QS284. Risk Factors for Anastomotic Leakage Following Laparoscopic Surgery of Middle and Low Rectal Cancers: Multicenter Study by Japan Society of Laparoscopic Colorectal Surgery

2009 ◽  
Vol 151 (2) ◽  
pp. 295
Author(s):  
T. Hinoi ◽  
M. Okajima ◽  
S. Ikeda ◽  
M. Yoshimitsu ◽  
F. Konishi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laparoscopic Surgery ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Multicenter Study ◽  
Laparoscopic Colorectal Surgery ◽  
Japan Society ◽  
Rectal Cancers

scholarly journals Persistent Descending Mesocolon as a Risk Factor of Laparoscopic Surgery for Colorectal Cancer: A Single Institution Experience

2019 ◽  
Vol 104 (9-10) ◽  
pp. 439-445
Author(s):  
Hidekazu Takahashi ◽  
Nobuo Tanaka ◽  
Osamu Takayama ◽  
Masashi Baba ◽  
Masaru Murata ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Laparoscopic Surgery ◽  
Colorectal Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Three Dimensional ◽  
Tumor Location ◽  
Computed Tomographic ◽  
Preoperative Diagnostic ◽  
Tomographic Slice

The objectives of this study are to clarify the significance of persistent descending mesocolon (PDM), a kind of intestinal malrotation, in laparoscopic colorectal surgery and present potentially useful preoperative diagnostic methods for PDM. Although several risk factors for laparoscopic colorectal surgery have been convincingly reported, the impact of PDM on laparoscopic surgery for colorectal cancer remains less studied. This was an observational study with a retrospective analysis. A consecutive 110 patients undergoing laparoscopic colorectal surgery for colorectal cancer were included. To identify risk factors for operative time of laparoscopic surgery for colorectal cancer, we examined age, sex, body mass index, American Society of Anesthesiologists Performance Status score, tumor location, depth of tumor invasion, lymph node metastasis, and PDM as potential risk factors. For identification of appropriate preoperative diagnostic imaging, we reviewed three-dimensional vessel images reconstructed from computed tomographic slice data of all patients. During the study period, no effective pre- or intraoperative diagnoses of PDM were achieved. A total of 4 patients were diagnosed with PDM. Sex (P = 0.0032); tumor location (P = 0.0044); lymph node metastasis (P = 0.022); and PDM (P = 0.0007) were identified as risk factors based on multivariate analysis. A ventrally branched left colic artery visualized by three-dimensional imaging appeared to be a highly specific feature of PDM. Laparoscopic surgery for colorectal cancer with PDM was difficult without the recognition of PDM. PDM was well-defined preoperatively using three-dimensional vessels images reconstructed from computed tomographic slice data.

Laparoscopic Colorectal Surgery Modifies Risk Factors for Postoperative Morbidity

2004 ◽  
Vol 47 (10) ◽  
pp. 1686-1693 ◽  
Author(s):  
Andrea Vignali ◽  
Marco Braga ◽  
Walter Zuliani ◽  
Matteo Frasson ◽  
Giovanni Radaelli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Postoperative Morbidity ◽  
Laparoscopic Colorectal Surgery

Machine learning models for prediction of postoperative ileus in patients underwent laparoscopic colorectal surgery

2020 ◽  
Author(s):  
Xueyan Li ◽  
Genshan Ma ◽  
Xiaobo Qian ◽  
Yamou Wu ◽  
Xiaochen Huang ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Colorectal Surgery ◽  
Decision Tree ◽  
Risk Prediction ◽  
Postoperative Ileus ◽  
Laparoscopic Colorectal Surgery ◽  
Machine Learning Algorithms ◽  
Gradient Boosting ◽  
Malignant Lesions

Abstract Background: We aimed to assess the performance of machine learning algorithms for the prediction of risk factors of postoperative ileus (POI) in patients underwent laparoscopic colorectal surgery for malignant lesions. Methods: We conducted analyses in a retrospective observational study with a total of 637 patients at Suzhou Hospital of Nanjing Medical University. Four machine learning algorithms (logistic regression, decision tree, random forest, gradient boosting decision tree) were considered to predict risk factors of POI. The total cases were randomly divided into training and testing data sets, with a ratio of 8:2. The performance of each model was evaluated by area under receiver operator characteristic curve (AUC), precision, recall and F1-score. Results: The morbidity of POI in this study was 19.15% (122/637). Gradient boosting decision tree reached the highest AUC (0.76) and was the best model for POI risk prediction. In addition, the results of the importance matrix of gradient boosting decision tree showed that the five most important variables were time to first passage of flatus, opioids during POD3, duration of surgery, height and weight. Conclusions: The gradient boosting decision tree was the optimal model to predict the risk of POI in patients underwent laparoscopic colorectal surgery for malignant lesions. And the results of our study could be useful for clinical guidelines in POI risk prediction.

Laparoscopic reintervention for anastomotic leakage after primary laparoscopic colorectal surgery

2007 ◽  
Vol 94 (12) ◽  
pp. 1562-1566 ◽  
Author(s):  
J. Wind ◽  
A. G. Koopman ◽  
M. I. van Berge Henegouwen ◽  
J. F. M. Slors ◽  
D. J. Gouma ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Laparoscopic Colorectal Surgery

scholarly journals Hand-assisted laparoscopic surgery for left-sided colon and rectal cancer: 10 Years single centre experience

2016 ◽  
Vol 63 (1) ◽  
pp. 23-28
Author(s):  
Rokas Rackauskas ◽  
Audrius Dulskas ◽  
Vygintas Aliukonis ◽  
Narimantas Samalavicius
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Colorectal Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Tertiary Care ◽  
Stage Iv ◽  
Operation Time ◽  
Minimal Invasive ◽  
Invasive Technique ◽  
Colon And Rectal Cancer

Introduction. Hand-assisted laparoscopic surgery (HALS) was introduced into clinical practice in the mid-1990s. Although this technique was established as a bridge to total laparoscopic colorectal surgery there are still those who oppose it. In this study we report our 10 year experience of practicing HALS. Methods. This study is a retrospective analysis of prospectively collected data of 426 patients undergoing hand-assisted laparoscopic colorectal surgery for left-sided colon and rectal cancer in a single tertiary care institution, the National Cancer Institute, from January, 2006, to July, 2016. All consenting patients with left sided colon and rectal cancer were included in the analysis. Results. Patient population showed a similar female and male ratio 212 (49.76%) vs. 214 (50.24%). Average age was 64.13 ? 9.92 years (from 26 to 91). Operation time was 108 minutes ? 44.1 min (30 - 320 min). The mean length of the postoperative hospital stay was 6.88, ranging from 2 to 34 days. The pathohistological examination revealed mean lymph node harvest was 16.4 ? 9.61, ranging from 0 to 54. Stage I and II cancer prevailed in the majority of cases, accounting for 129 (30.28%) for each, stage III - 135 (31.69%), and stage IV - 33 (7.74%). Complication rate was 7.27%. Surgical reintervention was required in 10 cases (2.35%). Mortality rate occurred only in two (0.47%) patients. Conclusion. In conclusion, the HALS technique combines the benefits of a minimal invasive technique for the patient and palpatory benefits for the surgeon, which makes surgery for left-sided colon and rectum cancer faster, and with a similar outcome to laparoscopic colectomy.

The Introduction of Laparoscopic Colorectal Surgery: Can It Improve Hospital Economics?

2020 ◽  
pp. 1-8
Author(s):  
Martijn Maassen van den Brink ◽  
Thaís T.T. Tweed ◽  
Patrick A. de Hoogt ◽  
A.G.M. Hoofwijk ◽  
Karel W.E. Hulsewé ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Colorectal Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Operating Time ◽  
Median Hospital Stay ◽  
Total Cost ◽  
Hospital Economics ◽  
Financial Benefits ◽  
Clinical Benefits ◽  
Improve Hospital

<b><i>Introduction:</i></b> Clinical benefits of laparoscopic surgery are well established, but evidence for financial benefits is limited. This study aimed to compare the financial impact of the introduction of laparoscopic colorectal surgery. <b><i>Methods:</i></b> This study included patients who underwent colorectal surgery between January 2010 and 2015. We collected a range of financial data and divided the patients into 2 groups. Primary outcome was total cost defined by surgical-related costs. <b><i>Results:</i></b> A total of 1,246 patients were included, of which 440 surgeries were performed laparoscopically. The total median cost of laparoscopy was higher compared to open surgery (EUR 4,665 vs. EUR 4,268, <i>p</i> = 0.001). Laparoscopy was associated with higher equipment costs (EUR 857 vs. EUR 232, <i>p</i> &#x3c; 0.001), longer operating time (3.2 vs. 2.5 hours, <i>p</i> &#x3c; 0.001), and more readmissions (10.9 vs. 8.5%, <i>p</i> &#x3c; 0.001). However, after adjusting for heterogeneity, no difference was found in total cost. Surgical-related costs were counterbalanced by lower costs associated with shorter median hospital stay (6 vs. 9 days, <i>p</i> &#x3c; 0.001), less morbidity (37.3 vs. 55.1%, <i>p</i> &#x3c; 0.001), and less mortality (1.8 vs. 5.6%, <i>p</i> = 0.013) for laparoscopy. <b><i>Conclusion:</i></b> During the introduction of laparoscopy for colorectal surgery, no significant differences were found in total cost between laparoscopic and open colorectal surgery. However, favorable postoperative outcomes were achieved with laparoscopic surgery.

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