Impact of intraoperative hypocapnia on postoperative complications in laparoscopic surgery for colorectal cancer

Surgery Today ◽  
2021 ◽  
Author(s):  
Satoru Morita ◽  
Masashi Tsuruta ◽  
Koji Okabayashi ◽  
Takashi Ishida ◽  
Kohei Shigeta ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications

scholarly journals Laparoscopic surgery for colorectal cancer with persistent descending mesocolon

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Yukiharu Hiyoshi ◽  
Yuji Miyamoto ◽  
Kojiro Eto ◽  
Yohei Nagai ◽  
Masaaki Iwatsuki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Blood Flow ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Sigmoid Colon ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Marginal Artery ◽  
Ir Imaging

Abstract Background Persistent descending mesocolon (PDM) is caused by the absence of fusion of the descending colon to the retroperitoneum. We herein report two colorectal cancer cases with PDM that were treated with laparoscopic surgery. Case presentation Case 1: a 50-year-old man with sigmoid colon cancer and synchronous liver metastasis. After neoadjuvant chemotherapy, he underwent laparoscopic sigmoidectomy with lymph node dissection cutting the root of the inferior mesenteric artery (IMA) and synchronous liver resection. He experienced postoperative stenosis of the reconstructed colon possibly due to an impaired arterial blood flow in the reconstructed colon. Case 2: a 77-year-old man with rectal cancer. Laparoscopic low anterior resection preserving the left colic artery (LCA) was performed. Intraoperative infrared ray (IR) imaging using indocyanine green (ICG) showed good blood flow of the reconstructed colon. He had no postoperative complications. In cases of PDM, the mesentery of the descending and sigmoid colon containing the LCA is often shortened, and the marginal artery of the reconstructed colon is located close to the root of the LCA. Lymph node dissection accompanied by cutting the LCA carries a risk of marginal artery injury. Therefore, we recommend lymph node dissection preserving the LCA in colorectal cancer patients with PDM in order to maintain the blood flow of the reconstructed colon. If the IMA and LCA absolutely need to be cut for complete lymph node dissection, the marginal artery should be clearly identified and preserved. In addition, intraoperative IR imaging is extremely useful for evaluating colonic perfusion and reducing the risk of anastomotic complications. Conclusion In colorectal cancer surgery in patients with PDM, surgeons should be aware of these tips for maintaining the blood flow of the reconstructed colon and thereby avoid postoperative complications caused by an impaired blood flow.

scholarly journals Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer

2020 ◽  
Vol 36 (4) ◽  
pp. 229-242 ◽  
Author(s):  
Hyun Hee Kim ◽  
Myong Hoon Ihn ◽  
Yun Hee Lee ◽  
Jihyoun Lee ◽  
Sangchul Yun ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Adverse Events ◽  
Elderly Patients ◽  
Chemotherapy Regimen ◽  
Postoperative Chemotherapy ◽  
Smoking History ◽  
Curative Intent ◽  
Physical Status Classification

Purpose: We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.Methods: Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.Results: Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).Conclusion: This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

scholarly journals Risk Factors for Postoperative Complications in Elderly After Colorectal Cancer Resection

2017 ◽  
Vol 102 (7-8) ◽  
pp. 299-306 ◽  
Author(s):  
Daisuke Kyuno ◽  
Kazuaki Sasaki ◽  
Keisuke Ohno ◽  
Ai Konno ◽  
Takeshi Murakami ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Logistic Regression ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Morbidity And Mortality ◽  
Cancer Resection ◽  
Colorectal Cancer Resection

This study aimed to assess perioperative morbidity and mortality in elderly patients following colorectal cancer resection and to investigate risk factors for postoperative complications. This study reviewed 697 consecutive patients who underwent elective colorectal cancer resection between 2005 and 2013 at our institution. Patients were divided into 3 groups according to their age: ≤74 (n = 420), 75 to 89 (n = 261), and ≥90 years (n = 16). Clinical findings, morbidity, and mortality were compared among these groups. Univariate and multivariate logistic regression analyses were performed with clinically relevant variables for the complications that increased with aging. Postoperative delirium and pneumonia showed significant increases with aging. There were no significant differences in mortality and morbidity among the 3 groups, except for the 2 aforementioned diseases. Multiple logistic regression analysis showed that dementia and laparoscopic surgery were independent determinants of postoperative delirium and that age and American Society of Anesthesiologists (ASA) score were independent risk factors for postoperative pneumonia. Dementia, high ASA score, and age were the risk factors for higher postoperative morbidity in elderly patients. Our results demonstrated the effectiveness of laparoscopic surgery for the prevention of postoperative delirium after colorectal resection.

scholarly journals Laparoscopic procedure is associated with lower morbidity for simultaneous resection of colorectal cancer and liver metastases: an updated meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Long Pan ◽  
Chenhao Tong ◽  
Siyuan Fu ◽  
Jing Fang ◽  
Qiuxia Gu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Meta Analysis ◽  
Effective Length ◽  
Cochrane Library ◽  
Intraoperative Blood Loss ◽  
Surgery Group ◽  
Simultaneous Resection

Abstract Background It has been demonstrated that simultaneous resection of both primary colorectal lesion and metastatic hepatic lesion is a safe approach with low mortality and postoperative complication rates. However, there are some controversies over which kind of surgical approach is better. The aim of study was to compare the efficacy and safety of laparoscopic surgeries and open surgeries for simultaneous resection of colorectal cancer (CRC) and synchronous colorectal liver metastasis (SCRLM). Methods A systemic search of online database including PubMed, Web of Science, Cochrane Library, and Embase was performed until June 5, 2019. Intraoperative complications, postoperative complications, and long-term outcomes were synthesized by using STATA, version 15.0. Cumulative and single-arm meta-analyses were also conducted. Results It contained twelve studies with 616 patients (273 vs 343, laparoscopic surgery group and open surgery group, respectively) and manifested latest surgical results for the treatment of CRC and SCRLM. Among patients who underwent laparoscopic surgeries, they had lower rates of postoperative complications (OR = 0.66, 95% CI: 0.46 to 0.96, P = 0.028), less intraoperative blood loss (weight mean difference (WMD) = − 113.31, 95% CI: − 189.03 to − 37.59, P = 0.003), less time in the hospital and recovering after surgeries (WMD = − 2.70, 95% CI: − 3.99 to − 1.40, P = 0.000; WMD = − 3.20, 95% CI: − 5.06 to − 1.34, P = 0.001), but more operating time (WMD = 36.57, 95% CI: 7.80 to 65.35, P = 0.013). Additionally, there were no statistical significance between two kinds of surgical approaches in disease-free survival and overall survival. Moreover, cumulative meta-analysis indicated statistical difference in favor of laparoscopic surgery in terms of morbidity was firstly detected in the 12th study in 2018 (OR = 0.66, 95% CI: 0.46 to 0.96, P = 0.028) as the 95% CI narrowed. Conclusion Compared with open surgeries, laparoscopic surgeries are safer (postoperative complications and intraoperative blood loss) and more effective (length of hospital stay and postoperative stay), and it can be considered as the first option for management of SCRLM in high-volume laparoscopic centers. Trial registration CRD42020151176

Outcomes of laparoscopic surgery for pT3/pT4 colorectal cancer in young vs. old patients

2019 ◽  
Vol 74 (4) ◽  
Author(s):  
Gabriele Bellio ◽  
Marina Troian ◽  
Arianna Pasquali ◽  
Nicolò de Manzini
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Old Patients

Modern capabilities for prognosis of postoperative complications in patients with colorectal cancer

2020 ◽  
pp. 36-51
Author(s):  
G. Rodoman ◽  
G. Gendlin ◽  
N. Malgina ◽  
T. Dolgina
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Surgical Patients ◽  
Cardiac Complications ◽  
Optimal Point

The article discusses the most frequently used prognostic scales intended to assess the risk of cardiac complications in surgical patients. The choice of optimal point scales for patients with colorectal cancer is justified.

PREDICTIVE FACTORS IN THE CHOICE OF SURGICAL TREATMENT FOR COLORECTAL CANCER WITH LAPAROSCOPIC OR "OPEN" ACCESS

2017 ◽  
Vol 63 (3) ◽  
pp. 470-474
Author(s):  
Rustem Topuzov ◽  
Georgiy Manikhas ◽  
Eskender Topuzov ◽  
Mikhail Khanevich ◽  
Magomed Abdulaev ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Open Access ◽  
Comparative Study ◽  
Retrospective Analysis ◽  
Predictive Factors

There are presented results of surgical treatment of 347 patients with colorectal cancer. Based on the retrospective analysis a comparative study of results of surgical treatment for colorectal cancer using laparoscopic technologies and “open” access was carried out. Predictive factors that correlate with the risk of postoperative complications with laparoscopic and “open” access at the surgical stage of treatment for colorectal cancer were determined.

Sign in / Sign up

Export Citation Format

Share Document