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. 2022 Dec;24(12):1505-1515.
doi: 10.1111/codi.16243. Epub 2022 Jul 18.

Impact of operation duration on postoperative outcomes of minimally-invasive right colectomy

Nicola de'Angelis  1   2 , Carlo Alberto Schena  1 , Micaela Piccoli  3 , Gianmaria Casoni Pattacini  3 , Francesca Pecchini  3 , Des C Winter  4 , Lauren O'Connell  4 , Paolo Carcoforo  5 , Alessia Urbani  5 , Filippo Aisoni  5 , Aleix Martínez-Pérez  1 , Valerio Celentano  6   7 , Massimo Chiarugi  8 , Dario Tartaglia  8 , Federico Coccolini  8 , Francesco Arces  8 , Salomone Di Saverio  9 , Alice Frontali  10   11 , David Fuks  12 , Christine Denet  12 , Pietro Genova  13 , Mario Guerrieri  14 , Monica Ortenzi  14 , Miquel Kraft  15 , Gianluca Pellino  15 , Laura Vidal  15 , Zaher Lakkis  16 , Céphise Antonot  16 , Ornella Perrotto  17 , Jeanne Vertier  17 , Bertrand Le Roy  17 , Renato Micelli Lupinacci  18 , Marco Milone  19 , Giovanni Domenico De Palma  19 , Roberto Petri  20 , Antonio Santangelo  20 , Stefano Scabini  21 , Raffaele De Rosa  21 , Valeria Tonini  22 , Alain Valverde  23 , Giorgio Bianchi  1 , Maria Clotilde Carra  24 , Luigi Zorcolo  25 , Simona Deidda  25 , Angelo Restivo  25 , Enrico Andolfi  26 , Jean-Christophe Paquet  27 , Sebastiano Bartoletti  28 , Lorenzo Orci  28 , Frederic Ris  28 , Eloy Espin  15 ; MERCY Study Collaborating Group
Affiliations

Impact of operation duration on postoperative outcomes of minimally-invasive right colectomy

Nicola de'Angelis et al. Colorectal Dis. 2022 Dec.

Abstract

Aim: Operation time (OT) is a key operational factor influencing surgical outcomes. The present study aimed to analyse whether OT impacts on short-term outcomes of minimally-invasive right colectomies by assessing the role of surgical approach (robotic [RRC] or laparoscopic right colectomy [LRC]), and type of ileocolic anastomosis (i.e., intracorporal [IA] or extra-corporal anastomosis [EA]).

Methods: This was a retrospective analysis of the Minimally-invasivE surgery for oncological Right ColectomY (MERCY) Study Group database, which included adult patients with nonmetastatic right colon adenocarcinoma operated on by oncological RRC or LRC between January 2014 and December 2020. Univariate and multivariate analyses were used.

Results: The study sample was composed of 1549 patients who were divided into three groups according to the OT quartiles: (1) First quartile, <135 min (n = 386); (2) Second and third quartiles, 135-199 min (n = 731); and (3) Fourth quartile ≥200 min (n = 432). The majority (62.7%) were LRC-EA, followed by LRC-IA (24.3%), RRC-IA (11.1%), and RRC-EA (1.9%). Independent predictors of an OT ≥ 200 min included male gender, age, obesity, diabetes, use of indocyanine green fluorescence, and IA confection. An OT ≥ 200 min was significantly associated with an increased risk of postoperative noninfective complications (AOR: 1.56; 95% CI: 1.15-2.13; p = 0.004), whereas the surgical approach and the type of anastomosis had no impact on postoperative morbidity.

Conclusion: Prolonged OT is independently associated with increased odds of postoperative noninfective complications in oncological minimally-invasive right colectomy.

Keywords: laparoscopy; minimally-invasive surgery; operating time; right colectomy; robotic right colectomy.

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References

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