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Laparoscopic colectomy for patients with poor American Society of Anesthesiology classifications. | LitMetric

AI Article Synopsis

  • * Out of 458 patients with ASA-PS ≥3, laparoscopic surgery was found to have a shorter operation time, less blood loss, fewer complications, and shorter hospital stays compared to open surgery.
  • * The results suggest that laparoscopic surgery is a safer and more effective option for patients with poor ASA-PS, highlighting it as a better surgical approach in this specific patient population.

Article Abstract

Introduction: The American Society of Anesthesiologists (ASA) classification is used to assess the fitness of a patient for surgery. Whether laparoscopic surgery is appropriate for colorectal cancer patients with poor ASA performance status (PS) remains unclear.

Methods: Among 4585 patients who underwent colorectal surgery between 2016 and 2023, this study retrospectively reviewed all 458 patients with ASA-PS ≥3. Patients were divided into two groups: patients treated by open surgery (O group, n = 80); and patients treated by laparoscopic surgery (L group, n = 378). We investigated the impact of surgical approach on postoperative complications in patients with colorectal cancer and ASA-PS ≥3.

Results: Operation time was longer (170 min vs. 233 min, p < .001), blood loss was less (156 mL vs. 23 mL, p < .001), postoperative complications were less frequent (40.0% vs. 25.1%, p = .008), and hospital stay was shorter (23 days vs. 14 days, p < .001) in L group. Univariate analysis revealed rectal cancer, open surgery, longer operation time, and blood loss as factors significantly associated with postoperative complications. Multivariate analysis revealed open surgery (odds ratio [OR] 2.100, 95% confidence interval [CI] 1.164-3.788; p = .013) and longer operation time (OR 1.747, 95% CI 1.098-2.778; p = .018) as independent predictors of postoperative complications.

Conclusion: Laparoscopic surgery provides favorable outcomes for colorectal cancer patients with poor ASA-PS.

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Source
http://dx.doi.org/10.1111/ases.13393DOI Listing

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