Safety and feasibility of laparoscopic surgery for colorectal cancer in elderly patients (YSURG1401 study).

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 725-725
Author(s):  
Yosuke Atsumi ◽  
Masakatsu Numata ◽  
Toru Aoyama ◽  
Tsutomu Hayashi ◽  
Naoto Yamamoto ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Surgical Outcomes ◽  
Operation Time ◽  
University Hospital ◽  
Age Group ◽  
Significant Difference ◽  
Group A ◽  
Group B

725 Background: The safety and feasibility of laparoscopic surgery (LAP) for colorectal cancer has not yet been fully evaluated in elderly patients. The aim of this study was to compare the short term surgical outcomes of LAP and evaluate the safety and feasibility of LAP in colorectal cancer patients aged > 75 years. Methods: This retrospective study enrolled consecutive patients who underwent laparoscopic surgery for colorectal cancer between April 2013 and March 2014 at Yokohama City University Hospital and its related general hospitals. The patients were categorized into two groups: elderly patients (≧75 years of age: group A) and non-elderly patients ( < 75 years of age: group B). Surgical outcomes and postoperative complications were compared between the two groups. The severity of complications was evaluated using the Clavien–Dindo classification. Results: A total of 237 patients were evaluated in the present study. Eighty-four patients were classified into group A, and 153 into group B. Preoperative clinicopathological outcomes demonstrated no significant differences except for the ASA score. When comparing the surgical outcomes between group A and group B, the rate of conversion to open procedure (3.6 % vs 5.2 %, P = 0.751), median operation time (232 min vs 232 min, P = 0.318), median blood loss (20 ml vs 12 ml, P = 0.353). There was no significant difference in the surgical outcomes. Although the incidence of Japanese D3 dissection was significantly lower in Group A (56 % vs 69.3 %, P = 0.047), the incidences of postoperative surgical complications of grade ≧ Ⅱ were similar between two groups (15.5 % vs 11.8 %, p = 0.427). The length of postoperative hospital stay was also similar (10days vs 10days, p = 0.347). Conclusions: The present study suggested that laparoscopic surgery for colorectal cancer is safe and feasible, regardless of the age of the patient, especially for elderly patients who may be candidates for colorectal cancer surgery.

A Comparative Study of Epidemiology, Clinicopathologic Features and Outcome of Colorectal Cancer Patients between Ain Shams University Hospitals and Luxor International Hospital

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tarek Hussein Kamel ◽  
Amr Lotfy Farag ◽  
Dr/Sherif Hassanin Ahmed ◽  
Chresteen Talaat Samy Hanna
Keyword(s):  
Colorectal Cancer ◽  
Comparative Study ◽  
Disease Free Survival ◽  
University Hospital ◽  
Treatment Modalities ◽  
Clinicopathologic Features ◽  
Free Survival ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide. Objectives The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years. Patients and Methods The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015. Results There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group. Conclusion The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.

scholarly journals CLINICAL AND PATHOLOGICAL FEATURES OF COLONIC ILEUS FROM OBSTRUCTIVE COLORECTAL CANCER. ACTUAL CHARACTERISTICS

2021 ◽  
Vol 27 (1) ◽  
pp. 3582-3584
Author(s):  
Konstantin Kostov ◽  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Emergency Surgery ◽  
Good Condition ◽  
Tumor Stage ◽  
University Hospital ◽  
Obstructive Colorectal Cancer ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group B

Purpose: The purpose of this study is to analyze the possible change in the characteristics of patients with colonic ileus from obstructive colorectal cancer in UMHATEM "N. Pirogov ". Material and Methods: For two separate periods of 2 years in the Department of General, Visceral and Emergency Surgery in University Hospital "N. I. Pirogov" from ileus caused by colorectal carcinoma were operated respectively: Group A (1.1.2010-31.12.2011) - 187 patients (average 71.2 years, women were 88, men 99) Group B (1.1.2014-31.12.2015) - 141 patients (average 73.5 years, women were 69, men 72). Results: In group B there was an increase in the infected patients at an earlier stage. There was no significant difference in the localization of the tumor process in the two groups. In contrast to the increased number of patients hospitalized at an earlier ileus stage, there was no difference in the two groups according to the tumor stage. Conclusions: Emergency surgery is indicated for cases with full bowel obstruction and significant prediction of rupture. Surgery procedure like proximal colostomy is reccomended for elderly patients and complicated comorbidity. Primary procedure like segmental and subtotal colectomy is appropriate for patients in good condition. Segmental resection is favorable in elderly patients and those with shock who may not tolerate lengthy surgery.

Laparoscopic versus open partial nephrectomy for the management of highly complex renal tumors with PADUA score ⩾10: A single center analysis.

2021 ◽  
pp. 039156032110016
Author(s):  
Francesco Chiancone ◽  
Marco Fabiano ◽  
Clemente Meccariello ◽  
Maurizio Fedelini ◽  
Francesco Persico ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Operation Time ◽  
Renal Tumors ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Introduction: The aim of this study was to compare laparoscopic and open partial nephrectomy (PN) for renal tumors of high surgical complexity (PADUA score ⩾10). Methods: We retrospectively evaluated 93 consecutive patients who underwent PN at our department from January 2015 to September 2019. 21 patients underwent open partial nephrectomy (OPN) (Group A) and 72 underwent laparoscopic partial nephrectomy (LPN) (Group B). All OPNs were performed with a retroperitoneal approach, while all LPNs were performed with a transperitoneal approach by a single surgical team. Post-operative complications were classified according to the Clavien-Dindo system. Results: The two groups showed no difference in terms of patients’ demographics as well as tumor characteristics in all variables. Group A was found to be similar to group B in terms of operation time ( p = 0.781), conversion to radical nephrectomy ( p = 0.3485), and positive surgical margins ( p = 0.338) while estimated blood loss ( p = 0.0205), intra-operative ( p = 0.0104), and post-operative ( p = 0.0081) transfusion rates, drainage time ( p = 0.0012), pain score at post-operative day 1 (<0.0001) were significantly lower in Group B. The rate of enucleation and enucleoresection/polar resection was similar ( p = 0.1821) among the groups. Logistic regression analysis indicated that preoperative factors were not independently associated with the surgical approach. There was a statistically significant difference in complication rate (<0.0001) between the two groups even if no significant difference in terms of grade ⩾3 post-operative complications ( p = 0.3382) was detected. Discussion: LPN represents a feasible and safe approach for high complex renal tumors if performed in highly experienced laparoscopic centers. This procedure offers good intraoperative outcomes and a low rate of post-operative complications.

RANDOMIZED COMPARATIVE STUDY OF ONDANSETRON AND COMBINATION OF ONDANSETRON AND DEXAMETHASONE, AS A PROPHYLAXIS OF POST-OPERATIVE NAUSEAAND VOMITING IN ADULTS UNDERGOING ELECTIVE LAPAROSCOPIC SURGERIES

2021 ◽  
pp. 48-49
Author(s):  
Rumani Ruku ◽  
Jasmeen Chowdhary
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Care ◽  
Demographic Variables ◽  
Nausea And Vomiting ◽  
Age Group ◽  
Patient Response ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea

Background: Post-operative nausea and vomiting (PONV) is quite associated with laparoscopic surgery. In-spite of advances in surgery and post surgical care, nausea and vomiting still has a high incidence. This study was planned to explore the efcacy of a combination therapy of ondansetron with dexamethasone against PONVand compare the results with the efcacy of ondensetron-only. Method:Arandomized clinical trial study was conducted in the Department of Anesthesia, GMC Jammu, over a period of 6 months, on 50 patients in the age group of 18-50 years, of either gender, undergoing laparoscopic surgeries under general anesthesia. Patients were divided into two groups of 25 each: Group A received 4 mg of Ondansetron intravenously, while Group B received 4 mg of Ondansetron and 8 mg of Dexamethasone intravenously, soon after intubation. Results: The demographic variables of two groups were similar. While 19 (76%) patients showed post-operative nausea in Group A, while in Group B, only 8 (32%) patients experienced nausea, which was very signicant. Similarly, 11 (44%) patients showed post-operative vomiting in GroupAand only 2 (8%) complained of vomiting. 24% patients did not complain about any kind of nausea or vomiting in GroupA. Mild nausea was observedin60%patientsinGroupA,while amongonly32%patientsingroupB.Nocomplications of anykindwereobservedduringthisstudy. Conclusion: Ondensetron and dexamethasone, administered intravenously, after intubation, in laparoscopic surgery, is safe and has a better patient response in preventing post-operative nausea and vomiting.

scholarly journals The Efficacy and Safety of Nabufen and Sufentanil in the Prevention of Visceral Pain After Gynecological Laparoscopic Surgery: A Randomised Controlled Trial

2020 ◽  
Author(s):  
Xiaoxia Gu ◽  
Jingjing Wang ◽  
Huihua Liao ◽  
Jian Mo ◽  
Weiming Huang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Adverse Reactions ◽  
Visceral Pain ◽  
Sedation Score ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D ◽  
Ramsay Sedation Score

Abstract Background: To compare the efficacy and safety of different compatibility schemes in the prevention of visceral pain after gynecological laparoscopic surgery. Methods: from April 2019 to April 2020, patients undergoing elective gynecological laparoscopic surgery in our hospital were randomly divided into four groups: group A: sufentanil 3 μ g / kg; group B: low-dose nalbuphine group: 0.1 mg / kg of nabufen + 3 μ g / kg of sufentanil; group C: medium dose of nabufen group: 1 mg / kg of nabufen + 2 μ g / kg of sufentanil; group D: high-dose nabufen 2 There were 30 cases in each group. The degree of pain and the number of adverse reactions at 2, 4, 8, 12, 24 and 48 hours after operation were observed and recorded. The number and dosage of morphine used as a remedial analgesic were recorded. The pain degree was assessed by visual analogue scale (VAS). The total amount of analgesic pump used, the total number of times of pressing and the effective times of pressing were recorded. The adverse reactions included respiratory depression, nausea and vomiting, drowsiness, restlessness and skin The skin itches. Results: the analgesic effect of group B was similar to that of group A, and there was no significant difference in the number of invalid pressing, total pressing times and rescue analgesia rate (P > 0.05), while the invalid pressing times, total pressing times and remedial analgesia rate of group C and group D were significantly lower than those of group A (P < 0.05). There was no significant difference between group C and group D in the number of invalid compressions, the total number of compressions and the rate of remedial analgesia (P > 0.05), suggesting that increasing the dose of nalbuphine could not significantly increase the analgesic effect. The incidence of postoperative nausea and vomiting, skin pruritus, lethargy and Ramsay Sedation score in group B and group C were significantly lower than those in group A (P < 0.05). Ramsay Sedation score and incidence of drowsiness were lower than those in group D, which indicated that the incidence of adverse reactions was higher in group D than group B and group C.Conclusion: the combination of 1 mg / kg nabufen and 2 μ g / kg sufentanil is a safe and effective combination scheme for the prevention of visceral pain after gynecological laparoscopic surgery with small adverse reactions.Trial registration: http://www.chictr.org.cn/showproj.aspx?proj=40635Registration number：ChiCTR1900025076 . Prospectively registered on 10 August 2019.

scholarly journals COMPARISON BETWEEN THERAPEUTIC ULTRASOUND AND SCAR MOBILIZATION OVER PERSISTENT POSTNATAL DYSPAREUNIA

2017 ◽  
Vol 10 (9) ◽  
pp. 48
Author(s):  
Mariyam Farzana Sf ◽  
Ponmathi P ◽  
Sivakumar Pvr
Keyword(s):  
Quality Of Life ◽  
Analogue Scale ◽  
Therapeutic Ultrasound ◽  
Ultrasound Therapy ◽  
Age Group ◽  
Functional Index ◽  
Significant Difference ◽  
Group A ◽  
Group B

  Objective: Dyspareunia is known as the painful sexual intercourse. This study was conducted to compare the effectiveness between therapeutic ultrasound and scar mobilization in persistent postnatal dyspareunia.Methods: This is an experimental study. 30 subjects with superficial dyspareunia, age group between 25 and 35 years are taken in this study and 15 subjects in Group A were treated with ultrasound therapy, 15 subjects in Group B were treated with scar mobilization. Female sexual functional index questionnaire (FSFI) and visual analogue scale (VAS) were used as the outcome measure.Results: Results showed a significant difference in FSFI and VAS measurements in both the groups, but clinically Group A showed better improvement in pain and quality of life than Group B.Conclusion: There is no significant difference between ultrasound therapy and scar mobilization over the pain and quality of life in patients with persistent postnatal dyspareunia.

PS01.063: THE EFFECT OF DISEASE DURATION ON SURGICAL OUTCOMES FOR PATIENTS WITH EROSIVE GERD TREATED BY LAPAROSCOPIC SURGERY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 67-67
Author(s):  
Kazuto Tsuboi ◽  
Nobuo Omura ◽  
Fumiaki Yano ◽  
Masato Hoshino ◽  
Se-Ryung Yamamoto ◽  
...  
Keyword(s):  
Los Angeles ◽  
Surgical Outcomes ◽  
Disease Duration ◽  
Conflicts Of Interest ◽  
Operation Time ◽  
Acid Reflux ◽  
Los Angeles Classification ◽  
Patients Satisfaction ◽  
Group A ◽  
Group B

Abstract Background Erosive gastro-esophageal reflux disease (e-GERD) is associated with various symptoms caused by reflux of acid and gastric contents from the stomach to the esophagus. In general, it seems that as the duration of the disease is longer, surgical outcomes are inferior because of disease progression. The aim of this study is to evaluate the relationship between the disease duration and surgical outcomes of laparoscopic fundoplication (LF). Methods Two hundred and fifty-one (mean age was 53.4 years, male in 166) patients with e-GERD who underwent LF as an initial operation at our institution were extracted from the database. E-GERD was defined as equal to or more than grade A esophagitis by Los Angeles classification. These patients were divided into three groups by the length of disease duration: less than two years in Group A (n = 104), two to 5 years in Group B (n = 68) and equal to or more than 5 years in Group C (n = 79). We analyzed patients’ background, pre-operative symptoms, surgical outcomes, patients’ satisfaction and post-operative course. Before surgery, a standardized questionnaire was used to assess the degree of frequency and severity of symptoms (heartburn, regurgitation, dysphagia, vomiting and chest pain). Moreover, satisfaction with the operation was evaluated using the standardized questionnaire. Results Age and degree of acid reflux by pH-metry were significantly different among the three groups (P = 0.0054 and 0.0345, respectively). As to the pre-operative symptom score, the severity score of heartburn and the frequency score of regurgitation were significantly lower in Group A (P = 0.0225 and 0.031, respectively). Although operation time was significantly difference among the three groups (P = 0.0423), there were no differences in intraoperative blood loss, occurrence of peri-operative complications, post-operative course and patients’ satisfaction. Conclusion Although the patients who suffered equal to or over two years had more severe heartburn and regurgitation because of prolonged acid reflux, the duration of the disease does not seem to affect the surgical outcomes. Disclosure All authors have declared no conflicts of interest.

scholarly journals Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Takayuki Baba ◽  
Tomohiro Nizawa ◽  
Toshiyuki Oshitari ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Surgical Outcomes ◽  
Case Series ◽  
Cell Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

Is Gastrectomy Safe in the Elderly? A Single Institution Review

2011 ◽  
Vol 77 (4) ◽  
pp. 488-492 ◽  
Author(s):  
Eric S. Hager ◽  
Hamid Abdollahi ◽  
Albert G. Crawford ◽  
Neil Moudgill ◽  
Ernest L. Rosato ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Hospital Mortality ◽  
Gastric Resection ◽  
Tertiary Care ◽  
The Elderly ◽  
The United States ◽  
Mortality Rates ◽  
Significant Difference ◽  
Group A ◽  
Group B

The population of the United States is aging. Studies within the last several years have demonstrated that major abdominal operations in elderly patients can be done safely, but with increased rates of complications. We set out to determine the rates of morbidity and mortality in elderly patients undergoing gastric resection at a tertiary care university hospital. A retrospective analysis was performed of 157 consecutive gastric resections between January 1998 and July 2007. Group A (n = 99) consisted of patients < 75-years-old at surgery, whereas group B (n = 58) included patients who were ≥ 75 years of age at time of surgery. These two groups had their clinical and demographic data analyzed. Postoperative length of hospital stay, perioperative major morbidity, and in-hospital mortality were analyzed using analysis of variance, χ2, and multivariate analyses. The average age of patients in group A was 57 years, compared with 81 years in group B. We found no significant difference in the percentage of gastric resections for malignancy (group A, 49% vs group B, 62%) or emergency surgery (group A, 10% vs group B, 10%) between age groups. There was a significant increase in length of stay in the older patients (11.7 days vs 17.6 days; P = 0.032), as well as major complications (11.1% in group A vs 27.6% in group B; P = 0.008). The in-hospital mortality rates approached significance (group A, 4% vs group B, 12%; P = 0.057). Gastric resection in elderly patients carries with it longer hospital stays, higher risk of complications, and in-hospital mortality rates despite similarity in patient disease. This information is imperative to convey to the elderly patients in the preoperative period before gastric resection.

The Effect of Combined Clopidogrel and Aspirin Therapy after Off-Pump Coronary Surgery

2009 ◽  
Vol 4 (5) ◽  
pp. 265-268 ◽  
Author(s):  
Emir Mujanovic ◽  
Midhat Nurkic ◽  
Jasmin Caluk ◽  
Ibrahim Terzic ◽  
Emir Kabil ◽  
...  
Keyword(s):  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Median Sternotomy ◽  
Operation Time ◽  
Graft Patency ◽  
Off Pump ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective The purpose of this randomized study was to evaluate the effect on graft patency by adding clopidogrel to aspirin in off-pump coronary artery bypass (OPCAB) grafting and the possible side effects of such therapy. Methods Twenty patients who underwent standard OPCAB through median sternotomy were randomized immediately after surgery in two groups. Patients in group A (n = 10) received 100 mg of aspirin starting preoperatively, continuing indefinitely. Patients in group B received 100 mg of aspirin and, in addition, 75 mg of clopidogrel starting immediately after the operation and for 3 months. Postoperative bleeding and other perioperative parameters were compared. Angiography was repeated 3 months after surgery to determine the patency and quality of grafts. Results Preoperative risk factors were similar in the two groups. There was no significant difference in average number of distal anastomosis (P = 0.572), operation time (P = 0.686), postoperative bleeding (P = 0.256), ventilation time (P = 0.635), and intensive care unit stay (P = 0.065). Length of stay was shorter in group B (P = 0.024). There was no postoperative complication in either groups. Eight of 27 grafts in group A and 2 of 29 grafts in group B (P = 0.037) were occluded at the time of control angiography. Conclusions Early administration of a combined regimen of clopidogrel and aspirin after OPCAB grafting is not associated with increased postoperative bleeding or other major complications. Despite the small number of patients in this study and small number of examined grafts, the results suggest that the addition of clopidogrel may increase graft patency after OPCAB grafting.

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