Is laparoscopic colorectal cancer surgery associated with an increased risk in obese patients? A retrospective study from China

Purpose. To identify and evaluate the influence of intraperitoneal chemotherapy without hyperthermia (ICwh) to the incidence of anastomotic leakage (AL) after colorectal cancer surgery. Methods. A systematic review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses in order to review all studies investigating the relationship between ICwh and AL in patients undergoing colorectal surgery. The primary outcome was overall incidence rate of anastomotic leakage. Results. Four studies were included in the final review. ICwh was associated with an overall increased risk of anastomotic leakage [OR 2.05 (1.06, 3.98), P = 0.03 ]. But there was no significant increased incidence rate when fluorouracil was implanted into the abdominal cavity for ICwh [OR 2.48 (0.55, 11.10), P = 0.24 ]. Conclusions. This meta-analysis provides some evidence to suggest ICwh may increase the incidence of postoperative AL in colorectal cancer. However, fluorouracil implantation for ICwh does not increase the risk of AL, which seems to be a relatively safe method of ICwh.

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Outcomes of colorectal cancer surgery in nonagenarian patients: a multicenter retrospective study

Journal of Gastrointestinal Oncology ◽

10.21037/jgo-21-324 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Wei-Gen Zeng ◽

Meng-Jia Liu ◽

Zhi-Xiang Zhou ◽

Jun-Jie Hu ◽

Zhen-Jun Wang

Keyword(s):

Colorectal Cancer ◽

Retrospective Study ◽

Cancer Surgery ◽

Colorectal Cancer Surgery

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Morbidity and mortality after colorectal cancer surgery in patients with cirrhosis: A critical review of the literature.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.608 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 608-608

Author(s):

Tarek Boussaha ◽

Jean François Cadranel ◽

Allaoua Smail ◽

Hortensia Lison ◽

Armand Garioud ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Colorectal Surgery ◽

Postoperative Morbidity ◽

Cancer Surgery ◽

Morbidity And Mortality ◽

Colorectal Cancer Surgery ◽

Increased Risk ◽

Cirrhotic Patients ◽

Independent Risk Factors

608 Background: Cirrhotic patients with localized colorectal cancer are potential candidates for tumor resection. The aim of this review was to evaluate the morbi-mortality after colorectal surgery. Methods: Comprehensive search was conducted using PUBMED, EMBASE, and the COCHRANE Library. Prospective and retrospective studies were selected. The study population included cirrhotic patients who underwent colorectal resection for non-metastatic colorectal cancer and patients with benign and other malignant disease. The postoperative morbi-mortality and independent risk factors were analysed. Results: Eight studies were identified. Among these, four studies compared the risk of colorectal surgery in patients with and without liver cirrhosis. The number of patients varied from 41 to 6,120. The severity of cirrhosis in most of the studies was classified with the Child-Pugh score. Class B and C were observed in 20% to 60% of the patients. Sepsis represented the main postoperative complication and occurred in 48% to 77% of patients. Mortality varied according to the Child-Pugh score, ranging from 11% to 41%, and was significantly higher for patients with cirrhosis in Child-Pugh Class C. Urgent surgical procedure had a negative impact on prognosis. The average length of hospital stay ranged from 9 to 18 days. Cirrhosis was associated with a 2-3 time and a 4-10 time increased risk of postoperative mortality in the absence and presence of portal hypertension, respectively compared with non-cirrhotic patients. The independent risk factors for postoperative morbidity and mortality were encephalopathy, ascites, low haemoglobin, prolonged prothrombin time, elevated bilirubin, hypoalbuminemia, postoperative infection, total colectomy, elective or non-elective surgery, the presence of co-morbidities and MELD score ≥ 15. Conclusions: Colorectal cancer surgery is associated with an increased risk of postoperative morbidity and mortality in cirrhosis patients. Studies evaluating exclusively the operative risk for colorectal cancer surgery in this patient’s population are rare. Prospective controlled trials to optimize the perioperative management of those patients are needed.

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Monitoring compliance of venous thromboembolism prophylaxis following colorectal cancer surgery: A single-centre, retrospective study

International Journal of Surgery ◽

10.1016/j.ijsu.2018.05.189 ◽

2018 ◽

Vol 55 ◽

pp. S43

Author(s):

B. Gurung ◽

C.T. Karia ◽

B.A. Astraszkiewicz ◽

J. Yeung ◽

A. Miller

Keyword(s):

Colorectal Cancer ◽

Retrospective Study ◽

Venous Thromboembolism ◽

Cancer Surgery ◽

Single Centre ◽

Thromboembolism Prophylaxis ◽

Colorectal Cancer Surgery ◽

Venous Thromboembolism Prophylaxis

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The impact of comorbidities on post-operative complications following colorectal cancer surgery

PLoS ONE ◽

10.1371/journal.pone.0243995 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0243995

Author(s):

David E. Flynn ◽

Derek Mao ◽

Stephanie T. Yerkovich ◽

Robert Franz ◽

Harish Iswariah ◽

...

Keyword(s):

Colorectal Cancer ◽

Atrial Fibrillation ◽

Cancer Surgery ◽

High Grade ◽

Colorectal Cancer Surgery ◽

Cancer Resection ◽

Colorectal Cancer Resection ◽

Increased Risk ◽

Operative Complications ◽

Post Operative Complications

Background Colorectal cancer surgery is complex and can result in severe post-operative complications. Optimisation of surgical outcomes requires a thorough understanding of the background complexity and comorbid status of patients. Aim The aim of this study is to determine whether certain pre-existing comorbidities are associated with high grade post-operative complications following colorectal cancer surgery. The study also aims to define the prevalence of demographic, comorbid and surgical features in a population undergoing colorectal cancer resection. Method A colorectal cancer database at The Prince Charles Hospital was established to capture detailed information on patient background, comorbidities and clinicopathological features. A single-centre retrospective study was undertaken to assess the effect of comorbidities on post-operative outcomes following colorectal cancer resection. Five hundred and thirty-three patients were reviewed between 2010–2018 to assess if specific comorbidities were associated with higher grade post-operative complications. A Clavien-Dindo grade of three or higher was defined as a high grade complication. Results Fifty-eight percent of all patients had an ASA grade of ASA III or above. The average BMI of patients undergoing resection was 28 ± 6.0. Sixteen percent of all patients experienced a high grade complications. Patients with high grade complications had a higher mean average age compared to patients with low grade or no post-operative complications (74 years vs 70 years, p = 0.01). Univariate analysis revealed patients with atrial fibrillation, COPD, ischaemic heart disease and heart failure had an increased risk of high grade complications. Multivariate analysis revealed pre-existing atrial fibrillation (OR 2.70, 95% CI 1.53–4.89, p <0.01) and COPD (OR 2.02 1.07–3.80, p = 0.029) were independently associated with an increased risk of high grade complications. Conclusion Pre-existing atrial fibrillation and COPD are independent risk factors for high grade complications. Targeted perioperative management is necessary to optimise outcomes.

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