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Impact of imaging magnification on colorectal surgery: a matched analysis of a single tertiary center

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Abstract

Background

Laparoscopy has been increasingly applied in colorectal surgery, and imaging systems have been improving concurrently. The present study aims to compare outcomes following colorectal surgery with the 4K and traditional high-definition (HD) video systems.

Methods

All consecutive patients undergoing laparoscopic colorectal surgery between April 2016 and June 2020 were retrospectively retrieved from a prospective institutional database. The study population was matched according to the imaging system (4K versus HD groups) through a propensity score matching (PSM) based on perioperative characteristics of 15 patients. A stratified analysis according to surgical procedures (right, left colectomy, and low anterior resection) was also performed. Primary endpoints were intraoperative blood loss and perioperative transfusions. Also, intra- and postoperative morbidity, operative time, lymph node harvest, and length of hospital stay (LOS) were investigated as secondary outcomes.

Results

After PSM, 225 patients were included in both 4K and HD groups. The intraoperative blood loss was significantly lower in the 4K group (p = 0.008), although no different volumes of blood transfusion were required. Postoperative complications presented in similar proportions, while significantly higher rates of abdominal collection (p = 0.045), reoperation (p = 0.005), and postoperative urinary disorders occurred in the HD group. After stratification, the right colectomy subgroup shared similar associations with the study population. LOS did not change between groups, although readmissions were significantly lower in the 4K group (p < 0.001).

Conclusions

The 4K imaging system represents a technological advance providing better surgical outcomes, such as the minimization of intraoperative blood loss and postoperative morbidity.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

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Funding

This research did not receive any specific grant from public, commercial, or not-for-profit funding agencies.

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Author notes

  1. F. Puccetti and L. Cinelli share the first authorship.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, San Raffaele Research Hospital, Via Olgettina 60, 20132, Milan, Italy

    F. Puccetti, L. Cinelli, M. Molteni, L. Gozzini, U. Casiraghi, L. A. Barbieri, E. Treppiedi, A. Cossu, R. Rosati & U. Elmore

  2. Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy

    F. Puccetti, R. Rosati & U. Elmore

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  1. F. Puccetti
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Contributions

Conception and design F.P. and R.R. Administrative support: R.R. Provision of study materials or patients: F.P. and R.R. Collection and assembly of data: F.P., L.C., M.M., L.G., U.C., and U.E. Data analysis and interpretation: F.P., L.C., M.M., L.G., U.C., R.R., and U.E. Manuscript writing: All authors. Final approval of manuscript: F.P., L.C., M.M., L.G., U.C., L.A.B., E.T., A.C., R.R., and U.E.

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Correspondence to F. Puccetti.

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Puccetti, F., Cinelli, L., Molteni, M. et al. Impact of imaging magnification on colorectal surgery: a matched analysis of a single tertiary center. Tech Coloproctol 27, 1057–1063 (2023). https://doi.org/10.1007/s10151-023-02767-5

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