Division of Colon and Rectal Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan.
Division of General Medicine Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan.
Medicine (Baltimore). 2022 Aug 5;101(31):e29863. doi: 10.1097/MD.0000000000029863.
Some studies showed that when distant metastasis or locally advanced tumors were observed, the participation of 2 or more operating surgeons (combined surgery) in the operation could improve the prognosis of patients. The multispecialty operative team would perform combined surgery in colon cancer patients with some complications since 2015. The goal of this study is to confirm performing combined surgery would improve the outcomes of colon cancer patients. A retrospective observational study was conducted, which involved all colon cancer patients between November 2015 and December 2019 at one would-be medical center. Patients were divided into 3 cohorts: those with complicated cases and had combined surgery (C_2S), those with complicated cases and had surgery performed by a single surgeon (C_1S), and those with uncomplicated cases and had surgery performed by a single surgeon (NC_1S). Overall survival and disease-free survival were compared among the 3 groups. A total of 296 colon cancer patients during the study period. Among them, 35 were C_2S, 87 were C_1S, and 174 were NC_1S. Patients in the NC_1S group had significantly higher 12-, 24-, and 36-month OS rates compared to those in the C_1S group (P < .01). In contrast, there was no significant difference in overall survival among patients in the NC_1S and C_2S group (P =.15). The quality of surgery must be impact the prognosis, especially in the individual who was complicated case, the survival in patients who had surgery performed by multispecialty operative team would be improved.
一些研究表明，当观察到远处转移或局部晚期肿瘤时，2 名或更多手术医生（联合手术）参与手术可以改善患者的预后。自 2015 年以来，多学科手术团队开始为患有某些并发症的结肠癌患者实施联合手术。本研究的目的是确认实施联合手术是否会改善结肠癌患者的预后。本研究为回顾性观察性研究，纳入了 2015 年 11 月至 2019 年 12 月期间某潜在医学中心的所有结肠癌患者。患者分为 3 组：复杂病例且接受联合手术（C_2S）的患者、复杂病例且由单名医生手术（C_1S）的患者和简单病例且由单名医生手术（NC_1S）的患者。比较了 3 组患者的总生存和无病生存。在研究期间共有 296 例结肠癌患者。其中，35 例为 C_2S，87 例为 C_1S，174 例为 NC_1S。NC_1S 组患者的 12、24 和 36 个月 OS 率明显高于 C_1S 组（P<0.01）。相反，NC_1S 组和 C_2S 组患者的总生存率无显著差异（P=0.15）。手术质量必须对预后产生影响，尤其是在患者为复杂病例的情况下，多学科手术团队实施手术可以提高患者的生存率。
