scholarly journals Age and comorbidities do not affect short-term outcomes after laparoscopic rectal cancer resection in elderly patients. A multi-institutional cohort study in 287 patients

2021 ◽  
Author(s):  
Roberto Peltrini ◽  
Nicola Imperatore ◽  
Filippo Carannante ◽  
Diego Cuccurullo ◽  
Gabriella Teresa Capolupo ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Rectal Resection ◽  
Laparoscopic Approach ◽  
Postoperative Outcomes ◽  
Rectal Cancer Surgery ◽  
Short Term ◽  
Number Of Patients ◽  
Laparoscopic Rectal Resection

AbstractPostoperative complications and mortality rates after rectal cancer surgery are higher in elderly than in non-elderly patients. The aim of this study is to evaluate whether, like in open surgery, age and comorbidities affect postoperative outcomes limiting the benefits of a laparoscopic approach. Between April 2011 and July 2020, data of 287 patients with rectal cancer submitted to laparoscopic rectal resection from different institutions were collected in an electronic database and were categorized into two groups: < 75 years and ≥ 75 years of age. Perioperative data and short-term outcomes were compared between these groups. Risk factors for postoperative complications were determined on multivariate analysis, including age groups and previous comorbidities as variables. Seventy-seven elderly patients had both higher ASA scores (p < 0.001) and cardiovascular disease rates (p = 0.02) compared with 210 non-elderly patients. There were no significative differences between groups in terms of overall postoperative complications (p = 0.3), number of patients with complications (p = 0.2), length of stay (p = 0.2) and death during hospitalization (p = 0.9). The only independent variables correlated with postoperative morbidity were male gender (OR 2.56; 95% CI 1.53–3.68, p < 0.01) and low-medium localization of the tumor (OR 2.12; 75% CI 1.43–4.21, p < 0.01). Although older people are more frail patients, short-term postoperative outcomes in patients ≥ 75 years of age were similar to those of younger patients after laparoscopic surgery for rectal cancer. Elderly patients benefit from laparoscopic rectal resection as well as non-elderly patient, despite advanced age and comorbidities.

Short-Term Outcomes of Pelvic Peritoneum Reconstruction with Barbed Suture After Laparoscopic Rectal Resection for Rectal Cancer

2021 ◽  
Author(s):  
Jing Wen ◽  
Jian Shen ◽  
Qiushi Huang ◽  
Shan He
Keyword(s):  
Rectal Cancer ◽  
Small Bowel ◽  
Lymph Nodes ◽  
Small Bowel Obstruction ◽  
Rectal Resection ◽  
Perineal Hernia ◽  
Barbed Suture ◽  
Short Term ◽  
Pelvic Peritoneum ◽  
Laparoscopic Rectal Resection

Abstract Background: Laparoscopic rectal resection may cause various surgical complications including perineal hernia and adhesive small-bowel obstruction. Pelvic peritoneum reconstruction (PPR) could prevent those complications. The aim of the study is to evaluate the short-term clinical, technical and safety outcomes of PPR using the barbed suture in laparoscopic rectal resection. Methods: This is a retrospective cohort study conducted in Chengdu second’s people hospital. Between January 2014 and December 2019, a total of 402 patients who underwent curative surgery for rectal cancer in Chengdu Second People’s Hospital were enrolled in the study. Among them, 216 patients who underwent laparoscopic rectal resection with PPR were allocated into the experimental group, and 186 patients who underwent laparoscopic rectal resection without PPR were allocated into control group. All the patients received standard preoperative and postoperative treatments. Observational indicators (1) surgical and postoperative conditions; (2) postoperative pathological examination. (3) postoperative complications. The data were represented by X ± s. t-test and X2 test were used for counting data. Results (1) Surgery condition: all patients in the two groups underwent successful surgery without conversion to open surgery. There were no differences between the two groups in terms of surgical approach, resection margin, tumor size, postoperative T-stage, postoperative N-stage, positive lymph nodes, harvest lymph nodes, perineal wound infection, perineal hernia, postoperative pneumonia, postoperative hemorrhage, presacral fluid, or abscess. The operative time, blood loss, the incidence of anastomotic leakage, and small-bowel obstruction showed a significant difference between the two groups. Conclusion We hypothesized that pelvic peritoneum reconstruction with barbed suture could improve the efficiency of intracorporeal closure of the pelvic cavity after in laparoscopic rectal resection, which can significantly reduce postoperative perineal-related complications. Further, we expect that use of the barbed sutures will reduce intra-operative stress on the endoscopic surgeon.

scholarly journals The Impact of Complications on Short-Term Outcomes of Pelvic Peritoneum Reconstruction with Barbed Suture in Laparoscopic Rectal Resection for Rectal Cancer

2021 ◽  
Author(s):  
Jing Wen ◽  
Jian Shen ◽  
Qiushi Huang ◽  
Shan He
Keyword(s):  
Rectal Cancer ◽  
Lymph Nodes ◽  
Rectal Resection ◽  
Pathological Examination ◽  
Barbed Suture ◽  
Short Term ◽  
Pelvic Peritoneum ◽  
Laparoscopic Rectal Resection ◽  
Significant Difference ◽  
The Impact

Abstract Objective: This study aimed to evaluate the safety and short-term outcomes of pelvic peritoneum reconstruction with barbed sutures in laparoscopic rectal resection for rectal cancer. Methods: This is a retrospective cohort study conducted in Chengdu second’s people hospital. The clinicopathological data of 402 patients with rectal cancer admitted to our department hospital from January to December 2019 were collected. There was total of 402 patients, including 218 males and 174 females, with an average age of 68 years. Among them, 216 patients who underwent laparoscopic rectal resection with pelvic peritoneum reconstruction (PPR) were allocated into the PPR group, and 186 patients who underwent conventional laparoscopic rectal resection were allocated into a non-PPR group. All the patients received standard preoperative and postoperative treatments. Observational indicators (1) surgical and postoperative conditions; (2) postoperative pathological examination. (3) postoperative complications. Results (1) Surgery condition: all patients in the two groups underwent successful surgery without conversion to open surgery. There were no differences between the two groups in terms of surgical approach, resection margin, tumor size, postoperative T-stage, postoperative N-stage, positive lymph nodes, harvest lymph nodes, perineal wound infection, perineal hernia, postoperative pneumonia, postoperative hemorrhage, presacral fluid, or abscess. The operative time, blood loss, the incidence of anastomotic leakage, and small-bowel obstruction showed a significant difference between the two groups. Conclusion pelvic peritoneum reconstruction with barbed suture in laparoscopic rectal resection is safe and feasible for the treatment of rectal cancer, which can significantly reduce postoperative perineal-related complications.

scholarly journals Short-term Outcomes of Elective 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea: Does Laparoscopy Have Benefits?

2020 ◽  
Vol 36 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Jun Woo Bong ◽  
Yong Sik Yoon ◽  
Jong Lyul Lee ◽  
Chan Wook Kim ◽  
In Ja Park ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Postoperative Complications ◽  
Restorative Proctocolectomy ◽  
Complication Rate ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Bowel Function ◽  
Open Group ◽  
Open Approach ◽  
Short Term

Purpose: This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).Methods: We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.Results: There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.Conclusion: Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.

Laparoscopic rectal resection following regrowth of rectal cancer in watch and wait programme

2021 ◽  
Author(s):  
AF Ramzee ◽  
A Mureb ◽  
M Al Dhaheri ◽  
K Qadir ◽  
M Abu Nada ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Rectal Resection ◽  
Watch And Wait ◽  
Laparoscopic Rectal Resection

Short-Term Outcomes of Laparoscopic Rectal Surgery for Primary Rectal Cancer in Elderly Patients: Is it Safe and Beneficial?

2009 ◽  
Vol 13 (9) ◽  
pp. 1614-1618 ◽  
Author(s):  
Takashi Akiyoshi ◽  
Hiroya Kuroyanagi ◽  
Masatoshi Oya ◽  
Tsuyoshi Konishi ◽  
Meiki Fukuda ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Elderly Patients ◽  
Rectal Surgery ◽  
Short Term ◽  
Primary Rectal Cancer ◽  
Laparoscopic Rectal Surgery
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