Effect evaluation of day endoscopic super minimally invasive surgery for rectal neuroendocrine tumors based on propensity score matching method

doi:10.3877/cma.j.issn.2095-7157.2024.03.005

Abstract

Abstract:

Objective

To evaluate the efficacy of the implementation of day endoscopic super minimally invasive surgery(SMIS) for rectal neuroendocrine tumors (NETs) based on the propensity score matching method.

Methods

A retrospective analysis was conducted on the clinical data of 90 patients who underwent SMIS for rectal NETs in the Gastroenterology Department of the First Medical Center of the Chinese PLA General Hospital from February 2023 to January 2024.The patients were divided into a day surgery group (21 cases) and an inpatient surgery group (69 cases).The propensity score matching method was used to balance the confounding factors between the two groups, and then statistical analysis was performed to evaluate the matched data.

Results

After PSM, each group contained 20 patients, and there were no statistical differences in general information between the two groups. Compared with the inpatient surgery group, the day surgery group showed no statistical difference in the rates of complete resection, en bloc resection, and complication occurrence. However, the length of hospital stay and hospitalization costs were lower in the day-time surgery group.

Conclusion

The implementation of day endoscopic super minimally invasive surgery for rectal neuroendocrine tumors is safe and effective, reducing the time of hospital stay and hospitalization costs, thus alleviating the time and economic burden for patients.

Key words: Rectal neuroendocrine tumors, Day surgery, Super minimally invasive surgery, Efficacy

Ruiqing Zhu, Ronggui Zhang, Xiuxue Feng, Bo Zhang, Shengzhen Liu, Ningli Chai, Enqiang Linghu. Effect evaluation of day endoscopic super minimally invasive surgery for rectal neuroendocrine tumors based on propensity score matching method[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2024, 11(03): 166-170.

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References 20

[1]	中国抗癌协会神经内分泌肿瘤专业委员会．中国抗癌协会神经内分泌肿瘤整合诊治指南(精简版)[J].中国肿瘤临床，2023，50(8)：385-397.
[2]	Dasari A，Shen C，Halperin D，et al.Trends in the Incidence，Prevalence, and Survival Outcomes in Patients With Neuroendocrine Tumors in the United States[J].JAMA Oncol，2017，3(10)：1335-1342.
[3]	Wang XY，Chai NL，Linghu EQ，et al.Efficacy and safety of hybrid endoscopic submucosal dissection compared with endoscopic submucosal dissection for rectal neuroendocrine tumors and risk factors associated with incomplete endoscopic resection[J].Ann Transl Med，2020，8(6)：368-378.
[4]	Osagiede O，Habermann E，Day C，et al.Factors associated with worse outcomes for colorectal neuroendocrine tumors in radical versus local resections[J].J Gastrointest Oncol，2024，11(5)：836-846.
[5]	Ploeckinger Ursula，Kloeppel Guenter，Wiedenmann Bertram，et al.The German NET-Registry：An Audit on the Diagnosis and Therapy of Neuroendocrine Tumors[J].Neuroendocrinology，2009，90(4)：349-363.
[6]	Chang JS，Chen LT，Shan YS，et al.An updated analysis of the epidemiologic trends of neuroendocrine tumors in Taiwan[J].Sci Rep，2021，11(1)：7881-7890.
[7]	Fraenkel M，Kim M，Faggiano A，et al.Incidence of gastroentero-pancreatic neuroendocrine tumours：a systematic review of the literature [J].Endocr Relat Cancer，2014，21(3)：R153-163.
[8]	Kaltsas G，Walter T，Knigge U，et al.European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for appendiceal neuroendocrine tumours (aNET) [J].J Neuroendocrinol，2023，35(10)：e13332.
[9]	Bailey CR，Ahuja M，Bartholomew K，et al.Guidelines for day-case surgery 2019：Guidelines from the Association of Anaesthetists and the British Association of Day Surgery[J].Anaesthesia，2019，74(6)：778-792.
[10]	徐一栋，沈忠磊，冯丹丹，等．日间病房模式的内镜息肉冷切除术治疗老年人结直肠息肉的临床效果[J].中国内镜杂志，2023，29(12)：44-50.
[11]	雷甜甜，马洪升，杨锦林．四川大学华西医院消化内科日间手术模式探索与实践[J].华西医学，2022，37(2)：267-273.
[12]	Nagtegaal ID，Odze RD，Klimstra D，et al.WHO Classification of Tumours Editorial Board.The 2019 WHO classification of tumours of the digestive system[J].Histopathology，2020，76(2)：182-188.
[13]	Shi Y，Zhu P，Jia J，et al.Cost-effectiveness of Same-day Discharge Surgery for Primary Total Hip Arthroplasty：A Pragmatic Randomized Controlled Study[J].Front Public Health，2022，10：825727.
[14]	Paluch AJ，Matthews AH，Mullins S，et al.Adopting the day surgery default in the provision of lumbar discectomy and decompressive surgery[J].J Perioper Pract，2023，33(5)：139-147.
[15]	Olry de Labry Lima A，Špacírová Z，Espín J．Description of day case costs and tariffs of cataract surgery from a sample of nine European countries[J].Cost Eff Resour Alloc，2022，20(1)：11-17.
[16]	白雪，马洪升，罗利．中外日间手术发展对比研究及展望[J].中国医院管理，2014，34(5)：35-37.
[17]	Wang L，Baser O，Wells P，et al.Benefit of early discharge among patients with low-risk pulmonary embolism[J].PLoS One，2017，12(10): e0185022.
[18]	Choi CW，Park SB，Kang DH，et al.The clinical outcomes and risk factors associated with incomplete endoscopic resection of rectal carci-noid tumor[J].Surg Endosc，2017，31(12)：5006-5011.
[19]	Cha B，Shin J，Ko WJ，et al.Prognosis of incompletely resected small rectal neuroendocrine tumor using endoscope without additional treatment[J].BMC Gastroenterol，2022，22(1)：293-300.
[20]	Moon CM，Huh KC，Jung SA，et al.Long-Term Clinical Outcomes of Rectal Neuroendocrine Tumors According to the Pathologic Status After Initial Endoscopic Resection：A KASID Multicenter Study[J].Am J Gastroenterol，2016，111(9)：1276-1285.

变量	匹配前		P值	匹配后		P值
变量	日间组(n＝21)	病房组(n＝69)	P值	日间组(n＝20)	病房组(n＝20)	P值
性别			0.048		1.00
男	14	29		13	13
女	7	40		7	7
年龄[M(Q_R)，岁]	50(28～72)	52(28～76)	0.027	50(28～72)	52.5(28～65)	0.882
慢性病史			0.435
有	4	19		4	16	1.00
无	17	50		4	16
大小[M(Q_R)，mm]	8(3～20)	6(3～20)	0.797	7(3～20)	6.5(3～15)	0.836
外观			0.740		0.435
亚蒂隆起	1	5		1	2
半球型隆起	8	31		7	10
浅隆起	12	33		12	8
深度
黏膜层	2	2	0.197	1	1	1.00
黏膜下层	19	67		19	19
分期			0.706
G1	12	44		11	13	0.859
G2	9	25		9	7
术式			0.008			0.232
ESD	14	63		13	16
EMR	7	6		7	4

变量	匹配前		P值	匹配后		P值
变量	日间组(n＝21)	病房组(n＝69)	P值	日间组(n＝20)	病房组(n＝20)	P值
性别			0.048		1.00
男	14	29		13	13
女	7	40		7	7
年龄[M(Q_R)，岁]	50(28～72)	52(28～76)	0.027	50(28～72)	52.5(28～65)	0.882
慢性病史			0.435
有	4	19		4	16	1.00
无	17	50		4	16
大小[M(Q_R)，mm]	8(3～20)	6(3～20)	0.797	7(3～20)	6.5(3～15)	0.836
外观			0.740		0.435
亚蒂隆起	1	5		1	2
半球型隆起	8	31		7	10
浅隆起	12	33		12	8
深度
黏膜层	2	2	0.197	1	1	1.00
黏膜下层	19	67		19	19
分期			0.706
G1	12	44		11	13	0.859
G2	9	25		9	7
术式			0.008			0.232
ESD	14	63		13	16
EMR	7	6		7	4

变量	日间组	病房组	P值
整块切除率	20(100)	19(95)	1.00
完整切除率	19(95)	20(100)	1.00
并发症			1.00
出血	0	0
穿孔	0	0
感染	0	0
住院天数[M(Q_R)，d]	1	3(2～5)	0.002
住院费用[M(Q_R)，元]	10446(8779～13831)	12343(9768～13921)	0.043

变量	日间组	病房组	P值
整块切除率	20(100)	19(95)	1.00
完整切除率	19(95)	20(100)	1.00
并发症			1.00
出血	0	0
穿孔	0	0
感染	0	0
住院天数[M(Q_R)，d]	1	3(2～5)	0.002
住院费用[M(Q_R)，元]	10446(8779～13831)	12343(9768～13921)	0.043

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