Comment on “Predictors for Anastomotic Leak, Postoperative Complications, and Mortality After Right Colectomy for Cancer: Results From an International Snapshot Audit”

2020 ◽  
Vol 64 (2) ◽  
pp. e40-e40
Author(s):  
Francesco Marchegiani ◽  
Cristiano Huscher
Keyword(s):  
Postoperative Complications ◽  
Anastomotic Leak ◽  
Right Colectomy ◽  
Complications And Mortality

scholarly journals Securing the surgical field for mobilization of right-sided colon cancer using the duodenum-first multidirectional approach in laparoscopic surgery

2021 ◽  
Author(s):  
K. Nagayoshi ◽  
S. Nagai ◽  
K. P. Zaguirre ◽  
K. Hisano ◽  
M. Sada ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Operative Time ◽  
Right Colectomy ◽  
R0 Resection ◽  
Medial Approach ◽  
Total Operative Time ◽  
Advanced Tumors

Abstract Background The aim of this study was to compare the short-term outcomes of the duodenum-first multidirectional approach (DMA) in laparoscopic right colectomy with those of the conventional medial approach to assess its safety and feasibility. Methods This retrospective study enrolled 120 patients who had laparoscopic surgery for right-sided colon cancer in our institution between April 2013 and December 2019. Fifty-four patients underwent colectomy using the multidirectional approach; among these, 20 underwent the DMA and 34 underwent the caudal-first multidirectional approach (CMA). Sixty-six patients underwent the conventional medial approach. Complications within 30 days of surgery were compared between the groups. Results There were 54 patients in the multidirectional group [29 females, median age 72 years (range 36–91 years)] and 66 in the medial group [42 females, median age 72 years (range 41–91 years)]. Total operative time was significantly shorter in multidirectional approach patients than conventional medial approach patients (208 min vs. 271 min; p = 0.01) and significantly shorter in patients who underwent the DMA compared to the CMA (201 min vs. 269 min; p < 0.001). Operative time for the mobilization procedure was also significantly shorter in patients who underwent the DMA (131 min vs. 181 min; p < 0.001). Blood loss and incidence of postoperative complications did not differ. In 77 patients with advanced T3/T4 tumors, the DMA, CMA, and conventional medial approach were performed in 13, 21, and 43 patients, respectively. Total operative time and operative time of the mobilization procedure were significantly shorter in patients undergoing DMA. Blood loss and incidence of postoperative complications did not differ. R0 resection was achieved in all patients with advanced tumors. Conclusions The DMA in laparoscopic right colectomy is safe and feasible and can achieve R0 resection with a shorter operative time than the conventional medial approach, even in patients with advanced tumors.

651 A META-ANALYSIS OF SURVIVAL AFTER NEOADJUVANT CHEMORADIOTHERAPY VERSUS NEOADJUVANT CHEMOTHERAPY IN RESECTABLE LOCALLY ADVANCED ESOPHAGEAL CANCERS BASED ON HISTOLOGIC SUBTYPES

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Rawat Waratchanont ◽  
Jirat Leelapatanadit ◽  
Wichitra Asanprakit ◽  
Viriya Kaewkangsadan ◽  
Sukchai Sattaporn
Keyword(s):  
Overall Survival ◽  
Postoperative Complications ◽  
Neoadjuvant Chemotherapy ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Progression Free Survival ◽  
Comprehensive Search ◽  
Complications And Mortality ◽  
Histologic Subtypes

Abstract   Neoadjuvant treatments provided survival benefits over surgery alone in resectable locally advanced esophageal and esophagogastric junction (EGJ) cancer patients. Both neoadjuvant chemoradiotherapy (nCRT) and neoadjuvant chemotherapy (nCT) are shown to be effective treatments. However, the direct comparison between two methods based on histologic subtypes, squamous cell carcinoma (SCC) and adenocarcinoma (AC) is still limited. This study examined the hypothesis that nCRT could provide the better overall survival (OS) than nCT. Methods A comprehensive search of studies comparing nCRT and nCT in patients with esophageal and EGJ cancer based on histologic subtypes was conducted. A meta-analysis of randomized (8 articles) and non-randomized (15 articles) studies was performed using odds ratio (OR) and 95% confidence intervals (CI95%). The OS was the main objective, whereas the secondary objective were complete pathological response (pCR) rate, curative resection (R0) rate, locoregional progression free-survival (L-PFS) rate, postoperative complications and mortality. Results Twenty three articles included 1,671 SCC and 9,285 AC patients. Neither 3- nor 5-year OS was found to be different. However, SCC patients receiving nCRT showed the better 3-year OS (OR 1.67, CI95% 1.17–2.40, p = 0.005). Both pCR and R0 rates were superior in nCRT group (OR 3.30, CI95% 2.46–4.44 and 2.46, CI95% 1.66–3.65, p &lt; 0.00001, respectively). The better 3-year L-PFS was observed in nCRT group (OR 1.47, CI95% 1.17–1.85, p = 0.008), but 5-year L-PFS was comparable. The 30-day mortality was comparable, while 90-day mortality was higher in nCRT group (OR 1.32, CI95% 1.01–1.72, p = 0.04). Conclusion The nCRT provided the better overall survival especially in SCC patients and also increased locoregional control. Meanwhile, postoperative complications and mortality were higher after nCRT. Due to clinical heterogeneity, the multidisciplinary team management for each patient is required before treatment.

Presepsin and Procalcitonin Levels as Markers of Adverse Postoperative Complications and Mortality in Cardiac Surgery Patients

2018 ◽  
Vol 47 (1-3) ◽  
pp. 140-148 ◽  
Author(s):  
Anna Clementi ◽  
Grazia Maria Virzì ◽  
María-Jimena Muciño-Bermejo ◽  
Federico Nalesso ◽  
Davide Giavarina ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Complications ◽  
Predictive Value ◽  
Renal Outcome ◽  
Positive Trend ◽  
Receiver Operating Characteristic Curves ◽  
Primary Endpoints ◽  
Significant Difference ◽  
Respiratory Outcome ◽  
Complications And Mortality

Backgound: This study was aimed at evaluating the presepsin and procalcitonin levels to predict adverse postoperative complications and mortality in cardiac surgery patients. Methods: A total of 122 cardiac surgery patients were enrolled for the study. Presepsin and procalcitonin levels were measured 48 h after the procedure. The primary endpoints were adverse renal, respiratory, and cardiovascular outcomes and mortality. Results: Presepsin and procalcitonin levels were significantly higher in patients with adverse renal and respiratory outcome (p < 0.001 and 0.0081). The presepsin levels were significantly higher in patients with adverse cardiovascular outcome (p = 0.023) and the procalcitonin values in patients with sepsis (p = 0.0013). Presepsin levels were significantly higher in patients who died during hospitalization (382 pg/mL, interquartile range [IQR] 243–717.5 vs. 1,848 pg/mL, IQR 998–5,451.5, p = 0.049). In addition, the predictive value for in-hospital, 30-days, and 6-months mortality was higher for presepsin, with a significant difference between the 2 biomarkers (p = 0.025, p = 0.035, p = 0.003; respectively). Presepsin and procalcitonin seem to have comparable predictive value for adverse renal, cardiovascular, and respiratory outcome in cardiac surgery patients. Although a positive trend was notable for presepsin and adverse renal outcome (area under the ROC [receiver operating characteristic] curves [AUC] of 0.760, 95% CI 0.673–0.833 versus procalcitonin: AUC 0.692; 95% CI 0.601–0.773): no statistically significant difference was evident between the AUC of the 2 biomarkers (p = 0.25). Conclusions: Presepsin and ­procalcitonin seem to have comparable predictive value for ­adverse renal, cardiovascular, and respiratory outcome in cardiac surgery patients. Also, presepsin possesses a better predictive value for in-hospital, 30-days, and 6-months mortality.

Pulmonary Hypertension as a Predictor of Postoperative Complications and Mortality After Liver Transplantation

2010 ◽  
Vol 42 (4) ◽  
pp. 1188-1190 ◽  
Author(s):  
L. De Pietri ◽  
R. Montalti ◽  
B. Begliomini ◽  
A. Reggiani ◽  
L. Lancellotti ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Pulmonary Hypertension ◽  
Postoperative Complications ◽  
Complications And Mortality

scholarly journals SuPAR predicts postoperative complications and mortality in patients with asymptomatic aortic stenosis

Open Heart ◽  
2018 ◽  
Vol 5 (1) ◽  
pp. e000743 ◽  
Author(s):  
Gethin W Hodges ◽  
Casper N Bang ◽  
Jesper Eugen-Olsen ◽  
Michael H Olsen ◽  
Kurt Boman ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Aortic Stenosis ◽  
Complications And Mortality

scholarly journals Postoperative complications and mortality after major gastrointestinal surgery

Medicina ◽  
2014 ◽  
Vol 50 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Triin Jakobson ◽  
Juri Karjagin ◽  
Liisa Vipp ◽  
Martin Padar ◽  
Ants-Hendrik Parik ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Gastrointestinal Surgery ◽  
Complications And Mortality

Predicting postoperative complications and mortality after acetabular surgery in the elderly

2020 ◽  
Vol 31 (2) ◽  
pp. 162-167 ◽  
Author(s):  
Chang-Yeon Kim ◽  
Nikunj N. Trivedi ◽  
Lakshmanan Sivasundaram ◽  
George Ochenjele ◽  
Raymond W. Liu ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
The Elderly ◽  
Surgery In The Elderly ◽  
Complications And Mortality

scholarly journals Impact of Renal Function on the Surgical Outcomes of Displaced Femoral Neck Fracture in Elderly Patients

2019 ◽  
Vol 8 (8) ◽  
pp. 1149 ◽  
Author(s):  
Kwon ◽  
Lim ◽  
Yang ◽  
Lee ◽  
Jeon ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Femoral Neck ◽  
Renal Impairment ◽  
Femoral Neck Fracture ◽  
Bipolar Hemiarthroplasty ◽  
Neck Fracture ◽  
Group 3 ◽  
Group 2 ◽  
Complications And Mortality ◽  
Group 1

Background: The aim of this study was to investigate the relationship between estimated glomerular filtration rate (eGFR) and outcomes of bipolar hemiarthroplasty for femoral neck fracture in elderly patients, and to compare postoperative complications and mortality among groups according to eGFR. Methods: A total of 181 patients who underwent bipolar hemiarthroplasty for displaced femoral neck fracture were divided into three groups according to eGFR. Data were retrospectively analyzed. Group 1 had 96 patients with eGFR greater than or equal to 60 mL/min/1.73 m2; Group 2 had 54 patients with eGFR greater than or equal to 30 mL/min/1.73 m2 and lower than 60 mL/min/1.73 m2; and Group 3 had 31 patients with eGFR lower than 30 mL/min/1.73 m2. Postoperative complications and mortality were compared between groups at a minimum 2-year follow-up. Results: Patients in Group 3 had the longest hospital stay of the three groups (p = 0.001). The rates of medical complications did not differ significantly among groups. However, Group 2 and 3 had higher rates of surgical complications (p = 0.001) and mortality (p = 0.043) than Group 1. Severe renal impairment was associated with increased risk of postoperative complications compared to mild renal impairment (odds ratio (95% confidence interval) = 4.33 (1.32–13.19), p = 0.015). Conclusion: Patients with moderate or severe decreased eGFR associated with chronic kidney disease (CKD) could have higher postoperative complications and mortality after bipolar hemiarthroplasty compared to patients with CKD stage 1 or 2.

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