Comparison of the Effects of Laparoscopic and Open Surgery on Postoperative Acute Kidney Injury in Patients with Colorectal Cancer: Propensity Score Analysis
Postoperative acute kidney injury (AKI) is a serious complication that increases patient morbidity and mortality. However, few studies have evaluated the effect of laparoscopic surgery on postoperative AKI. This study compared the incidence of postoperative AKI between laparoscopic and open surgery...
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| Format: | Article |
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MDPI AG
2021-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/7/1438 |
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| author | Ji Hoon Sim Sa-Jin Kang Ji-Yeon Bang Jun-Gol Song |
| author_facet | Ji Hoon Sim Sa-Jin Kang Ji-Yeon Bang Jun-Gol Song |
| author_sort | Ji Hoon Sim |
| collection | DOAJ |
| description | Postoperative acute kidney injury (AKI) is a serious complication that increases patient morbidity and mortality. However, few studies have evaluated the effect of laparoscopic surgery on postoperative AKI. This study compared the incidence of postoperative AKI between laparoscopic and open surgery in patients with colorectal cancer. This study retrospectively analyzed 3637 patients who underwent colorectal cancer surgery between June 2008 and February 2012. The patients were classified into laparoscopic (<i>n</i> = 987) and open (<i>n</i> = 2650) surgery groups. We performed multivariable regression analysis to assess the risk factors for AKI and propensity score matching analysis to compare the incidence of AKI between the two groups. We also assessed postoperative intensive care unit (ICU) admission, complications, hospital stay, and 1-year mortality. We observed no significant differences in the incidence of postoperative AKI between the two groups before (8.8% vs. 9.1%, <i>p</i> = 0.406) and after (8.8% vs. 7.7%, <i>p</i> = 0.406) matching. Laparoscopic surgery was not associated with AKI even after adjusting for intraoperative variables (adjusted odds ratio (OR): 1.17, 95% confidence interval (CI): 0.84–1.62, <i>p</i> = 0.355). Body mass index, diabetes mellitus, hypertension, and albumin were risk factors for AKI. ICU admission (0.6% vs. 2.5%, <i>p</i> = 0.001), complications (0.2% vs. 1.5%, <i>p</i> = 0.002), hospital stay (6.89 days vs. 8.61 days, <i>p</i> < 0.001), and 1-year mortality (0.1% vs. 0.9%, <i>p</i> = 0.021) were significantly better in the laparoscopic than in the open group. The incidence of postoperative AKI did not differ significantly between laparoscopic and open surgery. However, considering its better surgical outcomes, laparoscopic surgery may be recommended for patients with colorectal cancer. |
| first_indexed | 2024-03-10T12:42:01Z |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T12:42:01Z |
| publishDate | 2021-04-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-d97bc570654940529d8da33308b644882023-11-21T13:51:51ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01107143810.3390/jcm10071438Comparison of the Effects of Laparoscopic and Open Surgery on Postoperative Acute Kidney Injury in Patients with Colorectal Cancer: Propensity Score AnalysisJi Hoon Sim0Sa-Jin Kang1Ji-Yeon Bang2Jun-Gol Song3Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, KoreaDepartment of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, KoreaDepartment of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, KoreaDepartment of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, KoreaPostoperative acute kidney injury (AKI) is a serious complication that increases patient morbidity and mortality. However, few studies have evaluated the effect of laparoscopic surgery on postoperative AKI. This study compared the incidence of postoperative AKI between laparoscopic and open surgery in patients with colorectal cancer. This study retrospectively analyzed 3637 patients who underwent colorectal cancer surgery between June 2008 and February 2012. The patients were classified into laparoscopic (<i>n</i> = 987) and open (<i>n</i> = 2650) surgery groups. We performed multivariable regression analysis to assess the risk factors for AKI and propensity score matching analysis to compare the incidence of AKI between the two groups. We also assessed postoperative intensive care unit (ICU) admission, complications, hospital stay, and 1-year mortality. We observed no significant differences in the incidence of postoperative AKI between the two groups before (8.8% vs. 9.1%, <i>p</i> = 0.406) and after (8.8% vs. 7.7%, <i>p</i> = 0.406) matching. Laparoscopic surgery was not associated with AKI even after adjusting for intraoperative variables (adjusted odds ratio (OR): 1.17, 95% confidence interval (CI): 0.84–1.62, <i>p</i> = 0.355). Body mass index, diabetes mellitus, hypertension, and albumin were risk factors for AKI. ICU admission (0.6% vs. 2.5%, <i>p</i> = 0.001), complications (0.2% vs. 1.5%, <i>p</i> = 0.002), hospital stay (6.89 days vs. 8.61 days, <i>p</i> < 0.001), and 1-year mortality (0.1% vs. 0.9%, <i>p</i> = 0.021) were significantly better in the laparoscopic than in the open group. The incidence of postoperative AKI did not differ significantly between laparoscopic and open surgery. However, considering its better surgical outcomes, laparoscopic surgery may be recommended for patients with colorectal cancer.https://www.mdpi.com/2077-0383/10/7/1438laparoscopic surgerycolorectal canceracute kidney injurysurvival |
| spellingShingle | Ji Hoon Sim Sa-Jin Kang Ji-Yeon Bang Jun-Gol Song Comparison of the Effects of Laparoscopic and Open Surgery on Postoperative Acute Kidney Injury in Patients with Colorectal Cancer: Propensity Score Analysis Journal of Clinical Medicine laparoscopic surgery colorectal cancer acute kidney injury survival |
| title | Comparison of the Effects of Laparoscopic and Open Surgery on Postoperative Acute Kidney Injury in Patients with Colorectal Cancer: Propensity Score Analysis |
| title_full | Comparison of the Effects of Laparoscopic and Open Surgery on Postoperative Acute Kidney Injury in Patients with Colorectal Cancer: Propensity Score Analysis |
| title_fullStr | Comparison of the Effects of Laparoscopic and Open Surgery on Postoperative Acute Kidney Injury in Patients with Colorectal Cancer: Propensity Score Analysis |
| title_full_unstemmed | Comparison of the Effects of Laparoscopic and Open Surgery on Postoperative Acute Kidney Injury in Patients with Colorectal Cancer: Propensity Score Analysis |
| title_short | Comparison of the Effects of Laparoscopic and Open Surgery on Postoperative Acute Kidney Injury in Patients with Colorectal Cancer: Propensity Score Analysis |
| title_sort | comparison of the effects of laparoscopic and open surgery on postoperative acute kidney injury in patients with colorectal cancer propensity score analysis |
| topic | laparoscopic surgery colorectal cancer acute kidney injury survival |
| url | https://www.mdpi.com/2077-0383/10/7/1438 |
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