Emile Sameh Hany, Horesh Nir, Garoufalia Zoe, Gefen Rachel, Dourado Justin, Dasilva Giovanna, Wexner Steven D
Colorectal Surgery Department, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA.
General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospitals, Mansoura, Egypt.
J Surg Oncol. 2025 Feb;131(2):143-150. doi: 10.1002/jso.27872. Epub 2024 Sep 16.
This study aimed to investigate factors associated with prolonged operative time in laparoscopic right hemicolectomy for colon cancer.
This was a retrospective review of patients with colon cancer who underwent laparoscopic right hemicolectomy between 2011 and 2021. Linear and binary logistic regression analyses were performed to determine factors associated with prolonged operative time. The association between longer operative times and complications and hospital stay was assessed.
One hundred and ninety-seven patients (52.3% female; mean age: 68.8 ± 14.1 years) were included. Factors independently associated with operative time were male sex (β = 17.3, 95% CI: 2, 32.5; p = 0.026) and extended hemicolectomy (β = 67.7, 95% CI: 27.6, 107.9; p = 0.001). American Society of Anesthesiologists (ASA) IV classification had a borderline significant association with operative time (β = 100.4, 95% CI: -2.05, 202.9; p = 0.055). Male sex (r = 0.158; p = 0.026), body mass index (r = 0.205; p = 0.004), ASA classification (r = 0.232; p = 0.001), extended hemicolectomy (r = 0.256; p < 0.001), and intracorporeal vessel control (r = 0.161; p = 0.025) had significant positive correlation with operative times. Patients with operative times ≥ 160 min had significantly longer hospital stays (5 vs. 4 days; p = 0.043) and similar complication rates to patients with shorter operative times.
Male sex, advanced ASA classification, and extended hemicolectomy were independently and significantly associated with longer operative times in laparoscopic right hemicolectomy. Longer operative times were associated with longer hospital stays and similar complication rates.
本研究旨在调查结肠癌腹腔镜右半结肠切除术手术时间延长的相关因素。
这是一项对2011年至2021年间接受腹腔镜右半结肠切除术的结肠癌患者的回顾性研究。进行线性和二元逻辑回归分析以确定与手术时间延长相关的因素。评估较长手术时间与并发症及住院时间之间的关联。
纳入197例患者（女性占52.3%；平均年龄：68.8±14.1岁）。与手术时间独立相关的因素为男性（β=17.3，95%CI：2，32.5；p=0.026）和扩大半结肠切除术（β=67.7，95%CI：27.6，107.9；p=0.001）。美国麻醉医师协会（ASA）IV级分类与手术时间有临界显著关联（β=100.4，95%CI：-2.05，202.9；p=0.055）。男性（r=0.158；p=0.026）、体重指数（r=0.205；p=0.004）、ASA分级（r=0.232；p=0.001）、扩大半结肠切除术（r=0.256；p<0.001）和体内血管控制（r=0.161；p=0.025）与手术时间呈显著正相关。手术时间≥160分钟的患者住院时间显著更长（5天对4天；p=0.043），且并发症发生率与手术时间较短的患者相似。
男性、较高的ASA分级和扩大半结肠切除术在腹腔镜右半结肠切除术中与较长手术时间独立且显著相关。较长手术时间与较长住院时间及相似并发症发生率相关。
