Yana Puckett, MD, MPH, MBA, MSc, Diana Mitchell, MBA, RN, Theophilus Pham, MBA, Amir Aryaie, MD. Texas Tech University Health Sciences Center
Background: Studies have suggested that excising 12 or more lymph nodes during colectomy in patients with colon cancer is associated with improved survival. To date, no study has investigated whether minimally invasive surgery affects ability to retrieve 12 + lymph nodes in elective colon cancer surgery. We elected to determine whether a difference exits on ability to retrieve 12 + nodes in elective colon cancer colectomies performed open vs. laparoscopic.
Methods: The National Surgical Quality Improvement Program (NSQIP) database was analyzed for the year 2014, 2015. Inclusion criteria was Colon Cancer (ICD-9 Code 153.9), age greater than 18. Exclusion criteria was missing data. Data abstracted included number of lymph nodes retrieved and type of operation performed. Data was compared between patients that underwent laparoscopic colectomy compared to open colectomy. Binary logistic regression was used to identify confounding variables in retrieval of 12 + lymph nodes.
Results: After accounting for missing cases, a total of 18,792 patients with a diagnosis of colon cancer were analyzed. Greater than 12 lymph nodes were retrieved in 88% (16,538) of patients. Overall mean lymph nodes retrieved were the same between two groups 20 (SD 11) (p=0.43) . However, open operative approach compared to laparoscopic was associated with 15% greater odds of retrieval of 12+ lymph nodes (OR 1.148; 95%CI (1.035-1.272); P=0.009).
Conclusion: Majority of colectomies, whether done open or laparoscopically, retrieve 12 or more lymph nodes. However, there may be increased odds of retrieving more than 12 lymph nodes with open approach compared to laparoscopic.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91692
Program Number: P273
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster