ArticleSurgical endoscopy2019
Surgical starting time in the morning versus the afternoon: propensity score matched analysis of operative outcomes following laparoscopic colectomy for colorectal cancer.
Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Surgeon fatigue does not affect surgical outcomes: a systematic review and meta-analysis.Surgery today · 2021Pooled it
- Influence of surgical start time on the quality of surgery for middle and low rectal cancer: a post hoc analysis of the real trial.International journal of surgery (London, England) · 2025Trial
- Impact of surgical start time on clinical outcomes in urologic surgery: a single-center study of major oncologic surgeries and adrenalectomy.World journal of urology · 2026Article
- Balancing Objectivity and Humanity: Ethical Challenges and Considerations in Surgical Candidacy Decisions.HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues · 2026Article
- Circadian variation of post-operative complications in lung resection surgery.Frontiers in physiology · 2026Article
- Safety of nighttime elective hepatectomy for hepatocellular carcinoma patients: a retrospective study.Annals of surgical treatment and research · 2024Article
- Surgical starting time of the day and survival in gastric cancer.Scientific reports · 2023Article
- Late surgical start time is associated with increased blood transfusion following gastric bypass surgery.PloS one · 2023Article
- After-hours esophagectomy may pose additional risk to patients with esophageal cancer.Journal of thoracic disease · 2021Article
- Impact of surgeon work duration prior to distal pancreatectomy on perioperative outcomes: a propensity score matching analysis.BMC surgery · 2021Article
- Effect of Time (Season, Surgical Starting Time, Waiting Time) on Patients with Gastric Cancer.Risk management and healthcare policy · 2021Article
- Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe number of colorectal cancer cases is increasing, and so the number of laparoscopic colectomy procedures being performed is also increasing, leading to an increased workload for surgeons. However, operating for prolonged time periods may cause surgeons to lose their concentration and develop fatigue. We hypothesized that there is a time-of-day variation in outcome for patients with colorectal cancer who undergo laparoscopic colectomy. The present study aimed to compare the operative outcome between laparoscopic colectomy for colorectal cancer performed in the morning versus the afternoon.
methodsThis was a single-center, retrospective study. All 1961 consecutive patients who underwent laparoscopic surgery for colorectal cancer between 2007 and 2017 were included; 1006 of these patients underwent morning surgery, while 955 underwent afternoon surgery. These patients were analyzed using propensity score matching, giving 791 patients in each group. The short- and long-term outcomes in both groups were compared.
resultsBefore propensity score matching, the morning group had a larger mean tumor size than the afternoon group (30 cm vs 35 cm; P = 0.0035). After matching, the two groups did not significantly differ in any patient characteristics. Compared with the afternoon group, the morning group had a significantly lesser incidence of intra-operative organ injury (0.25% vs 1.13%; P = 0.027), and a significantly greater incidence of post-operative abdominal abscess (2.03% vs 0.75% P = 0.028). The incidences of other complications and morbidities were similar in both groups. The median operative time in the morning group (201 min) was significantly longer than that in the afternoon group (193 min; P = 0.0124). The two groups did not differ in 5-year overall survival rates and 5-year disease-free rates within any disease stage.
conclusionsSurgical start times are correlated with surgical outcomes. Our data will help to ensure the safest possible surgeries.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.