TY - JOUR
T1 - Postoperative outcomes of right hemicolectomy for cancer in 11 countries of Latin America
T2 - A multicentre retrospective study
AU - LATAM Collaborative Colorectal Surgery Consortium
AU - Avellaneda, Nicolas
AU - Gonzalez, Marcos
AU - Caycedo-Marulanda, Antonio
AU - Chwat, Carina
AU - Karas, Joshua
AU - Trucco, Pablo
AU - Vaccaro, Carlos
AU - Rodriguez, Gerardo Martín
AU - Canesín, Camilo Sebastián
AU - Leiro, Fabio
AU - Bianchi, Romina
AU - Rotholtz, Nicolás
AU - Harriott, Camila Bras
AU - Lemme, Gustavo
AU - Valli, Diego
AU - Potolicchio, Analía
AU - Quiroga, Yenny
AU - Salazar, Esteban Gonzalez
AU - Sedzisow, Simon
AU - Novellis, Lucia
AU - Trucco, Juan Pablo
AU - Perriello, Juan
AU - Gallardo, Alfredo
AU - Napolitano, Milena
AU - Carrie, Augusto
AU - Muñoz, Juan Pablo
AU - Ferro, Ezequiel
AU - Barletta, Diego
AU - Sotelo, Juan Manuel
AU - Quelin, Lucas
AU - Posner, Federico
AU - Vieyra, Nicolás
AU - Mendez, Ramon
AU - Barrera, Augusto
AU - Barrera, Alejandro
AU - Díaz, Felipe Quezada
AU - Mena, Felipe
AU - Reyes, Juan Carlos
AU - Robayo, Daniela
AU - Aparicio, Steven
AU - Linares, Sergio
AU - Bruno, Víctor
AU - Mesa, Jorge Alberto Bernal
AU - Pacheco, Maikel
AU - Niño, Nelson
AU - Rivera, Carlos Perez
AU - Robayo, Diana
AU - Olazabal, Amador Omelio
AU - Alvarez, Cabote Yosvany
AU - Segovia, David Silva
N1 - Funding Information:
This study was not funded and received no financial support.
Publisher Copyright:
© 2023 Association of Coloproctology of Great Britain and Ireland.
PY - 2023/5
Y1 - 2023/5
N2 - Aim: There is scant evidence regarding surgical outcomes of patients with colon cancer in Latin America. The aim of this work was to compare perioperative (30 day) outcomes of patients undergoing surgery for right colon cancer in Latin America based on centre volume. Method: This is a multi-institutional retrospective cohort study. Individuals operated on for right colon cancer with curative intent in an urgent or elective setting between 2016 and 2021 were eligible for inclusion in the study. Patients were divided into two groups according to whether they were operated on in low-volume or high-volume centres (defined as more than 30 cases/year). Results: A total of 2676 patients from 46 hospitals in 11 countries of Latin America were included, with 389 (14.5%) in the low-volume group. The median age was 67.37 years. The high-volume group presented higher rates of laparoscopic procedures (56.8 vs. 35.7%, p < 0.001, OR 2.36), with lower conversion rates, fewer intraoperative complications and a shorter operating time. The high-volume group had a shorter length of hospital stay. The overall complication rate for the whole group was 15.9%, with a lower incidence of these events in the high-volume group (13.7 vs. 28.7%, p < 0.001, OR 0.40). Overall, anastomotic leakage, reoperation and mortality rates were 5.6%, 9.2% and 6.1%, respectively, with differences favouring high-volume centres. On multivariate analysis, low-volume group, history of cardiac disease, emergency surgery, operation performed by a general surgeon, open approach and intraoperative complications were independent predictors of major postoperative complications. Conclusion: This is the first study in Latin America to show better postoperative outcomes at a regional scale when surgery for right colon cancer is performed in high-volume centres. Further studies are needed to validate these data and to identify which of the factors can explain the present results.
AB - Aim: There is scant evidence regarding surgical outcomes of patients with colon cancer in Latin America. The aim of this work was to compare perioperative (30 day) outcomes of patients undergoing surgery for right colon cancer in Latin America based on centre volume. Method: This is a multi-institutional retrospective cohort study. Individuals operated on for right colon cancer with curative intent in an urgent or elective setting between 2016 and 2021 were eligible for inclusion in the study. Patients were divided into two groups according to whether they were operated on in low-volume or high-volume centres (defined as more than 30 cases/year). Results: A total of 2676 patients from 46 hospitals in 11 countries of Latin America were included, with 389 (14.5%) in the low-volume group. The median age was 67.37 years. The high-volume group presented higher rates of laparoscopic procedures (56.8 vs. 35.7%, p < 0.001, OR 2.36), with lower conversion rates, fewer intraoperative complications and a shorter operating time. The high-volume group had a shorter length of hospital stay. The overall complication rate for the whole group was 15.9%, with a lower incidence of these events in the high-volume group (13.7 vs. 28.7%, p < 0.001, OR 0.40). Overall, anastomotic leakage, reoperation and mortality rates were 5.6%, 9.2% and 6.1%, respectively, with differences favouring high-volume centres. On multivariate analysis, low-volume group, history of cardiac disease, emergency surgery, operation performed by a general surgeon, open approach and intraoperative complications were independent predictors of major postoperative complications. Conclusion: This is the first study in Latin America to show better postoperative outcomes at a regional scale when surgery for right colon cancer is performed in high-volume centres. Further studies are needed to validate these data and to identify which of the factors can explain the present results.
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U2 - 10.1111/codi.16505
DO - 10.1111/codi.16505
M3 - Article
C2 - 36748272
AN - SCOPUS:85160873543
SN - 1462-8910
VL - 25
SP - 923
EP - 931
JO - Colorectal Disease
JF - Colorectal Disease
IS - 5
ER -
