Surgical starting time in the morning versus the afternoon: propensity score matched analysis of operative outcomes following laparoscopic colectomy for colorectal cancer
Background The number of colorectal cancer cases is increasing, and so the number of laparoscopic colectomy procedures being performed is also increasing, leading to an increased workload for surgeons. However, operating for prolonged time periods may cause surgeons to lose their concentration and d...
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| Veröffentlicht in: | Surgical endoscopy 2019-06, Vol.33 (6), p.1769-1776 |
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| creator | Ishiyama, Y. Ishida, F. Ooae, S. Takano, Y. Seki, J. Shimada, S. Nakahara, K. Maeda, C. Enami, Y. Sawada, N. Hidaka, E. Kudo, S. |
| description | Background
The number of colorectal cancer cases is increasing, and so the number of laparoscopic colectomy procedures being performed is also increasing, leading to an increased workload for surgeons. However, operating for prolonged time periods may cause surgeons to lose their concentration and develop fatigue. We hypothesized that there is a time-of-day variation in outcome for patients with colorectal cancer who undergo laparoscopic colectomy. The present study aimed to compare the operative outcome between laparoscopic colectomy for colorectal cancer performed in the morning versus the afternoon.
Methods
This was a single-center, retrospective study. All 1961 consecutive patients who underwent laparoscopic surgery for colorectal cancer between 2007 and 2017 were included; 1006 of these patients underwent morning surgery, while 955 underwent afternoon surgery. These patients were analyzed using propensity score matching, giving 791 patients in each group. The short- and long-term outcomes in both groups were compared.
Results
Before propensity score matching, the morning group had a larger mean tumor size than the afternoon group (30 cm vs 35 cm;
P
= 0.0035). After matching, the two groups did not significantly differ in any patient characteristics. Compared with the afternoon group, the morning group had a significantly lesser incidence of intra-operative organ injury (0.25% vs 1.13%;
P
= 0.027), and a significantly greater incidence of post-operative abdominal abscess (2.03% vs 0.75%
P
= 0.028). The incidences of other complications and morbidities were similar in both groups. The median operative time in the morning group (201 min) was significantly longer than that in the afternoon group (193 min;
P
= 0.0124). The two groups did not differ in 5-year overall survival rates and 5-year disease-free rates within any disease stage.
Conclusions
Surgical start times are correlated with surgical outcomes. Our data will help to ensure the safest possible surgeries. |
| doi_str_mv | 10.1007/s00464-018-6449-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2116848834</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2116545714</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-9a76be49fd53804bce0cbb0b09af9e4b0481c332ab4ed109d89c2b4457a19a0f3</originalsourceid><addsrcrecordid>eNp1kUFv1DAQhS0EokvhB3BBlrhwCYyT2V2bG6qgIFXiQHuObGeydZXYwXaK9i_xK-s0BSSkniyPv_fGT4-x1wLeC4D9hwSAO6xAyGqHqCr1hG0ENnVV10I-ZRtQDVT1XuEJe5HSDRRcie1zdtJArQQibtjvH3M8OKsHnrKO2fkDz24k7jzP18THEP0yu6WY5nQ_0n2m6EPwH_kUw0Q-uXzkyYZYcJ3tNXVcez0ck0s89LwgUWd3SzzM2YaREu_DMIRfi--gJx1DEU_OchsGsjmMxwLE5VYsbS5fs9pbii_Zs14PiV49nKfs6svny7Ov1cX3829nny4qi43MldL7nSFUfbdtJKCxBNYYMKB0rwgNoBS2aWptkDoBqpPK1gZxu9dCaeibU_Zu9S3xfs6Ucju6ZGkYtKcwp7YWYidRygYL-vY_9CbMsYRfqW0xFQslVsqWqClS307RjToeWwHtUmS7FtmWItulyFYVzZsH59mM1P1V_GmuAPUKpPLkDxT_rX7c9Q4ERK22</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2116545714</pqid></control><display><type>article</type><title>Surgical starting time in the morning versus the afternoon: propensity score matched analysis of operative outcomes following laparoscopic colectomy for colorectal cancer</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Ishiyama, Y. ; Ishida, F. ; Ooae, S. ; Takano, Y. ; Seki, J. ; Shimada, S. ; Nakahara, K. ; Maeda, C. ; Enami, Y. ; Sawada, N. ; Hidaka, E. ; Kudo, S.</creator><creatorcontrib>Ishiyama, Y. ; Ishida, F. ; Ooae, S. ; Takano, Y. ; Seki, J. ; Shimada, S. ; Nakahara, K. ; Maeda, C. ; Enami, Y. ; Sawada, N. ; Hidaka, E. ; Kudo, S.</creatorcontrib><description>Background
The number of colorectal cancer cases is increasing, and so the number of laparoscopic colectomy procedures being performed is also increasing, leading to an increased workload for surgeons. However, operating for prolonged time periods may cause surgeons to lose their concentration and develop fatigue. We hypothesized that there is a time-of-day variation in outcome for patients with colorectal cancer who undergo laparoscopic colectomy. The present study aimed to compare the operative outcome between laparoscopic colectomy for colorectal cancer performed in the morning versus the afternoon.
Methods
This was a single-center, retrospective study. All 1961 consecutive patients who underwent laparoscopic surgery for colorectal cancer between 2007 and 2017 were included; 1006 of these patients underwent morning surgery, while 955 underwent afternoon surgery. These patients were analyzed using propensity score matching, giving 791 patients in each group. The short- and long-term outcomes in both groups were compared.
Results
Before propensity score matching, the morning group had a larger mean tumor size than the afternoon group (30 cm vs 35 cm;
P
= 0.0035). After matching, the two groups did not significantly differ in any patient characteristics. Compared with the afternoon group, the morning group had a significantly lesser incidence of intra-operative organ injury (0.25% vs 1.13%;
P
= 0.027), and a significantly greater incidence of post-operative abdominal abscess (2.03% vs 0.75%
P
= 0.028). The incidences of other complications and morbidities were similar in both groups. The median operative time in the morning group (201 min) was significantly longer than that in the afternoon group (193 min;
P
= 0.0124). The two groups did not differ in 5-year overall survival rates and 5-year disease-free rates within any disease stage.
Conclusions
Surgical start times are correlated with surgical outcomes. Our data will help to ensure the safest possible surgeries.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-018-6449-9</identifier><identifier>PMID: 30291444</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Aged ; Aged, 80 and over ; Colectomy ; Colorectal cancer ; Colorectal Neoplasms - mortality ; Colorectal Neoplasms - pathology ; Colorectal Neoplasms - surgery ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Incidence ; Japan - epidemiology ; Laparoscopy ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Operative Time ; Postoperative Complications - epidemiology ; Proctology ; Propensity Score ; Retrospective Studies ; Surgeons ; Surgery ; Surgical outcomes ; Survival Analysis</subject><ispartof>Surgical endoscopy, 2019-06, Vol.33 (6), p.1769-1776</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Surgical Endoscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-9a76be49fd53804bce0cbb0b09af9e4b0481c332ab4ed109d89c2b4457a19a0f3</citedby><cites>FETCH-LOGICAL-c438t-9a76be49fd53804bce0cbb0b09af9e4b0481c332ab4ed109d89c2b4457a19a0f3</cites><orcidid>0000-0001-7754-7926</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-018-6449-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-018-6449-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30291444$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ishiyama, Y.</creatorcontrib><creatorcontrib>Ishida, F.</creatorcontrib><creatorcontrib>Ooae, S.</creatorcontrib><creatorcontrib>Takano, Y.</creatorcontrib><creatorcontrib>Seki, J.</creatorcontrib><creatorcontrib>Shimada, S.</creatorcontrib><creatorcontrib>Nakahara, K.</creatorcontrib><creatorcontrib>Maeda, C.</creatorcontrib><creatorcontrib>Enami, Y.</creatorcontrib><creatorcontrib>Sawada, N.</creatorcontrib><creatorcontrib>Hidaka, E.</creatorcontrib><creatorcontrib>Kudo, S.</creatorcontrib><title>Surgical starting time in the morning versus the afternoon: propensity score matched analysis of operative outcomes following laparoscopic colectomy for colorectal cancer</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
The number of colorectal cancer cases is increasing, and so the number of laparoscopic colectomy procedures being performed is also increasing, leading to an increased workload for surgeons. However, operating for prolonged time periods may cause surgeons to lose their concentration and develop fatigue. We hypothesized that there is a time-of-day variation in outcome for patients with colorectal cancer who undergo laparoscopic colectomy. The present study aimed to compare the operative outcome between laparoscopic colectomy for colorectal cancer performed in the morning versus the afternoon.
Methods
This was a single-center, retrospective study. All 1961 consecutive patients who underwent laparoscopic surgery for colorectal cancer between 2007 and 2017 were included; 1006 of these patients underwent morning surgery, while 955 underwent afternoon surgery. These patients were analyzed using propensity score matching, giving 791 patients in each group. The short- and long-term outcomes in both groups were compared.
Results
Before propensity score matching, the morning group had a larger mean tumor size than the afternoon group (30 cm vs 35 cm;
P
= 0.0035). After matching, the two groups did not significantly differ in any patient characteristics. Compared with the afternoon group, the morning group had a significantly lesser incidence of intra-operative organ injury (0.25% vs 1.13%;
P
= 0.027), and a significantly greater incidence of post-operative abdominal abscess (2.03% vs 0.75%
P
= 0.028). The incidences of other complications and morbidities were similar in both groups. The median operative time in the morning group (201 min) was significantly longer than that in the afternoon group (193 min;
P
= 0.0124). The two groups did not differ in 5-year overall survival rates and 5-year disease-free rates within any disease stage.
Conclusions
Surgical start times are correlated with surgical outcomes. Our data will help to ensure the safest possible surgeries.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Colectomy</subject><subject>Colorectal cancer</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Postoperative Complications - epidemiology</subject><subject>Proctology</subject><subject>Propensity Score</subject><subject>Retrospective Studies</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Survival Analysis</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kUFv1DAQhS0EokvhB3BBlrhwCYyT2V2bG6qgIFXiQHuObGeydZXYwXaK9i_xK-s0BSSkniyPv_fGT4-x1wLeC4D9hwSAO6xAyGqHqCr1hG0ENnVV10I-ZRtQDVT1XuEJe5HSDRRcie1zdtJArQQibtjvH3M8OKsHnrKO2fkDz24k7jzP18THEP0yu6WY5nQ_0n2m6EPwH_kUw0Q-uXzkyYZYcJ3tNXVcez0ck0s89LwgUWd3SzzM2YaREu_DMIRfi--gJx1DEU_OchsGsjmMxwLE5VYsbS5fs9pbii_Zs14PiV49nKfs6svny7Ov1cX3829nny4qi43MldL7nSFUfbdtJKCxBNYYMKB0rwgNoBS2aWptkDoBqpPK1gZxu9dCaeibU_Zu9S3xfs6Ucju6ZGkYtKcwp7YWYidRygYL-vY_9CbMsYRfqW0xFQslVsqWqClS307RjToeWwHtUmS7FtmWItulyFYVzZsH59mM1P1V_GmuAPUKpPLkDxT_rX7c9Q4ERK22</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>Ishiyama, Y.</creator><creator>Ishida, F.</creator><creator>Ooae, S.</creator><creator>Takano, Y.</creator><creator>Seki, J.</creator><creator>Shimada, S.</creator><creator>Nakahara, K.</creator><creator>Maeda, C.</creator><creator>Enami, Y.</creator><creator>Sawada, N.</creator><creator>Hidaka, E.</creator><creator>Kudo, S.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7754-7926</orcidid></search><sort><creationdate>20190601</creationdate><title>Surgical starting time in the morning versus the afternoon: propensity score matched analysis of operative outcomes following laparoscopic colectomy for colorectal cancer</title><author>Ishiyama, Y. ; Ishida, F. ; Ooae, S. ; Takano, Y. ; Seki, J. ; Shimada, S. ; Nakahara, K. ; Maeda, C. ; Enami, Y. ; Sawada, N. ; Hidaka, E. ; Kudo, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-9a76be49fd53804bce0cbb0b09af9e4b0481c332ab4ed109d89c2b4457a19a0f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Colectomy</topic><topic>Colorectal cancer</topic><topic>Colorectal Neoplasms - mortality</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Postoperative Complications - epidemiology</topic><topic>Proctology</topic><topic>Propensity Score</topic><topic>Retrospective Studies</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ishiyama, Y.</creatorcontrib><creatorcontrib>Ishida, F.</creatorcontrib><creatorcontrib>Ooae, S.</creatorcontrib><creatorcontrib>Takano, Y.</creatorcontrib><creatorcontrib>Seki, J.</creatorcontrib><creatorcontrib>Shimada, S.</creatorcontrib><creatorcontrib>Nakahara, K.</creatorcontrib><creatorcontrib>Maeda, C.</creatorcontrib><creatorcontrib>Enami, Y.</creatorcontrib><creatorcontrib>Sawada, N.</creatorcontrib><creatorcontrib>Hidaka, E.</creatorcontrib><creatorcontrib>Kudo, S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ishiyama, Y.</au><au>Ishida, F.</au><au>Ooae, S.</au><au>Takano, Y.</au><au>Seki, J.</au><au>Shimada, S.</au><au>Nakahara, K.</au><au>Maeda, C.</au><au>Enami, Y.</au><au>Sawada, N.</au><au>Hidaka, E.</au><au>Kudo, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical starting time in the morning versus the afternoon: propensity score matched analysis of operative outcomes following laparoscopic colectomy for colorectal cancer</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2019-06-01</date><risdate>2019</risdate><volume>33</volume><issue>6</issue><spage>1769</spage><epage>1776</epage><pages>1769-1776</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
The number of colorectal cancer cases is increasing, and so the number of laparoscopic colectomy procedures being performed is also increasing, leading to an increased workload for surgeons. However, operating for prolonged time periods may cause surgeons to lose their concentration and develop fatigue. We hypothesized that there is a time-of-day variation in outcome for patients with colorectal cancer who undergo laparoscopic colectomy. The present study aimed to compare the operative outcome between laparoscopic colectomy for colorectal cancer performed in the morning versus the afternoon.
Methods
This was a single-center, retrospective study. All 1961 consecutive patients who underwent laparoscopic surgery for colorectal cancer between 2007 and 2017 were included; 1006 of these patients underwent morning surgery, while 955 underwent afternoon surgery. These patients were analyzed using propensity score matching, giving 791 patients in each group. The short- and long-term outcomes in both groups were compared.
Results
Before propensity score matching, the morning group had a larger mean tumor size than the afternoon group (30 cm vs 35 cm;
P
= 0.0035). After matching, the two groups did not significantly differ in any patient characteristics. Compared with the afternoon group, the morning group had a significantly lesser incidence of intra-operative organ injury (0.25% vs 1.13%;
P
= 0.027), and a significantly greater incidence of post-operative abdominal abscess (2.03% vs 0.75%
P
= 0.028). The incidences of other complications and morbidities were similar in both groups. The median operative time in the morning group (201 min) was significantly longer than that in the afternoon group (193 min;
P
= 0.0124). The two groups did not differ in 5-year overall survival rates and 5-year disease-free rates within any disease stage.
Conclusions
Surgical start times are correlated with surgical outcomes. Our data will help to ensure the safest possible surgeries.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30291444</pmid><doi>10.1007/s00464-018-6449-9</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7754-7926</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2019-06, Vol.33 (6), p.1769-1776 |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Aged Aged, 80 and over Colectomy Colorectal cancer Colorectal Neoplasms - mortality Colorectal Neoplasms - pathology Colorectal Neoplasms - surgery Female Gastroenterology Gynecology Hepatology Humans Incidence Japan - epidemiology Laparoscopy Male Medicine Medicine & Public Health Middle Aged Operative Time Postoperative Complications - epidemiology Proctology Propensity Score Retrospective Studies Surgeons Surgery Surgical outcomes Survival Analysis |
| title | Surgical starting time in the morning versus the afternoon: propensity score matched analysis of operative outcomes following laparoscopic colectomy for colorectal cancer |
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