scholarly journals Liberal perioperative fluid administration is an independent risk factor for morbidity and is associated with longer hospital stay after rectal cancer surgery

2017 ◽  
Vol 99 (2) ◽  
pp. 113-116 ◽  
Author(s):  
MR Boland ◽  
I Reynolds ◽  
N McCawley ◽  
E Galvin ◽  
S El-Masry ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Risk Factor ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Independent Risk Factor ◽  
Elective Surgery ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Major Morbidity ◽  
Grade Iii

INTRODUCTION Recent studies have advocated the use of perioperative fluid restriction in patients undergoing major abdominal surgery as part of an enhanced recovery protocol. Series reported to date include a heterogenous group of high- and low-risk procedures but few studies have focused on rectal cancer surgery alone. The aim of this study was to assess the effects of perioperative fluid volumes on outcomes in patients undergoing elective rectal cancer resection. METHODS A prospectively maintained database of patients with rectal cancer who underwent elective surgery over a 2-year period was reviewed. Total volume of fluid received intraoperatively was calculated, as well as blood products required in the perioperative period. The primary outcome was postoperative morbidity (Clavien-Dindo grade I–IV) and the secondary outcomes were length of stay and major morbidity (Clavien–Dindo grade III–IV). RESULTS Over a 2-year period (2012–2013), 120 patients underwent elective surgery with curative intent for rectal cancer. Median total intraoperative fluid volume received was 3680ml (range 1200–9670ml); 65/120 (54.1%) had any complications, with 20/120 (16.6%) classified as major (Clavien–Dindo grade III–IV). Intraoperative volume >3500ml was an independent risk factor for the development of postoperative all-cause morbidity (P=0.02) and was associated with major morbidity (P=0.09). Intraoperative fluid volumes also correlated with length of hospital stay (Pearson’s correlation coefficient 0.33; P<0.01). CONCLUSIONS Intraoperative fluid infusion volumes in excess of 3500ml are associated with increased morbidity and length of stay in patients undergoing elective surgery for rectal cancer.

Volume-outcome Relationship in Rectal Cancer Surgery

2021 ◽  
Author(s):  
Leandro Siragusa ◽  
Bruno Sensi ◽  
Danilo Vinci ◽  
Marzia Franceschilli ◽  
Giulia Bagaglini ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Blood Transfusion ◽  
Hospital Stay ◽  
Anastomotic Leak ◽  
Operative Time ◽  
Cancer Surgery ◽  
Leak Rate ◽  
Perioperative Outcomes ◽  
Rectal Cancer Surgery ◽  
Anastomotic Leak Rate

Abstract Introduction Hospital centralization effect is reported to lower complications and mortality for high risk and complex surgery operations, including colorectal surgery. However, no linear relation between volume and outcome has been demonstrated. Aim of the study was to evaluate the increased surgical volume effect on early outcomes of patient undergoing laparoscopic restorative anterior rectal resection (ARR).Methods A retrospective analysis of all consecutive patients undergoing ARR with primary anastomosis between November 2016 and December 2020 after centralization of rectal cancer cases in an academic Centre. Short outcomes are compared to those of patients operated in the same unit during the previous 10 years before service centralization. The primary outcome was anastomotic leak rate. Mean operative time, need of conversion, postoperative use of blood transfusion, radicality, in-hospital stay, number and type of complications, readmission and reoperation rate, mortality and 1-year and stoma persistence rates were evaluated as secondary outcomes.Results 86 patients were operated in the study period and outcomes compared to those of 101 patients operated during the previous ten years. Difference in volume of surgery was significant between the two periods (p 0.019) and the estimated leak rate was significantly lower in the higher volume unit (p 0.05). Mean operative time, need of conversion, postoperative use of blood transfusion and in-hospital stay (p <0.05) were also significantly reduced in Group A.Conclusion: This study suggests that the shift toward higher volume in rectal cancer surgery is associated to decreased anastomotic leak rate. Potentiation of lower volume surgical units may yield optimal perioperative outcomes.

scholarly journals Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery

2008 ◽  
Vol 14 (8) ◽  
pp. 1248 ◽  
Author(s):  
Varut Lohsiriwat ◽  
Darin Lohsiriwat ◽  
Wiroon Boonnuch ◽  
Vitoon Chinswangwatanakul ◽  
Thawatchai Akaraviputh ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Cancer Surgery ◽  
Major Risk Factor ◽  
Rectal Cancer Surgery

scholarly journals Volume-outcome relationship in rectal cancer surgery

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
L. Siragusa ◽  
B. Sensi ◽  
D. Vinci ◽  
M. Franceschilli ◽  
C. Pathirannehalage Don ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Blood Transfusion ◽  
Hospital Stay ◽  
Anastomotic Leak ◽  
Operative Time ◽  
Cancer Surgery ◽  
Leak Rate ◽  
Perioperative Outcomes ◽  
Rectal Cancer Surgery ◽  
Anastomotic Leak Rate

Abstract Introduction Hospital centralization effect is reported to lower complications and mortality for high risk and complex surgery operations, including colorectal surgery. However, no linear relation between volume and outcome has been demonstrated. Aim of the study was to evaluate the increased surgical volume effect on early outcomes of patient undergoing laparoscopic restorative anterior rectal resection (ARR). Methods A retrospective analysis of all consecutive patients undergoing ARR with primary anastomosis between November 2016 and December 2020 after centralization of rectal cancer cases in an academic Centre. Short-term outcomes are compared to those of patients operated in the same unit during the previous 10 years before service centralization. The primary outcome was estimated anastomotic leak rate. Mean operative time, need of conversion, postoperative use of blood transfusion, radicality, in-hospital stay, number and type of complications, readmission and reoperation rate, mortality and 1-year and stoma persistence rates were evaluated as secondary outcomes. Results 86 patients were operated in the study period and outcomes compared to those of 101 patients operated during the previous ten years. Difference in volume of surgery was significant between the two periods (p 0.019) and the estimated leak rate was significantly lower in the higher volume unit (p 0.047). Mean operative time, need of conversion, postoperative use of blood transfusion and in-hospital stay (p < 0.05) were also significantly reduced in Group A. Conclusion This study suggests that the shift toward higher volume in rectal cancer surgery is associated to decreased anastomotic leak rate. Potentiation of lower volume surgical units may yield optimal perioperative outcomes.

Risk Factor Analysis of Postoperative Complications After Robotic Rectal Cancer Surgery

2011 ◽  
Vol 35 (11) ◽  
pp. 2555-2562 ◽  
Author(s):  
Jeonghyun Kang ◽  
Byung Soh Min ◽  
Yoon Ah Park ◽  
Hyuk Hur ◽  
Seung Hyuk Baik ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Factor Analysis ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Cancer Surgery ◽  
Risk Factor Analysis ◽  
Rectal Cancer Surgery ◽  
Robotic Rectal Cancer Surgery

scholarly journals Do Outcomes in Elective Colon and Rectal Cancer Surgery Differ by Weekday? An Observational Study Using Data From the Dutch ColoRectal Audit

2019 ◽  
Vol 17 (7) ◽  
pp. 821-828
Author(s):  
Daniëlle D. Huijts ◽  
Onno R. Guicherit ◽  
Jan Willem T. Dekker ◽  
Julia T. van Groningen ◽  
Leti van Bodegom-Vos ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Elective Surgery ◽  
Cancer Surgery ◽  
Case Mix ◽  
Rectal Cancer Surgery ◽  
Failure To Rescue ◽  
Complication Risk ◽  
Colon And Rectal Cancer ◽  
Case Mix Adjustment ◽  
Elective Colon

AbstractBackground: Previous studies showing higher mortality after elective surgery performed on a Friday were based on administrative data, known for insufficient case-mix adjustment. The goal of this study was to investigate the risk of adverse events for patients with colon and rectal cancer by day of elective surgery using clinical data from the Dutch ColoRectal Audit. Patients and Methods: Prospectively collected data from the 2012–2015 Dutch ColoRectal Audit (n=36,616) were used to examine differences in mortality, severe complications, and failure to rescue by day of elective surgery (Monday through Friday). Monday was used as a reference, analyses were stratified for colon and rectal cancer, and case-mix adjustments were made for previously identified variables. Results: For both colon and rectal cancer, crude mortality, severe complications, and failure-to-rescue rates varied by day of elective surgery. After case-mix adjustment, lower severe complication risk was found for rectal cancer surgery performed on a Friday (odds ratio, 0.84; 95% CI, 0.72–0.97) versus Monday. No significant differences were found for colon cancer surgery performed on different weekdays. Conclusions: No weekday effect was found for elective colon and rectal cancer surgery in the Netherlands. Lower severe complication risk for elective rectal cancer surgery performed on a Friday may be caused by patient selection.

Mo1752 - Hospital Volume is a Significant Predictor of Length of Stay Following Rectal Cancer Surgery

2018 ◽  
Vol 154 (6) ◽  
pp. S-1333
Author(s):  
Katerina O. Wells ◽  
Gilder E. Richard ◽  
Walter Peters ◽  
James W. Fleshman
Keyword(s):  
Rectal Cancer ◽  
Length Of Stay ◽  
Hospital Volume ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery

scholarly journals Effect of Placing Double-lumen Irrigation-suction Tube on Spontaneous Closure of Anastomotic Leakage Following Rectal Cancer Surgery

2021 ◽  
Author(s):  
Weliang Tian ◽  
Ming Huang ◽  
Xin Xu ◽  
Zheng Yao ◽  
Risheng Zhao
Keyword(s):  
Rectal Cancer ◽  
Length Of Stay ◽  
Anastomotic Leakage ◽  
Cancer Surgery ◽  
Spontaneous Closure ◽  
Rectal Cancer Surgery ◽  
Double Lumen ◽  
Suction Tube ◽  
The Cost

Abstract Purpose: This study aimed to explore the effect of placement of double-lumen irrigation-suction tubes (DLIST) on the spontaneous closure of anastomotic leakages (AL) after rectal cancer surgery. Methods: The study was performed at two centers which was managed by the same chief. The treatment in the two center were same. From January 2011 to June 2020, patients with postoperative AL after rectal cancer surgery were eligible. Patients were divided into a passive drainage (PD) group and a DLIST group according to whether the PD,placed during the rectal cancer surgery, had been replaced with the DLIST. The effect of DLIST on the AL was evaluated.Result: There were 76 patients in the DLIST group and 52 in the PD group. The DLIST group was more inclined to achieve spontaneous closure of AL (HR =3.048; 95% CI: 1.787-5.197; P<0.001). Both length of stay and costs of the treatment in the DLIST group were lower (54 [41.25-117] days vs. 112 [66.75-127.75] days, P =0.005; and $18,721 [$14,982-44,960] vs. $40,840 [$20,932-50,529], P < 0.001).Conclusion: Placement of DLIST is an effective method for treating AL following rectal cancer surgery. Compared with PD, the cost of DLIST in the treatment of AL is lower and the length of stay is shorter.

scholarly journals Timing of Complications and Length of Stay after Rectal Cancer Surgery

2014 ◽  
Vol 218 (5) ◽  
pp. 914-919 ◽  
Author(s):  
Marianne Huebner ◽  
Martin Hübner ◽  
Robert R. Cima ◽  
David W. Larson
Keyword(s):  
Rectal Cancer ◽  
Length Of Stay ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery

Impact of Specialisation in the Practice of Rectal Cancer Surgery at a District General Hospital

Endoscopy ◽  
2004 ◽  
Vol 36 (10) ◽  
Author(s):  
AL Gidwani ◽  
RS Date ◽  
D Hughes ◽  
P Neilly ◽  
R Gilliland
Keyword(s):  
Rectal Cancer ◽  
General Hospital ◽  
District General Hospital ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery
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