Postoperative complications and long-term outcomes in Currarino syndrome

Author(s):  
Tsuyoshi Sakurai ◽  
Megumi Nakamura ◽  
Naobumi Endo
2016 ◽  
Vol 65 (07) ◽  
pp. 528-534 ◽  
Author(s):  
Yuping Li ◽  
Gening Jiang ◽  
Chang Chen ◽  
Xuefei Hu

Objectives Whether pneumonectomy is needed for the treatment of destroyed lungs is still controversial and unresolved in the clinic. Pneumonectomy is destructive and is associated with a significant incidence of postoperative complications. The purpose of this study is to analyze the operative techniques, postoperative morbidity, mortality, and long-term outcomes of patients with destroyed lungs who underwent pneumonectomy. Patients and Methods We retrospectively analyzed 137 patients with destroyed lungs who underwent pneumonectomy. The data were queried for the details of operative technique, development of perioperative complications, mortality, and long-term survival. Univariate and multivariate analyses were performed to investigate the risk factors of pneumonectomy among the patients. Results A total of 77 male and 60 female patients were reviewed. The youngest patient was 18 years, and the oldest was 75 years, with a mean age of 40.1 years. Postoperative complications were observed in 25 patients (18.2%). The rate of bronchopleural fistula (BPF) was 5.1% (7/137). Two perioperative deaths (1.5%) were noted. Univariate and multivariate analyses indicated the blood loss (hazard ratio [HR], 5.32; 95% confidence interval [CI], 1.27–18.50; p = 0.021) was the independent risk factor of postoperative complications, and the type of the disease (HR, 4.50; 95% CI, 1.19–9.69; p = 0.034) was the independent risk factor of the BPF, for the patients with destroyed lung after pneumonectomy. Conclusion Pneumonectomy for destroyed lung is a high risk for postoperative complications. Our findings suggested that pneumonectomy in destroyed lung was satisfactory with strict surgical indications, adequate preoperative preparation, and careful operative technique, and the long-term outcomes can be especially satisfactory. Pneumonectomy for destroyed lung is still a treatment option.


2018 ◽  
Vol 52 ◽  
pp. 303-308 ◽  
Author(s):  
Javier A. Cienfuegos ◽  
Jorge Baixauli ◽  
Carmen Beorlegui ◽  
Patricia Martínez Ortega ◽  
Lucía Granero ◽  
...  

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hailun Xie ◽  
Shuangyi Tang ◽  
Lishuang Wei ◽  
Jialiang Gan

Abstract Background The effect of the geriatric nutritional risk index (GNRI) on the prognosis of patients with gastrointestinal malignancy remains unclear. The aim of our study was to systematically explore the value of the GNRI in evaluating postoperative complications and long-term outcomes in gastrointestinal malignancy. Methods A systematic literature search was conducted using electronic databases to report the impact of the GNRI on postoperative complications and long-term outcomes of patients with gastrointestinal malignancies as of August 2020. The hazard ratio (HR) with a 95% confidence interval (CI) was used to evaluate the impact of the GNRI on long-term outcomes. The risk ratio (RR) with 95% CI was used to assess the impact of the GNRI on postoperative complications. Result A total of nine studies with 2,153 patients were enrolled in our meta-analysis. The results suggested that a low GNRI was correlated with poor overall survival of patients with gastrointestinal malignancy (HR = 1.94, 95% CI 1.65–2.28, p < 0.001). Patients with a low GNRI had a higher risk of complications than patients with a high GNRI (OR = 2.19, 95% CI 1.57–3.05, p < 0.001). In addition, patients with a low GNRI had shorter relapse-free survival (HR = 2.45, 95% CI 1.50–4.00, p < 0.001) and disease-free survival (HR = 1.84, 95% CI 1.23–2.76, p = 0.003) than those with a high GNRI. However, the GNRI was not an independent factor affecting cancer-specific survival (HR = 1.60, 95% CI 0.91–2.82, p = 0.101). Conclusion Based on existing evidence, the GNRI was a valuable predictor of complications and long-term outcomes in patients with gastrointestinal malignancy.


2018 ◽  
Vol 17 (2) ◽  
pp. e968
Author(s):  
M. Fellmann ◽  
L. Balssa ◽  
E. Clement ◽  
A. Frantczack ◽  
S. Bernardini ◽  
...  

2020 ◽  
Author(s):  
Jia-bin Wang ◽  
Zhen Xue ◽  
Jun Lu ◽  
Qing-liang He ◽  
Zhi-fang Zheng ◽  
...  

Abstract Background: The relationship between sarcopenia and the prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy.Methods: This study retrospectively collected data from 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression analyses were performed to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS).Results: In this study, 59 patients (42.8%) were diagnosed with sarcopenia. Among patients in the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9% and 30.4%, incidences of serious postoperative complications were 0% and 3.7%, incidences of postoperative surgical complications were 13.6% and 15.2%, and incidences of postoperative systemic complications were 20.3% and 15.2%, respectively (all p>0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS: 42.37% vs 65.82%, p=0.004; RFS: 52.54% vs 68.35%, p=0.036). The multivariate analysis revealed a relation between sarcopenia and the long-term prognoses of patients with g-NENs. A stratified analysis based on the pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p=0.007; RFS: 51.43% vs 74.36%, p=0.026); furthermore, the multivariate analysis identified sarcopenia as an independent risk factor for patients with gMANEC (p<0.05).Conclusions: Sarcopenia is not related to the short-term prognoses of patients with g-NENs. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.


2021 ◽  
pp. 29-39
Author(s):  
A. G. Grintcov ◽  
R. V. Ishenko ◽  
I. V. Sovpel ◽  
I. E. Sedakov ◽  
O. V. Sovpel ◽  
...  

Purpose. To analyze short-term and long-term outcomes of surgical treatment of the patients with hiatal hernia complicated by gastroesophageal reflux disease, depending on the choice of fundoplication method.Materials and methods. A retrospective analysis of the short and long-term outcomes of the treatment of 171 patients suffering hiatal hernia complicated by gastroesophageal reflux disease was performed. All patients were underwent laparoscopic hiatal hernia repair supplemented by Nissen fundoplication - 109 patients or Toupet fundoplication – 62 patients.Results. In the Nissen fundoplication group the incidence of intraoperative complications was 9.2% (11 patients), postoperative complications – 8.3% (9 patients), dysphagia in the early postoperative period was noted in 24 (22%) patients. In 5 years after surgery, gastroesophageal reflux was observed in 6 (5.5%) patients, anatomical recurrence in 13 (11.9%) patients. Dysphagia in the late postoperative period was noted in 7.3% (8 patients). In the Toupet fun doplication group the incidence of intraoperative complications was 11.3% (7 patients), the incidence of postoperative complications was 6.5% (4 patients), functional dysphagia in the early postoperative period was noted in 8 (12.9%) patients. In 5 years after surgery, gastroesophageal reflux was observed in 8 (12.9%) patients, anatomical relapse in 13 (11.9%) patients. Persistent long-term dysphagia in the late postoperative period was noted in 2(3.2%) patients.Findings. The choice of fundoplication method did not significantly affect on the duration of surgery, the frequency of intraoperative and postoperative complications, duration hospital stay, the incidence of early functional postoperative dysphagia, the number of unsatisfactory results in the long term period, including recurrence and dysphagia.


PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10100
Author(s):  
Hailun Xie ◽  
Shizhen Huang ◽  
Guanghui Yuan ◽  
Jiaan Kuang ◽  
Ling Yan ◽  
...  

Background and Purpose Several studies have proposed that the advanced lung cancer inflammation index (ALI), a new inflammation-related index, can be used for the prognosis assessment of various malignancies. However, few studies have reported its prognostic value in colorectal cancer (CRC). Therefore, this study explored the relationship between ALI and outcomes in CRC patients. Methods A total of 662 CRC patients who underwent surgery between 2012 and 2014 were included. The ALI was defined as: body mass index × serum albumin/neutrophil to lymphocyte ratio. The X-tile program identified the optimal cut-off value of ALI. Logistic regression analyses determined factors affecting postoperative complications. The Kaplan–Meier method and Cox proportional hazards analyses evaluated potential prognostic factors. Results The optimal cut-off of ALI in males and females were 31.6 and 24.4, respectively. Low-ALI was an independent risk factor for postoperative complications in CRC patients (odds ratio: 1.933, 95% CI [1.283–2.911], p = 0.002). Low-ALI groups also had significantly lower progression-free survival (PFS) and overall survival (OS), when compared with the high-ALI group, especially at advance tumor stages. Using multivariate analysis, ALI was determined as an independent prognostic factor for PFS (hazard ratio: 1.372, 95% CI [1.060–1.777], p = 0.016) and OS (hazard ratio: 1.453, 95% confidence interval: 1.113–1.898, p = 0.006). Conclusion ALI is an independent predictor of short and long-term outcomes in CRC patients, especially at advance tumor stages. The ALI-based nomograms can provide accurate and individualized prediction of postoperative complication risk and survival for CRC patients.


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