98. The effect of minimal invasive surgery on postoperative mortality in colorectal cancer surgery

2014 ◽  
Vol 40 (11) ◽  
pp. S46
Author(s):  
L. Gietelink ◽  
M.W.J.M. Wouters ◽  
R.A.E.M. Tollenaar ◽  
P.J. Tanis
2020 ◽  
pp. 145749692097605
Author(s):  
N. Karlsson ◽  
S. Zackrisson ◽  
P. Buchwald

Background and Aims: Incisional hernia is a frequent negative outcome after open and minimal invasive surgery of colorectal cancer. This study aimed to determine computed tomography–verified incisional hernia prevalence 1-year post colorectal cancer surgical resection in patients sutured with standardized small stich 4:1 technique, identify risk factors for incisional hernia and assess to what extent incisional hernia required surgical correction. Material and Methods: All patients subjected to resectional colorectal cancer surgery during 2012–2016 at Skåne University Hospital were identified in the Swedish Colorectal Cancer Registry. The 1-year follow-up computed tomography was re-evaluated to establish the presence of incisional hernia. Clinical data were collected from Swedish Colorectal Cancer Registry and the patients’ medical charts were reviewed. Non-parametric tests and binary logistic regression analysis were used for statistical analysis. Results: In total, 1744 tumors were identified resulting in 1231 patients meeting the inclusion criteria. In total, 25.9% (n = 319) had incisional hernia at the 1-year follow-up computed tomography and 13.2% (n = 162) of the colorectal cancer resections were minimal invasive surgery, and there was non-significant incisional hernia prevalence difference between open and minimal invasive surgery. However, for converted and non-converted minimal invasive surgery, the incisional hernia frequencies were 43.9% (n = 18) and 24.1% (n = 39), respectively (p = 0.012). Significant risk factors for incisional hernia were body mass index, wound rupture, and procedure time. During the follow-up time, 14.1% (n = 45) needed incisional hernia corrective surgery. Conclusion: Incisional hernia after colorectal cancer surgery is common despite standardized small stich 4:1 closure, but few incisional hernias are surgically corrected. Incisional hernia is equally frequent after open surgery and minimal invasive surgery. However, the risk of incisional hernia is considerably higher after minimal invasive surgery conversion.


2014 ◽  
Vol 259 (5) ◽  
pp. 844-849 ◽  
Author(s):  
Daniel Henneman ◽  
Annelotte C. M. van Bommel ◽  
Alexander Snijders ◽  
Heleen S. Snijders ◽  
Rob A. E. M. Tollenaar ◽  
...  

BMC Surgery ◽  
2013 ◽  
Vol 13 (Suppl 2) ◽  
pp. S12 ◽  
Author(s):  
Antonio Biondi ◽  
Giuseppe Grosso ◽  
Antonio Mistretta ◽  
Stefano Marventano ◽  
Chiara Toscano ◽  
...  

Author(s):  
Thanh Xuan Nguyen

TÓM TẮT Đặt vấn đề: Gây tê ngoài màng cứng để giảm đau trong và sau mổ được áp dụng rộng rãi trên thế giới từ nhiều thập niên qua. Kết quả của nhiều công trình nghiên cứu cho thấy phương pháp này làm giảm những biến chứng trong và sau mổ, giảm tỉ lệ tử vong sau mổ của các phẫu thuật nặng. Nghiên cứu nhằm đánh giá hiệu quả và các tác dụng phụ của gây tê ngoài màng cứng trong phẫu thuật ung thư đại, trực tràng. Phương pháp: Nghiên cứu mô tả cắt ngang trên 28 bệnh nhân được gây tê ngoài màng cứng trong mổ ung thư đại, trực tràng có phối hợp gây mê nội khí quản. Sinh hiệu và tình trạng sức khỏe của bệnh nhân được theo dõi trước và sau khi tiêm thuốc giảm đau. Ghi nhận mức độ giảm đau theo Visual Analog Scale (VAS), mức độ liệt vận động theo Bromage và các tác dụng phụ sau mổ. Kết quả: Hiệu quả giảm đau sau mổ tốt, tại các thời điểm sau mổ VAS đều ≤ 1,5. Tỉ lệ các biến chứng: tụt huyết áp: 7,14%, đau đầu: 7,14%, lạnh run: 10,71%, buồn nôn, nôn: 17,86%. Kết luận: Kỹ thuật gây tê ngoài màng cứng phối hợp với gây mê toàn thân là kỹ thuật giảm đau hiệu quả và an toàn cho phẫu thuật vùng bụng trong mổ và 24 giờ sau mổ. ABSTRACT THE EFFICIENCY OF SPINAL EPIDURAL ANESTHESIA FOR LAPAROSCOPIC COLORECTAL CANCER SURGERY Background: Epidural anesthesia for pain relief during and after surgery has been widely applied in the world for decades. The results of many studies show that this method reduces intra - and postoperative complications and reduces the postoperative mortality rate of major surgery. The study aimed to evaluate epidural anesthesia’s effectiveness and side effects in colorectal cancer surgery. Methods: A cross - sectional descriptive study on 28 patients receiving epidural anesthesia in surgery for colorectal cancer in combination with endotracheal anesthesia. The patient’s vital signs and health status were monitored before and after the injection of pain medication. Record the level of pain relief according to the Visual Analog Scale (VAS), the degree of motor paralysis according to Bromage, and the side effects after surgery. Results: Good postoperative pain relief effect, at all times after surgery, VAS was ≤ 1.5. Rate of complications: hypotension: 7.14%, headache: 7.14%, shiver: 10.71%, nausea, vomiting: 17.86%. Conclusion: The epidural anesthesia combined with general anesthesia is an effective and safe analgesia technique for abdominal surgery during surgery and 24 hours after surgery. Keywords: Epidural anesthesia, colorectal cancersurgery


Gut ◽  
2011 ◽  
Vol 60 (6) ◽  
pp. 806-813 ◽  
Author(s):  
E. J. A. Morris ◽  
E. F. Taylor ◽  
J. D. Thomas ◽  
P. Quirke ◽  
P. J. Finan ◽  
...  

2008 ◽  
Vol 6 (4) ◽  
pp. 0-0
Author(s):  
Giedrė Rudinskaitė ◽  
Narimantas Evaldas Samalavičius ◽  
Renatas Tikuišis

Giedrė Rudinskaitė1, Narimantas Evaldas Samalavičius2, Renatas Tikuišis31, 2 Vilniaus universiteto Onkologijos instituto Abdominalinės ir bendrosios chirurgijosir onkologijos skyrius, Santariškių g. 1, LT-08660 Vilnius3 Vilniaus universiteto Onkologijos instituto Intensyviosios terapijos ir anesteziologijos skyrius,Santariškių g. 1, LT-08660 VilniusEl paštas: [email protected] Nors minimaliai invaziniu būdu operuojama daugelis neonkologinių ligų, laparoskopinės kolorektalinio vėžio chirurgijos pripažinimas yra daug mažesnis. Priežastis buvo tokie veiksniai kaip operacijos technikos sudėtingumas, kaina, operacijos trukmė, ilga mokymosi kreivė ir rūpestis onkologiniu saugumu. Chirurgų bendruomenei užtruko daugiau nei dešimt metų įteisinti laparoskopinį kolorektalinio vėžio gydymo metodą: jis yra saugus, pacientams užtikrina visus laparoskopinės chirurgijos pranašumus. Duomenys taip pat parodė, kad išgyvenamumas po laparoskopinės ir laparotominės gaubtinės žarnos vėžio rezekcijos nesiskiria. Tyrimai, nagrinėjantys išgyvenamumą po tiesiosios žarnos vėžio laparoskopinės rezekcijos, buvo pradėti vėliau ir 5 metų išgyvenamumo rezultatai dar negauti. Šioje apžvalgoje pateikiami iki šiol gauti ir metaanalizės būdu išnagrinėti kolorektalinio vėžio laparoskopinių operacijų rezultatai Reikšminiai žodžiai: gaubtinės žarnos vėžys, tiesiosios žarnos vėžys, laparoskopinė rezekcija A comparison of laparoscopic and open colorectal cancer surgery Giedrė Rudinskaitė1, Narimantas Evaldas Samalavičius2, Renatas Tikuišis31, 2 Abdominal and General Surgical Oncology Department, Institute of Oncology,University of Vilnius, Santariškiu str. 1, LT-08660 Vilnius, Lithuania3 Intensive Care and Anestesiology Department, Institute of Oncology, University of Vilnius,Santariškių str. 1, LT-08660 Vilnius, LithuaniaE-mail: [email protected] Although minimally invasive surgery has been accepted for a variety of disorders, laparoscopic resection of colorectal cancer surgery gained much less acceptance. The reasons were the factors such as technical complexity, cost, duration of surgery, the long learning curve and concerns about oncologic safety. It took the surgical community more than a decade to admit that the laparoscopic optikon for colorectal cancer is legitimate: it is safe, and it provides the patients with the advantages of minimally invasive surgery. Data indicate that there are no oncologic differences between laparoscopic and open resections for the treatment of primary colon cancer. Initiated later than for colon cancer, the 5-year survival evaluation of the use of laparoscopy in rectal cancer is still ongoing. This review presents recently published metaanalyses of colorectal cancer laparoscopic surgery. Keywords: cancer of colon, rectal cancer, laparoscopic resection


2021 ◽  
Vol 18 (1) ◽  
pp. 8-13
Author(s):  
Dušica Banković-Lazarević ◽  
Verica Jovanović ◽  
Biljana Mijović ◽  
Jelena Brcanski ◽  
Marina Jelić ◽  
...  

Objective. The aim of this study was to compare mortality of patients after colorectal cancer surgery between hospitals in Serbia, which performed organized colorectal cancer screening and those which did not. Methods. The database included all patients who underwent surgery for colorectal cancer after the introduction of organized colorectal cancer screening Program in Serbia, in 2014-2015. The target group were patients 50-74 years old in the colorectal screening program, and the data was compared to the age-matched group from hospitals which did not perform the program logistic regression. Results. The was used to determine the significance of the differences in the observed variables, and the predictors of mortality after colorectal cancer surgery. Results. The 3631 patients were included in this study. The majority of them were operated due to the rectal cancer 2111 (58%), while 1062 (29.2%) were operated due to the colon cancer. Postoperative survival was significantly better in the target group in organized screening program (p<0.001; OR=0.46; 95%CI 0.33-0.62). There was a significant difference between patients who underwent surgery for colorectal cancer localized in the left colon, compared to the patients with localization in the right colon (p<0.001). The mortality after the surgery of colorectal cancer (4.7%) was followed by high comorbidity of cardiovascular diseases (24%). Conclusion. Patients included in the organized colorectal cancer screening have lower postoperative mortality than these not included. This indicates the necessity for further work on organized colorectal cancer screening, in order to reduce postoperative and overall mortality.


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