A propensity score-matched analysis of advanced energy devices and conventional monopolar device for colorectal cancer surgery: comparison of clinical and oncologic outcomes

Abstract

Purpose: The safety, efficiency, and versatility of novel surgical energy devices have been proved by recent studies. This study aims to investigate the impact of surgical energy devices on operative and oncologic outcomes of minimally invasive colorectal cancer surgery.

Methods: The study group included 80 patients who underwent minimally invasive colorectal cancer surgery with a conventional monopolar device and 217 patients with advanced surgical energy devices between August 2015 and December 2017. The propensity score matching for tumor lesion, preoperative level of CEA, and operation technique produced 63 matched pairs.

Results: In patient characteristics, there was no significant difference between the groups after the propensity score matching. The amount of blood loss (72 mL vs. 54 mL, P = 0.123) and conversion cases to another surgery (11.1% vs. 4.8%, P = 0.187) tended to be higher in monopolar group, while operation time and intraoperative complications were not significantly different. The short-term clinical outcomes including time to soft diet, the length of hospital stays, and the morbidity within 30 days after surgery or pathologic outcomes were comparable between the groups. During the median follow-up of 52.9 and 51.1 months in each study group, the 5-year overall survival rates of the monopolar and advanced energy groups were 84.6% and 91.6% (P = 0.276), and the 5-year disease-free survival rates were 78.0% and 84.6% (P = 0.328), respectively.

Conclusion: The use of surgical energy devices based on surgeons' preference did not show significant impact on operative and long-term outcomes compared with conventional monopolar devices in minimally invasive colorectal cancer surgery.