508 Does the Use of Neoadjuvant Therapy for Pancreatic Adenocarcinoma Increase Postoperative Morbidity and Mortality Rates?

Significant morbidity and mortality have historically been reported for surgical resection of gastric and gastroesophageal junction tumors. We evaluated our experience to determine morbidity and mortality and evaluated demographic and pathologic risk factors associated with postoperative outcome and long-term survival. A retrospective, Institutional Review Board-approved, single-institution database identified 102 patients who underwent resection with curative intent for gastroesophageal junction or gastric carcinoma from 2004 to 2012. The method of Kaplan and Meier was used to describe overall survival and estimate median survival. Of 102 patients, 74 were male and 28 were female. Of these, 24 patients were > 70 years of age at surgery (median = 62.9). Forty esophagectomies, 25 total gastrectomies, and 37 subtotal gastrectomies were performed. Two patients died (one esophagectomy and one gastrectomy). Forty-one developed a complication: 17 minor and 35 major, including six anastomotic leaks. Patients with low preoperative albumin ( P = 0.01) and increased age ( P = 0.05) were associated with having a postoperative complication; extent of nodal dissection ( P = 0.48), jejunostomy (0.24), performance status ( P = 0.77), type of surgery ( P = 0.74), and neoadjuvant therapy ( P = 0.24) were not associated. More extensive nodal dissection was associated with a decreased risk of death ( P = 0.007). Having any complication ( P = 0.20), an anastomotic leak ( P = 0.17), worse grade of complication ( P = 0.15), presence of feeding jejunostomy tube ( P = 0.17), and neoadjuvant therapy ( P = 0.30) were not associated with changes in overall survival. Thorough lymph node dissection improves survival without increasing postoperative morbidity. The data advocate for increased lymph node yield and close attention to nutritional support in gastroesophageal carcinoma patients.

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Postoperative Morbidity and Mortality Rates are Not Increased for Patients with Gastric and Gastroesophageal Cancer Who Undergo Preoperative Chemoradiation Therapy

Annals of Surgical Oncology ◽

10.1245/s10434-015-4643-8 ◽

2015 ◽

Vol 23 (1) ◽

pp. 156-162 ◽

Cited By ~ 17

Author(s):

Brian Badgwell ◽

Jaffer Ajani ◽

Mariela Blum ◽

Linus Ho ◽

Keith Fournier ◽

...

Keyword(s):

Postoperative Morbidity ◽

Mortality Rates ◽

Preoperative Chemoradiation ◽

Chemoradiation Therapy ◽

Morbidity And Mortality ◽

Gastroesophageal Cancer ◽

Preoperative Chemoradiation Therapy

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Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates*

Critical Care Medicine ◽

10.1097/01.ccm.0000119428.02968.9e ◽

2004 ◽

Vol 32 (4) ◽

pp. 916-921 ◽

Cited By ~ 319

Author(s):

Rinaldo Bellomo ◽

Donna Goldsmith ◽

Shigehiko Uchino ◽

Jonathan Buckmaster ◽

Graeme Hart ◽

...

Keyword(s):

Postoperative Morbidity ◽

Controlled Trial ◽

Medical Emergency Team ◽

Mortality Rates ◽

Morbidity And Mortality ◽

Medical Emergency ◽

Emergency Team

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Effect of Surgical Safety Checklists on Postoperative Morbidity and Mortality Rates, Shiraz, Faghihy Hospital, a 1-Year Study

Quality Management in Health Care ◽

10.1097/qmh.0b013e318231357c ◽

2011 ◽

Vol 20 (4) ◽

pp. 293-297 ◽

Cited By ~ 49

Author(s):

Mehrdad Askarian ◽

Farideh Kouchak ◽

Charles John Palenik

Keyword(s):

Postoperative Morbidity ◽

Mortality Rates ◽

Morbidity And Mortality ◽

Surgical Safety

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

Langenbeck s Archives of Surgery ◽

10.1007/s00423-022-02428-5 ◽

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.

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Factors Affecting Postoperative Morbidity and Mortality in Patients Who Received Neoadjuvant Therapy for Lung Cancer

The Annals of Clinical and Analytical Medicine ◽

10.4328/jcam.2935 ◽

2015 ◽

Vol 06 (Supplement 3) ◽

Keyword(s):

Lung Cancer ◽

Neoadjuvant Therapy ◽

Postoperative Morbidity ◽

Morbidity And Mortality ◽

Factors Affecting

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Controversies in the Management of Borderline Resectable Proximal Pancreatic Adenocarcinoma with Vascular Involvement

HPB Surgery ◽

10.1155/2008/839503 ◽

2008 ◽

Vol 2008 ◽

pp. 1-8 ◽

Cited By ~ 16

Author(s):

Olga N. Tucker ◽

Mohamed Rela

Keyword(s):

Pancreatic Adenocarcinoma ◽

Hepatic Artery ◽

Survival Rates ◽

High Volume ◽

Mortality Rates ◽

Morbidity And Mortality ◽

High Morbidity ◽

Borderline Resectable ◽

Term Survival ◽

Major Vessel

Synchronous major vessel resection during pancreaticoduodenectomy (PD) for borderline resectable pancreatic adenocarcinoma remains controversial. In the 1970s, regional pancreatectomy advocated by Fortner was associated with unacceptably high morbidity and mortality rates, with no impact on long-term survival. With the establishment of a multidisciplinary approach, improvements in preoperative staging techniques, surgical expertise, and perioperative care reduced mortality rates and improved 5-year-survival rates are now achieved following resection in high-volume centres. Perioperative morbidity and mortality following PD with portal vein resection are comparable to standard PD, with reported 5-year-survival rates of up to 17%. Segmental resection and reconstruction of the common hepatic artery/proper hepatic artery (CHA/PHA) can be performed to achieve an R0 resection in selected patients with limited involvement of the CHA/PHA at the origin of the gastroduodenal artery (GDA). PD with concomitant major vessel resection for borderline resectable tumours should be performed when a margin-negative resection is anticipated at high-volume centres with expertise in complex pancreatic surgery. Where an incomplete (R1 or R2) resection is likely neoadjuvant treatment with systemic chemotherapy followed by chemoradiation as part of a clinical trial should be offered to all patients.

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