was significantly longer than that in number 1 and 2 groups. The volume of blood loss in the number 2 group and the other group was significantly higher than that in the number 1 group. Kaplan-Meier survival analysis revealed similar 5-year overall survival (OS) and disease-free survival (DFS) rates among the 3 groups. Multivariate Cox regression analysis showed that surgical case order was not an independent risk factor for 5-year OS and DFS. Further analysis showed no significant difference in the 5-year OS and DFS among patients with different surgical case orders, regardless of age, pT stage, or range of gastrectomy (P >.05).
CONCLUSION: In high-volume centers, different surgical case orders can only affect operative time and intraoperative bleeding but not short- or long-term outcomes. Surgeons could schedule surgical procedures according to actual clinical needs to improve the quality of medical services.
METHODS: This study included patients who underwent laparoscopy-assisted radical gastrectomy at the Union Hospital of Fujian Medical University between January 2016 and December 2017. Overall, 1235 patients (number 1 group [n = 497], number 2 group [n = 426], and other group [n = 312]) were included in the propensity score matching (PSM; 1:1:1).
RESULTS: After PSM, there were no significant differences in clinicopathologic characteristics between the number 1 group, the number 2 group, and the other group. The operative time in the other group was significantly longer than that in number 1 and 2 groups. The volume of blood loss in the number 2 group and the other group was significantly higher than that in the number 1 group. Kaplan-Meier survival analysis revealed similar 5-year overall survival (OS) and disease-free survival (DFS) rates among the 3 groups. Multivariate Cox regression analysis showed that surgical case order was not an independent risk factor for 5-year OS and DFS. Further analysis showed no significant difference in the 5-year OS and DFS among patients with different surgical case orders, regardless of age, pT stage, or range of gastrectomy (P >.05).
CONCLUSION: In high-volume centers, different surgical case orders can only affect operative time and intraoperative bleeding but not short- or long-term outcomes. Surgeons could schedule surgical procedures according to actual clinical needs to improve the quality of medical services.