Evidence map›Paper›PMID 33839748›Full record

ArticleBJS open2021

Safety and feasibility of laparoscopic surgery for elderly rectal cancer patients in Japan: a nationwide study.

R Seishima, H Miyata, K Okabayashi, H Hasegawa, M Tsuruta, K Shigeta, M Monno, Y Yamashita, M Inomata, G Wakabayashi and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.5field-weighted citation impact, top 14% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 18 citations in OpenAlex.

  1. Article
  2. Article
  3. Competing Mortality Redefines the Net Benefit of Additional Surgery After Endoscopic Resection for T1 Colorectal Cancer in Older Adults.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026
    Review
  4. Article
  5. Article
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 1 country.

R SeishimaDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.
H MiyataDepartment of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan.
K OkabayashiDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.
H HasegawaDepartment of Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
M TsurutaDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.
K ShigetaDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.
M MonnoDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.
Y YamashitaDepartment of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
M InomataDepartment of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Yufu, Japan.
G WakabayashiDepartment of Surgery, Ageo Central General Hospital, Ageo, Japan.
Y KakejiDivision of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Y KitagawaDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.
M WatanabeDepartment of Surgery, Kitasato University Kitasato Institute Hospital, Sagamihara, Japan.
Keio University · JPFukuoka University · JPHakodate Central General Hospital · JPKitasato Institute Hospital · JPOita University · JPThe Japanese Society of Gastroenterological Surgery · JPTokyo Dental College Ichikawa General Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to analyse the perioperative results from a national dataset of rectal cancer resections in elderly patients.

methodsThe clinical records of patients undergoing rectal cancer surgery between 2012 and 2014 were retrieved from the Japanese National Clinical Database and analysed retrospectively. Patients were categorized according to age and those 80 years or older were defined as elderly. Subgroups were also defined according to the surgical approach (laparoscopy versus open surgery). The short-term outcomes, including mortality, anastomotic leak, surgical site infections and medical complications were compared between subgroups.

resultsOf 56 175 patients undergoing rectal cancer surgery, some 6717 patients were elderly and laparoscopy was performed in 46.8 per cent of the sample. When comparing laparoscopy and open surgery in elderly patients, the operative mortality rate (1.5 versus 2.8 per cent; P < 0.001), the incidence of anastomotic leakage (5.2 versus 6.5 per cent; P = 0.026), surgical site infections (6.0 versus 8.0 per cent; P = 0.001), pneumonia (1.4 versus 2.5 per cent; P = 0.001), renal failure (0.7 versus 1.3 per cent; P = 0.016) and cardiac events (0.3 versus 0.8 per cent; P = 0.008) were lower for laparoscopy than for open surgery. The overall complication rate in elderly patients (19.5 per cent) was comparable to that in the younger group (P = 0.07). However, incidence of systemic complications was significantly higher in elderly than in younger patients (all P < 0.001).

conclusionLaparoscopy was safe and feasible in elderly patients compared with open surgery. However, the rates of systemic complications were significantly higher than in younger patients.

Indexed as

AgedAged, 80 and overAnastomotic LeakDatabases, FactualFeasibility StudiesFemaleHumansJapanLaparoscopyLogistic ModelsMaleMiddle AgedMultivariate AnalysisPneumoniaPostoperative ComplicationsRectal Neoplasms

Identifiers

PMID33839748
PMCPMC8038266
OpenAlexW3154307374

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Registered trials

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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.