scholarly journals IDDF2020-ABS-0111 Does frailty predict postoperative outcomes in geriatric patients receiving surgery for colorectal cancer? A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiaobo Yang ◽  
Chenying Xu ◽  
Jiumei Cao ◽  
Li Xie ◽  
Qingqing Qiu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Geriatric Patients ◽  
Meta Analysis ◽  
Postoperative Outcomes

scholarly journals Does frailty predict postoperative outcomes in geriatric patients receiving surgery for colorectal cancer? A systematic review and meta-analysis

2020 ◽  
Author(s):  
XIAOBO YANG ◽  
Chenying Xu ◽  
Jiumei Cao ◽  
Li Xie ◽  
Qingqing Qiu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Postoperative Complications ◽  
Geriatric Patients ◽  
Clinical Decision Making ◽  
Meta Analysis ◽  
Postoperative Mortality ◽  
Preoperative Assessment ◽  
Postoperative Outcomes ◽  
Increased Risk

Abstract Background Surgery remains the mainstay of colorectal cancer (CRC) and substantially reduces cancer-related morbidity and mortality. Preoperative assessment for frailty in geriatric patients is critically important in risk stratification and clinical decision-making. In this systematic review and meta-analysis, we aimed to quantitatively summarise the effect of frailty on postoperative outcomes in geriatric patients receiving surgery for CRC. Methods A systematic literature search was conducted in MEDLINE, Cochrane and EMBASE from inception to 30 April 2020. Fully published articles reporting risk estimate(s) of frailty on postoperative complication(s), readmission and/ or mortality in patients aged ≥65 years who received surgery for CRC were eligible for qualitative and quantitative analyses. Results Across 10 articles of 9 unique studies (n = 69332) that were eventually included in the systematic review and meta-analysis, overall prevalence of frailty was 23.0% (95% CI: 11–43%, I 2 = 100%). Odds ratios (ORs) on overall and severe postoperative complications were respectively increased by 2.36- (95% CI: 1.66–3.35, P <0.01; I 2 = 12%) and 2.35-fold (95% CI: 1.30–4.27, P <0.01; I 2 = 72%) in frail patients compared to non-frail counterparts. On pooled analysis, frailty was significantly associated with an increased risk of postoperative readmission (OR:1.91; 95% CI: 1.35–2.70, P <0.01; I 2 = 6%). Whilst a significantly higher risk of frailty on mortality during 12 months after CRC surgery was observed (OR: 5.52; 95% CI:4.40–6.92, P <0.01; I 2 = 89%), the summary OR on 30-day/ inpatient mortality crossed the null line (OR: 1.65; 95% CI: 0.56–4.93, P = 0.37; I 2 = 55%). Funnel plot and Duval-Tweedie’s trim and fill test did not reveal significant publication bias. Conclusions In the studies reviewed, frailty appeared to be associated with increased risks for postoperative complications, readmission and mortality during 12 months in patients aged ≥65 years who received surgery for CRC. Nevertheless, no significant association between frailty and 30-day/ inpatient postoperative mortality was observed.

scholarly journals Effect of perioperative intravenous lidocaine on postoperative outcomes in patients undergoing resection of colorectal cancer: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048803
Author(s):  
Wentao JI ◽  
Xiaoting Zhang ◽  
Guolin Sun ◽  
Xiandong Wang ◽  
Jia Liu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Meta Analysis ◽  
Postoperative Outcomes ◽  
Secondary Outcome ◽  
Outcome Variable ◽  
Intravenous Lidocaine ◽  
Anti Inflammatory

IntroductionTechniques using local anaesthetics provide high-quality analgesia, while the anti-inflammatory properties of these drugs may represent an additional advantage. Perioperative intravenous lidocaine has shown positive effects not only on postoperative pain but also on bowel function and duration of hospital stay, due to its analgesic, anti-inflammatory and opioid-sparing effects. However, these potential benefits are not well established in patients undergoing resection with colorectal cancer. This research aims to determine the effect of perioperative intravenous lidocaine on postoperative outcomes in patients undergoing resection of colorectal cancer.Methods and analysisPubMed, Embase, Web of Science, CNKI, SinoMed and WanFang Data databases were electronically retrieved to include the randomised controlled trials comparing perioperative intravenous lidocaine with placebo infusion in patients undergoing resection of colorectal cancer before August 2021. Registers of clinical trials, potential grey literature and abstracts from conferences will also be searched. Two reviewers will screen literature, extract data and assess risk of bias of studies included independently. The primary outcome variable will be long-term survival outcome, tumour recurrence and metastasis rate, and restoration of intestinal function. The secondary outcome variables will consist of the severity of postoperative pain at 4, 12, 24 and 48 hours after surgery, the incidence of postoperative nausea and vomiting, and the length of hospital stay. A meta-analysis will be performed using RevMan V.5.4 software provided by the Cochrane Collaboration and Stata V.12.0. subgroup and sensitivity analyses will be conducted.Ethics and disseminationBecause the data used for this systematic review will be exclusively extracted from published studies, ethical approval and informed consent of patients will not be required. The systematic review will be published in a peer-reviewed journal, presented at conferences and shared on social media platforms.PROSPERO registration numberCRD42020216232.

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