https://scholars.lib.ntu.edu.tw/handle/123456789/413975
標題: | Effects of laparoscopic surgery on survival, quality of care and utilization in patients with colon cancer: a population-based study | 作者: | Tan E.C.-H. MING-CHIN YANG Chen C.-C. |
關鍵字: | colon cancer; complications; healthcare utilization; Laparoscopy; survival | 公開日期: | 2018 | 出版社: | Taylor and Francis Ltd | 卷: | 34 | 期: | 9 | 起(迄)頁: | 1663-1671 | 來源出版物: | Current Medical Research and Opinion | 摘要: | Objective: Laparoscopy is a safe and effective treatment for colon cancer. However, its effects on short- and long-term health outcomes and medical utilization are not fully elucidated. This study aimed to compare short- and long-term utilization and health outcomes of colon cancer patients who underwent either laparoscopic or open surgery in a population-based cohort. Methods: This study was conducted by linking data from Taiwan Cancer Registry, National Health Insurance claims and Death Registry. Patients aged 18 and older with colon cancer between 2009 and 2012 were included in the study. Propensity score matching was used to minimize selection bias between laparoscopic and open surgery groups. Cox proportional hazard regression and generalized linear mixed logistic regression were used to test hypotheses. Results: Among the 11,269 colon cancer patients who underwent colectomy, 3236 (28.72%) received laparoscopy and 8033 (71.28%) underwent open surgery. Patients who received laparoscopic surgery had better overall survival (HR = 0.82; 95% CI: 0.70–0.97). These patients also had lower 30 day mortality (0.44% vs. 0.91%), lower 1 year mortality (2.83% vs. 4.68%), lower overall occurrence of complications (6.16% vs. 8.77%), shorter mean length of stay (12.53 vs. 14.93 days) and lower cost for index hospitalization (US$4325.34 vs. US$4453.90). No significant differences were observed in medical utilization over a period of 365 days after the surgery. Conclusions: Our results demonstrate that, in both the short- and long-term post-operation periods, laparoscopic surgery reduced the likelihood of postoperative complications, 30 day, and 1 year mortality while being no more expensive than open surgery for colon cancer. ? 2018, ? 2018 Informa UK Limited, trading as Taylor & Francis Group. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049079710&doi=10.1080%2f03007995.2018.1484713&partnerID=40&md5=fadce7fa9f671a10657bf0927f31907a https://scholars.lib.ntu.edu.tw/handle/123456789/413975 |
ISSN: | 3007995 | DOI: | 10.1080/03007995.2018.1484713 | SDG/關鍵字: | bevacizumab; cetuximab; irinotecan; oxaliplatin; regorafenib; adult; aged; Article; cancer radiotherapy; clinical outcome; cohort analysis; colon cancer; colon resection; confounding variable; controlled study; female; health care quality; health care utilization; hospitalization cost; human; laparoscopic surgery; length of stay; logistic regression analysis; major clinical study; male; middle aged; mortality; open surgery; outcome assessment; overall survival; postoperative complication; postoperative period; propensity score; proportional hazards model; recurrence free survival; sepsis; survival; Taiwan; treatment outcome; adverse event; colon resection; colon tumor; hospitalization; laparoscopy; patient attitude; postoperative complication; procedures; retrospective study; survival analysis; Adult; Aged; Colectomy; Colonic Neoplasms; Female; Hospitalization; Humans; Laparoscopy; Male; Middle Aged; Patient Acceptance of Health Care; Postoperative Complications; Propensity Score; Quality of Health Care; Retrospective Studies; Survival Analysis; Taiwan; Treatment Outcome |
顯示於: | 健康政策與管理研究所 |
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