@article{b000ea3af609472d938aabd058d10c80,
title = "Comparison of clinical outcomes between laparoscopic and open surgery for left-sided colon cancer: a nationwide population-based study",
abstract = "The role of laparoscopic surgery for left-sided colon cancer has been supported by the results of randomized controlled trials. However, its benefits and disadvantages in the real world setting should be further assessed with population-based studies.The hospitalization data of patients undergoing open or laparoscopic surgery for left-sided colon cancer were sourced from the Taiwan National Health Insurance Research Database. Patient and hospital characteristics and perioperative outcomes including length of hospital stay, operation time, opioid use, blood transfusion, intensive care unit (ICU) admission, and use of mechanical ventilation were compared. The overall survival was also assessed. Patients undergoing laparoscopic surgery had shorter hospital stay (p < 0.0001) and less demand for opioid analgesia (p = 0.0005). Further logistic regression revealed that patients undergoing open surgery were 1.70, 2.89, and 3.00 times more likely to have blood transfusion, to be admitted to ICU, and to use mechanical ventilation than patients undergoing laparoscopic surgery. Operations performed in medical centers were also associated with less adverse events. The overall survival was comparable between the 2 groups.With adequate hospital quality and volume, laparoscopic surgery for left-sided colon cancer was associated with improved perioperative outcomes. The long-term survival was not compromised.",
keywords = "Aged, Blood Transfusion, Colonic Neoplasms/mortality, Databases, Factual, Female, Humans, Intensive Care Units, Kaplan-Meier Estimate, Laparoscopy, Length of Stay, Logistic Models, Male, Middle Aged, Treatment Outcome",
author = "Huang, {Yu Min} and Lee, {Yuan Wen} and Huang, {Yan Jiun} and Wei, {Po Li}",
note = "Funding Information: Database. The hospitalization data for this study were sourced from the NHIRD. The NHIRD was published by the National Health Research Institute and was derived from the system of the Taiwan NHI. Taiwan NHI has a number of unique characteristics: universal coverage, a single-payer payment system with the government as the sole insurer, comprehensive benefits, access to any medical institution of the patient{\textquoteright}s choice, low out-of-pocket payment, and a wide variety of providers well distributed throughout the country. This dataset includes medical claims data such as medical expenditures, patients{\textquoteright} demographics, diagnostic codes, operation codes, et cetera from Taiwan NHI program. This study was exempted from full review by the Taipei Medical University Institutional Review Board since the NHIRD consists of de-identified secondary data released to the public for research purposes. For this same reason, informed consent was not required. The use of data and methods of data processing in this study were in accordance with the relevant guidelines and regulations of the Taiwan National Health Insurance Research Database. Publisher Copyright: {\textcopyright} 2020, The Author(s).",
year = "2020",
month = dec,
day = "1",
doi = "10.1038/s41598-019-57059-6",
language = "English",
volume = "10",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",
number = "1",
}