Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Clin Transl Oncol. 2023 Dec;25(12):3471-3478. doi: 10.1007/s12094-023-03210-9. Epub 2023 May 12.
The aim of this study is to investigate whether previous abdominal surgery (PAS) affected stage I-III colorectal cancer (CRC) patients who underwent radical resection.
Stage I-III CRC patients who received surgery at a single clinical center from Jan 2014 to Dec 2022 were retrospectively included in this study. Baseline characteristics and short-term outcomes were compared between the PAS group and the non-PAS group. Univariate and multivariate logistic regression analyses were used to find risk factors for overall complications and major complications. A 1:1 ratio propensity score matching (PSM) was used to minimize the selection bias between the two groups. Statistical analysis was performed using SPSS (version 22.0) software.
A total of 5895 stage I-III CRC patients were included according to the inclusion and exclusion criteria. The PAS group had 1336 (22.7%) patients, and the non-PAS group had 4559 (77.3%) patients. After the PSM, there were 1335 patients in each group, and no significant difference was found in all baseline characteristics between the two groups (P > 0.05). After comparing the short-term outcomes, the PAS group had a longer operation time (before PSM, P < 0.01; after PSM, P < 0.01) and more overall complications (before PSM, P = 0.027; after PSM, P = 0.022) whether before or after PSM. In univariate and multivariate logistic regression analyses, PAS was an independent risk factor for overall complications (univariate analysis, P = 0.022; multivariate analysis, P = 0.029) but not for major complications (univariate analysis, P = 0.688).
Stage I-III CRC patients with PAS might experience longer operation time and have a higher risk of postoperative overall complications. However, it did not appear to significantly affect the major complications. Surgeons should take steps to improve surgical outcomes for patients with PAS.
本研究旨在探讨既往腹部手术（PAS）是否影响接受根治性切除术的 I-III 期结直肠癌（CRC）患者的分期。
回顾性纳入 2014 年 1 月至 2022 年 12 月在单临床中心接受手术的 I-III 期 CRC 患者。比较 PAS 组和非 PAS 组的基线特征和短期结局。采用单因素和多因素逻辑回归分析寻找总体并发症和主要并发症的危险因素。采用 1:1 比例倾向评分匹配（PSM）来最小化两组间的选择偏倚。统计分析采用 SPSS（版本 22.0）软件。
根据纳入和排除标准，共有 5895 例 I-III 期 CRC 患者入选。PAS 组 1336 例（22.7%），非 PAS 组 4559 例（77.3%）。PSM 后，每组各有 1335 例患者，两组间所有基线特征无显著差异（P＞0.05）。比较短期结局后，PAS 组的手术时间更长（PSM 前，P＜0.01；PSM 后，P＜0.01），总体并发症更多（PSM 前，P=0.027；PSM 后，P=0.022），无论是否进行 PSM。单因素和多因素逻辑回归分析显示，PAS 是总体并发症的独立危险因素（单因素分析，P=0.022；多因素分析，P=0.029），但不是主要并发症的危险因素（单因素分析，P=0.688）。
有 PAS 的 I-III 期 CRC 患者可能手术时间更长，术后总体并发症风险更高。但似乎对主要并发症无显著影响。外科医生应采取措施改善 PAS 患者的手术结局。
