Risk factors for anastomotic leak and postoperative morbidity and mortality after elective right colectomy for cancer: results from a prospective, multicentric study of 1102 patients

2015 ◽  
Vol 31 (1) ◽  
pp. 105-114 ◽  
Author(s):  
Matteo Frasson ◽  
◽  
Pablo Granero-Castro ◽  
José Luis Ramos Rodríguez ◽  
Blas Flor-Lorente ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anastomotic Leak ◽  
Postoperative Morbidity ◽  
Right Colectomy ◽  
Morbidity And Mortality ◽  
Multicentric Study

Risk factors for postoperative ileus following elective laparoscopic right colectomy: a retrospective multicentric study

2018 ◽  
Vol 33 (10) ◽  
pp. 1373-1382 ◽  
Author(s):  
Lise Courtot ◽  
Bertrand Le Roy ◽  
Ricardo Memeo ◽  
Thibault Voron ◽  
Nicolas de Angelis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Ileus ◽  
Right Colectomy ◽  
Multicentric Study ◽  
Laparoscopic Right Colectomy

scholarly journals Preoperative leukocytosis and the resection severity index are independent risk factors for survival in patients with intrahepatic cholangiocarcinoma

2020 ◽  
Vol 405 (7) ◽  
pp. 977-988
Author(s):  
Oliver Beetz ◽  
Clara A. Weigle ◽  
Sebastian Cammann ◽  
Florian W. R. Vondran ◽  
Kai Timrott ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Postoperative Complications ◽  
Intrahepatic Cholangiocarcinoma ◽  
Postoperative Morbidity ◽  
Severity Index ◽  
The Body ◽  
Morbidity And Mortality ◽  
Independent Risk Factors ◽  
Risk Factors For Survival

Abstract Purpose The incidence of intrahepatic cholangiocarcinoma is increasing worldwide. Despite advances in surgical and non-surgical treatment, reported outcomes are still poor and surgical resection remains to be the only chance for long-term survival of affected patients. The identification and validation of prognostic factors and scores, such as the recently introduced resection severity index, for postoperative morbidity and mortality are essential to facilitate optimal therapeutic regimens. Methods This is a retrospective analysis of 269 patients undergoing resection of histologically confirmed intrahepatic cholangiocarcinoma between February 1996 and September 2018 at a tertiary referral center for hepatobiliary surgery. Regression analyses were performed to evaluate potential prognostic factors, including the resection severity index. Results Median postoperative follow-up time was 22.93 (0.10–234.39) months. Severe postoperative complications (≥ Clavien-Dindo grade III) were observed in 94 (34.9%) patients. The body mass index (p = 0.035), the resection severity index (ASAT in U/l divided by Quick in % multiplied by the extent of liver resection graded in points; p = 0.006), additional hilar bile duct resection (p = 0.005), and number of packed red blood cells transfused during operation (p = 0.036) were independent risk factors for the onset of severe postoperative complications. Median Kaplan-Meier survival after resection was 27.63 months. Preoperative leukocytosis (p = 0.003), the resection severity index (p = 0.005), multivisceral resection (p = 0.001), and T stage ≥ 3 (p = 0.013) were identified as independent risk factors for survival. Conclusion Preoperative leukocytosis and the resection severity index are useful variables for preoperative risk stratification since they were identified as significant predictors for postoperative morbidity and mortality, respectively.

scholarly journals Short- and long-term outcomes for primary anastomosis versus Hartmann’s procedure in Hinchey III and IV diverticulitis: a multivariate logistic regression analysis of risk factors

2020 ◽  
Author(s):  
Ivan Facile ◽  
Raffaele Galli ◽  
Pavlo Dinter ◽  
Robert Rosenberg ◽  
Markus Von Flüe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Postoperative Morbidity ◽  
Primary Anastomosis ◽  
Multivariate Logistic Regression Analysis ◽  
Morbidity And Mortality ◽  
Perforated Diverticulitis ◽  
Multivariate Logistic Regression

Abstract Purpose The management of perforated diverticulitis with generalized peritonitis is still controversial and no preferred standardized therapeutic approach has been determined. We compared surgical outcomes between Hartmann’s procedure (HP) and primary anastomosis (PA) in patients with Hinchey III and IV perforated diverticulitis. Methods Multicenter retrospective analysis of 131 consecutive patients with Hinchey III and IV diverticulitis operated either with HP or PA from 2015 to 2018. Postoperative morbidity was compared after adjustment for known risk factors in a multivariate logistic regression. Results Sixty-six patients underwent HP, while PA was carried out in 65 patients, 35.8% of those were defunctioned. HP was more performed in older patients (74.6 vs. 61.2 years, p < .001), with Hinchey IV diverticulitis (37% vs. 7%, p < .001) and in patients with worse prognostic scores (P-POSSUM Physiology Score, p < .001, Charlson Comorbidity Index p < .001). Major morbidity and mortality were higher in HP compared to PA (30.3% vs. 9.2%, p = .002 and 10.6% vs. 0%, p = .007, respectively) with lower stoma reversal rate (43.9% vs. 86.9%, p < .001). In a multivariate logistic regression, PA was independently associated with lower postoperative morbidity and mortality (OR 0.24, 95% CI 0.06–0.96, p = .044). Conclusions In comparison to PA, HP is associated with a higher morbidity, higher mortality, and a lower stoma reversal rate. Although a higher prevalence of risk factors in HP patients may explain these outcomes, a significant increase in morbidity and mortality persisted in a multivariate logistic regression analysis that was stratified for the identified risk factors.

scholarly journals Sigmoid volvulus: outcomes of treatment and predictors of morbidity and mortality

2022 ◽  
Author(s):  
David Moro-Valdezate ◽  
José Martín-Arévalo ◽  
Vicente Pla-Martí ◽  
Stephanie García-Botello ◽  
Ana Izquierdo-Moreno ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Postoperative Morbidity ◽  
Elective Surgery ◽  
Mortality Rates ◽  
Sigmoid Volvulus ◽  
Morbidity And Mortality ◽  
Asa Score

Abstract Purpose To analyze the treatment outcomes for sigmoid volvulus (SV) and identify risk factors of complications and mortality. Methods Observational study of all consecutive adult patients diagnosed with SV who were admitted from January 2000 to December 2020 in a tertiary university institution for conservative management, urgent or elective surgery. Primary outcomes were 30-day postoperative morbidity, mortality and 2-year overall survival (OS), including analysis of risk factors for postoperative morbidity or mortality and prognostic factors for 2-year OS. Results A total of 92 patients were included. Conservative management was performed in 43 cases (46.7%), 27 patients (29.4%) underwent emergent surgery and 22 (23.9%) were scheduled for elective surgery. Successful decompression was achieved in 87.8% of cases, but the recurrence rate was 47.2%. Mortality rates following episodes were higher for conservative treatment than for urgent or elective surgery (37.2%, 22.2%, 9.1%, respectively; p = 0.044). ASA score > III was an independent risk factor for complications (OR = 5.570, 95% CI = 1.740–17.829, p < 0.001) and mortality (OR = 6.139, 95% CI = 2.629–14.335, p < 0.001) in the 30 days after admission. Patients who underwent elective surgery showed higher 2-year OS than those with conservative treatment (p = 0.011). Elective surgery (HR = 2.604, 95% CI = 1.185–5.714, p = 0.017) and ASA score > III (HR = 0.351, 95% CI = 0.192–0.641, p = 0.001) were independent prognostic factors for 2-year OS. Conclusion Successful endoscopic decompression can be achieved in most SV patients, but with the drawbacks of high recurrence, morbidity and mortality rates. Concurrent severe comorbidities and conservative treatment were independent prognostic factors for morbidity and survival in SV.

Morbidity and mortality after colorectal cancer surgery in patients with cirrhosis: A critical review of the literature.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 608-608
Author(s):  
Tarek Boussaha ◽  
Jean François Cadranel ◽  
Allaoua Smail ◽  
Hortensia Lison ◽  
Armand Garioud ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Colorectal Surgery ◽  
Postoperative Morbidity ◽  
Cancer Surgery ◽  
Morbidity And Mortality ◽  
Colorectal Cancer Surgery ◽  
Increased Risk ◽  
Cirrhotic Patients ◽  
Independent Risk Factors

608 Background: Cirrhotic patients with localized colorectal cancer are potential candidates for tumor resection. The aim of this review was to evaluate the morbi-mortality after colorectal surgery. Methods: Comprehensive search was conducted using PUBMED, EMBASE, and the COCHRANE Library. Prospective and retrospective studies were selected. The study population included cirrhotic patients who underwent colorectal resection for non-metastatic colorectal cancer and patients with benign and other malignant disease. The postoperative morbi-mortality and independent risk factors were analysed. Results: Eight studies were identified. Among these, four studies compared the risk of colorectal surgery in patients with and without liver cirrhosis. The number of patients varied from 41 to 6,120. The severity of cirrhosis in most of the studies was classified with the Child-Pugh score. Class B and C were observed in 20% to 60% of the patients. Sepsis represented the main postoperative complication and occurred in 48% to 77% of patients. Mortality varied according to the Child-Pugh score, ranging from 11% to 41%, and was significantly higher for patients with cirrhosis in Child-Pugh Class C. Urgent surgical procedure had a negative impact on prognosis. The average length of hospital stay ranged from 9 to 18 days. Cirrhosis was associated with a 2-3 time and a 4-10 time increased risk of postoperative mortality in the absence and presence of portal hypertension, respectively compared with non-cirrhotic patients. The independent risk factors for postoperative morbidity and mortality were encephalopathy, ascites, low haemoglobin, prolonged prothrombin time, elevated bilirubin, hypoalbuminemia, postoperative infection, total colectomy, elective or non-elective surgery, the presence of co-morbidities and MELD score ≥ 15. Conclusions: Colorectal cancer surgery is associated with an increased risk of postoperative morbidity and mortality in cirrhosis patients. Studies evaluating exclusively the operative risk for colorectal cancer surgery in this patient’s population are rare. Prospective controlled trials to optimize the perioperative management of those patients are needed.

scholarly journals Colorectal Surgery in Cirrhotic Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jacqueline Paolino ◽  
Randolph M. Steinhagen
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Portal Hypertension ◽  
Colorectal Surgery ◽  
Postoperative Morbidity ◽  
Perioperative Management ◽  
Meld Score ◽  
Morbidity And Mortality ◽  
Stomal Complications ◽  
Cirrhotic Patients

Patients with cirrhosis have a greater risk of morbidity and mortality following colorectal surgery. Therefore, preoperative medical optimization and risk assessment using criteria such as the MELD score are vital in preventing complications. Some risk factors include age, urgency of surgery, and ASA score. Postoperative morbidity and mortality are related to portal hypertension, ascites, infection, and anastomotic and stomal complications. This review highlights the assessment of risk and perioperative management of cirrhotic patients undergoing colorectal surgery.

scholarly journals Risk factors for early postoperative morbidity and mortality in patients underwent radical surgery for gastric carcinoma: A single center experience

2013 ◽  
Vol 11 (10) ◽  
pp. 1103-1109 ◽  
Author(s):  
Selahattin Vural ◽  
Osman Civil ◽  
Metin Kement ◽  
Yunus E. Altuntas ◽  
Nuri Okkabaz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Carcinoma ◽  
Postoperative Morbidity ◽  
Radical Surgery ◽  
Morbidity And Mortality ◽  
Single Center ◽  
Single Center Experience
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