The impact of surgical case order on short-term and long-term outcomes in patients undergoing laparoscopic gastrectomy: a propensity matched study

Abstract

Abstract Background and aim: Whether the surgical case order is an important factor affecting the short- and long-term outcomes of patients with GC has always been a concern. This study aimed to compare the short- and long-term outcomes of different surgical case orders Methods: We included patients who underwent laparoscopy-assisted radical gastrectomy at the Union Hospital of Fujian Medical University (Fuzhou, China) between January 2016 and December 2017. In total, 1235 patients (No.1 (n=497), No.2 (n=426), and Other groups (n=312)) were included in the propensity score matching (PSM, 1:1:1). Results: After PSM, there were no significant differences in clinicopathological characteristics between the No.1, No.2, and the Other groups. The operative duration in the Other group was significantly longer than that in groups No.1 and No.2. The volume of blood loss in the No.2 and the Other group was significantly higher than that in the No.1 group. Kaplan-Meier survival analysis revealed similar five-year overall survival (OS) and disease-free survival (DFS) rates among the three groups. Multivariate Cox regression analysis showed that surgical case order was not independent risk factors for 5-year OS and DFS. Further analysis showed no significant difference in the 5-year OS and DFS among patients with different surgical case orders, regardless of age, pT stage, or range of gastrectomy (P > 0.05). Conclusions: In high-volume centers, different surgical case orders can only affect operative time and intraoperative bleeding but not short- or long-term outcomes. Surgeons should reasonably schedule surgeries to provide better medical services and to improve patient motivation and care.