Prospective observational study comparing the perioperative outcomes of laparoscopic colectomy with or without epidural anesthesia: the Kanagawa Yokohama Colorectal Cancer Study Group (KYCC) 1806

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发表日期：

2024年5月4日

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Aya Kato,
Masakatsu Numata,
Shota Izukawa,
Takashi Ohgimi,
Hironao Okamoto,
Yosuke Atsumi,
Keisuke Kazama,
Masahiro Asari,
Koji Numata,
Sho Sawazaki,
Takuo Watanabe,
Yo Mikayama,
Teni Godai,
Akio Higuchi,
Hiroyuki Saeki,
Shinsuke Hatori,
Hiroyuki Mushiake,
Satomi Matsumoto,
Yasushi Rino,
Aya Saito,
Manabu Shiozawa

摘要

Purpose

There have been no adequate comparisons of the efficacy, safety, and efficiency of analgesia after laparoscopic colorectal resection (LAC), with and without epidural anesthesia (EDA).

Methods

This was a multicenter prospective observational study of patients undergoing LAC. The primary end point was the mean visual analog scale (VAS) score on postoperative days (PODs) 1–7. The secondary end points were the highest VAS, complication rate, days to first ambulation and fatigue, length of hospital stay, and time to commencement of surgery.

Results

We compared an EDA group (Group E, n = 48) and a no-EDA group (Group O, n = 48) after matching. The mean VAS was not significantly different between the groups (28.7 vs. 30.1, p = 0.288). On assessing the secondary end points, the highest VAS was not significantly different between the groups. In fact, the VAS was lower in Group E only on POD 2. There was no difference in the incidence of complications, the time to first postoperative evacuation was shorter in Group E, and postoperative hospitalization was similar. The time to surgery was shorter in Group O.

Conclusion

These results suggest that LAC without EDA is a feasible option, but with the early and regular use of adjunctive measures to provide more stable analgesia.