Short-Term Outcomes of Laparoscopic Surgery for Colorectal Cancer in Oldest-Old Patients

2015 ◽  
Vol 32 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Tetsuro Tominaga ◽  
Hiroaki Takeshita ◽  
Junichi Arai ◽  
Katsunori Takagi ◽  
Masaki Kunizaki ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Oldest Old ◽  
Operation Time ◽  
Open Group ◽  
Background Characteristics ◽  
Old Patients ◽  
Liquid Intake ◽  
Oral Liquid ◽  
Clinical Background ◽  
Laparoscopic Assisted

Background/Aims: Oldest-old patients generally have several comorbidities, and laparoscopic-assisted colectomy (LAC) has not been performed on these patients. However, the surgical technique of LAC has improved, and its indications have been extended. The aim of this study was to evaluate the safety and effectiveness of LAC for patients over 85 years old. Methods: Fifty-eight patients over 85 years old who underwent colectomy were retrospectively analyzed. The patients were divided into two groups (LAC group n = 15; open surgery group (Open group) n = 43), and clinicopathological features, surgical characteristics, and outcomes were compared. Results: There were no significant differences in clinical background characteristics between the groups. The LAC group had longer operation time and greater lymph node dissection (both p < 0.01). Postoperatively, the use of analgesics (p = 0.01) was less and the start of oral liquid intake (p = 0.03) was faster in the LAC group. Postoperative complications occurred in 3 patients (20%) in the LAC group and 13 patients (30%) in the Open group (p = 0.66); delirium (n = 6) and sub-ileus (n = 4) developed only in the Open group. Conclusion: After LAC, elderly patients tended to have less postoperative pain and started oral liquid intake earlier. LAC can be safe and effective, preventing postoperative complications that occur specifically in oldest-old patients.

The outcome of surgical treatment for oldest-old patients with gastric cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 40-40
Author(s):  
Makoto Hikage ◽  
Rie Makuuchi ◽  
Masanori Tokunaga ◽  
Yutaka Tanizawa ◽  
Etsuro Bando ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Serum Albumin ◽  
Oldest Old ◽  
Operation Time ◽  
Optimal Operation ◽  
Oncologic Outcomes ◽  
Cancer Center ◽  
Old Patients ◽  
Co Morbidity ◽  
Significant Difference

40 Background: The number of the oldest-old patients with gastric cancer has been increasing in Japan. Selecting optimal operation for these patients is difficult because coping with both radicality and tolerability of surgery is mandatory. The aim of this study is to clarify the feasibility and effectiveness of gastrectomy for these patients. Methods: A total of 721 old patients (aged 75 years old and older) with gastric cancer who underwent curative gastrectomy at Shizuoka Cancer Center between from Oct. 2002 to Aug. 2015 were included in this study. The patients were classified into oldest-old group (OOP; aged 85 years and older) and old group (OP; aged 75 to 84 years old). Characteristics of the patients and short and long-term outcomes were compared between the groups. Results: OOP group included 57 patients, and OP group 664 patients. Though median serum albumin level in OOP group (3.8 g/dl) was significantly lower than in OP group (4.1 g/dl) (p = 0.002), the other clinicopathological characteristics including gender, BMI, co-morbidity, ASA-PS, ECOG-PS and preoperative stage were not significantly different between the groups. In terms of operative results, gastrectomy with reduced extent of lymph node dissection was frequently performed in OOP group (33.3%) than in OP group (6.0%) with significant difference (p < 0.001). Median operation time was significantly shorter in OOP group (195 minutes) than in OP group (222 minutes) (p = 0.001), and median blood loss was significantly less in OOP group (154 ml) than in OP group (227 ml) (p = 0.041). There was no significant difference of the incidence of postoperative complications between the groups. There was no significant difference of overall survival (p = 0.973) and disease-specific-survival (p = 0.549) between the groups. In multivariate analysis, preoperative BMI < 20, serum albumin < 3.8 g/dl and 15 days or more postoperative hospital stay were revealed as significant independent prognostic factors. Conclusions: Gastrectomy is safe with acceptable oncologic outcomes for OOP with optimally reducing the extent of surgery in each patient. In order to improve the outcome in OOP, preoperative nutritional management and support for home health care system should be considered.

The C-reactive protein to albumin ratio predicts postoperative complications in oldest-old patients with colorectal cancer

2020 ◽  
Vol 35 (3) ◽  
pp. 423-431 ◽  
Author(s):  
Shintaro Hashimoto ◽  
Tetsuro Tominaga ◽  
Takashi Nonaka ◽  
Kiyoaki Hamada ◽  
Masato Araki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Oldest Old ◽  
C Reactive Protein ◽  
Old Patients ◽  
Albumin Ratio ◽  
Reactive Protein

scholarly journals Predictors of postoperative complications in elderly and oldest old patients with gastric cancer

2014 ◽  
Vol 18 (3) ◽  
pp. 653-661 ◽  
Author(s):  
Takehiro Takama ◽  
Keiichi Okano ◽  
Akihiro Kondo ◽  
Shintaro Akamoto ◽  
Masao Fujiwara ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Oldest Old ◽  
Old Patients

Treating Cancer and No-Cancer Pain in Older and Oldest Old Patients

2015 ◽  
Vol 21 (13) ◽  
pp. 1706-1714 ◽  
Author(s):  
G. Colloca ◽  
F. Lattanzio ◽  
L. Balducci ◽  
G. Onder ◽  
G. Ronconi ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Oldest Old ◽  
Old Patients

Treating Heart Failure in Older and Oldest Old Patients.

2015 ◽  
Vol 21 (13) ◽  
pp. 1659-1664 ◽  
Author(s):  
Davide Vetrano ◽  
Fabrizia Lattanzio ◽  
Anna Martone ◽  
Francesco Landi ◽  
Vincenzo Brandi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Oldest Old ◽  
Old Patients

scholarly journals Emergency department use by oldest-old patients from 2005 to 2010 in a Swiss university hospital

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Sarah Vilpert ◽  
Hélène Jaccard Ruedin ◽  
Lionel Trueb ◽  
Stéfanie Monod-Zorzi ◽  
Bertrand Yersin ◽  
...  
Keyword(s):  
Emergency Department ◽  
Oldest Old ◽  
University Hospital ◽  
Emergency Department Use ◽  
Old Patients

scholarly journals Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

HPB Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kamil Gulpinar ◽  
Suleyman Ozdemir ◽  
S. Erpulat Ozis ◽  
Turgut Aydin ◽  
Atila Korkmaz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Single Incision ◽  
Single Port ◽  
Operation Time ◽  
Scar Formation ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Skin Scar

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.

scholarly journals Laparoscopic isolated caudate lobe resection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maulik Parikh ◽  
Ho-Seong Han ◽  
Jai Young Cho ◽  
Mizelle D’Silva
Keyword(s):  
Survival Rate ◽  
Disease Free Survival ◽  
Operation Time ◽  
Caudate Lobe ◽  
Open Group ◽  
Caudate Lobectomy ◽  
Technological Advances ◽  
Estimated Blood Loss ◽  
Hospital Patients ◽  
National University

AbstractPreviously, isolated caudate lobectomy was rarely performed and the caudate lobe was usually resected along with other segments. Isolated caudate lobe resection is a challenging procedure even for an experienced surgeon. Our aim was to evaluate the feasibility, safety and outcomes of laparoscopic isolated caudate lobectomy and to compare these with the open technique. We retrospectively analyzed 21 patients who underwent isolated caudate lobectomy between January 2005 and December 2018 at Seoul National University Bundang Hospital. Patients who underwent either anatomical or non-anatomical resection of the caudate lobe were included. Patients were divided into two groups according to whether they underwent laparoscopic or open surgery. Intra-operative and postoperative outcomes were compared with a median follow-up of 43 months (4–149). A total of 21 patients were included in the study. Of these, 12 (57.14%) underwent laparoscopic and nine (42.85%) underwent open caudate lobectomy. Median operation time (204.5 vs. 200 minutes, p = 0.397), estimated blood loss (250 vs. 400 ml, p = 0.214) and hospital stay (4 vs. 7 days, p = 0.298) were comparable between laparoscopy and open group. The overall post operative complication rate was similar in both groups (p = 0.375). The 5-year disease free survival rate (42.9% vs 60.0%, p = 0.700) and the 5-year overall survival rate (76.2% vs 64.8%, p = 0.145) was similar between laparoscopy and open group. Our findings demonstrate that with increasing surgical expertise and technological advances, laparoscopic isolated caudate lobectomy can become a feasible and safe in selected patients.

Lymphocyte C-reactive protein ratio: A new biomarker to predict early complications after gastrointestinal oncologic surgery

2021 ◽  
pp. 1-9
Author(s):  
Murat Yildirim ◽  
Bulent Koca
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Inflammatory Markers ◽  
Operation Time ◽  
C Reactive Protein ◽  
Oncologic Surgery ◽  
Protein Ratio ◽  
Colorectal Cancer Surgery ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein

BACKGROUND: Lymphocyte-to-C-reactive protein ratio (LCR) has been used as a post-surgical prognostic biomarker in patients with gastric and colorectal cancer. However, its relationship with early postoperative complications in these patients is unknown. In this study, we aimed to reveal the relationship between LCR and postoperative complications. METHODS: Eighty-one patients operated for stomach and colorectal cancer between January 2020 and August 2020 were prospectively analyzed. On preoperative and postoperative days 1, 3 and 5, other inflammatory parameters, mainly LCR, neutrophil lymphocyte ratio (NLR), were recorded. The patients were divided into two groups according to Clavien-Dindo classification as stage III and higher complications major, stage I-II/non-complication minor. RESULTS: Fifty seven patients were operated for colorectal cancer, 24 patients for gastric cancer. The mean age of the patients was 65.6 ± 12.6, 34.6% of them was women. Age, operation time and hospital stay were significantly different between the groups (p= 0.004, p= 0.002, p< 0.001). Major complications developed in 18 patients. On postoperative day 5, LCR found superior diagnostic accuracy in predicting major postoperative complications compared to other inflammatory markers. On the postoperative 5th day, the cut-off value of LCR was 0.0034, 88.8% (71.9–94.8) sensitivity, and 85.7% (73.6–95.4) selectivity. CONCLUSION: Among different inflammatory markers, postoperative LCR is a safe and effective predictor of postoperative complications, especially after gastric and colorectal cancer surgery on day 5.

scholarly journals Relationship between Oral Bacterial Count and Postoperative Complications among Patients with Cardiovascular Disease Treated by Surgery: A Retrospective Cohort Study

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 850
Author(s):  
Rie Osako ◽  
Yuhei Matsuda ◽  
Chieko Itohara ◽  
Yuka Sukegawa-Takahashi ◽  
Shintaro Sukegawa ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Postoperative Complications ◽  
Operation Time ◽  
Bacterial Count ◽  
Cardiovascular Complications ◽  
Pericardial Fluid ◽  
Bacterial Counts ◽  
Lung Torsion ◽  
Propensity Score Adjustment ◽  
The Relationship

In this retrospective observational study, we evaluated the relationship between perioperative oral bacterial counts and postoperative complications in cardiovascular disease (CVD) patients. From April 2012 to December 2018, all patients scheduled for surgery received perioperative oral management (POM) by oral specialists at a single center. Tongue dorsum bacterial counts were measured on the pre-hospitalization day, preoperatively, and postoperatively. Background data were collected retrospectively. Among the 470 consecutive patients, the postoperative complication incidence rate was 10.4% (pericardial fluid storage, n = 21; postoperative pneumonia, n = 13; surgical site infection, n = 9; mediastinitis, n = 2; and seroma, postoperative infective endocarditis, lung torsion, and pericardial effusion, n = 1 each). Oral bacterial counts were significantly higher in the pre-hospitalization than in the pre- and postoperative samples (p < 0.05). Sex, cerebrovascular disease, and operation time differed significantly between complications and no-complications groups (p < 0.05). Multivariate analysis with propensity score adjustment showed a significant association between postoperative oral bacterial count and postoperative complications (odds ratio 1.26; 95% confidence interval, 1.00–1.60; p = 0.05). Since the development of cardiovascular complications is a multifactorial process, the present study cannot show that POM reduces complications but indicates POM may prevent complications in CVD patients.

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