scholarly journals Effect of hemodialysis on short-term outcomes after colon cancer surgery

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262531
Author(s):  
Toshio Shiraishi ◽  
Tetsuro Tominaga ◽  
Takashi Nonaka ◽  
Shintaro Hashimoto ◽  
Kiyoaki Hamada ◽  
...  

Background Hemodialysis patients who undergo surgery have a high risk of postoperative complications. The aim of this study was to determine whether colon cancer surgery can be safely performed in hemodialysis patients. Methods This multicenter retrospective study included 1372 patients who underwent elective curative resection surgery for colon cancer between April 2016 and March 2020. Results Of the total patients, 19 (1.4%) underwent hemodialysis, of whom 19 (100%) had poor performance status and 18 had comorbidities (94.7%). Minimally invasive surgery was performed in 78.9% of hemodialysis patients. The postoperative complication rate was significantly higher in hemodialysis than non-hemodialysis patients (36.8% vs. 15.5%, p = 0.009). All postoperative complications in the hemodialysis patients were infectious type. Multivariate analysis revealed a significant association of hemodialysis with complications (odds ratio, 2.9362; 95%CI, 1.1384–7.5730; p = 0.026). Conclusion Despite recent advances in perioperative management and minimally invasive surgery, it is necessary to be aware that short-term complications can still occur, especially infectious complications in hemodialysis patients.

Author(s):  
Atthaphorn Trakarnsanga ◽  
Martin R. Weiser

Overview: Minimally invasive surgery (MIS) of colorectal cancer has become more popular in the past two decades. Laparoscopic colectomy has been accepted as an alternative standard approach in colon cancer, with comparable oncologic outcomes and several better short-term outcomes compared to open surgery. Unlike the treatment for colon cancer, however, the minimally invasive approach in rectal cancer has not been established. In this article, we summarize the current status of MIS for rectal cancer and explore the various technical options.


2019 ◽  
Vol 35 (2) ◽  
pp. 307-315 ◽  
Author(s):  
Susanna Niemeläinen ◽  
Heini Huhtala ◽  
Anu Ehrlich ◽  
Jyrki Kössi ◽  
Esa Jämsen ◽  
...  

Abstract Purpose Patients aged > 80 years represent an increasing proportion of colon cancer diagnoses. Selecting patients for elective surgery is challenging because of possibly compromised health status and functional decline. The aim of this retrospective, population-based study was to identify risk factors and health measures that predict short-term mortality after elective colon cancer surgery in the aged. Methods All patients > 80 years operated electively for stages I–III colon cancer from 2005 to 2016 in four Finnish hospitals were included. The prospectively collected data included comorbidities, functional status, postoperative surgical and medical outcomes as well as mortality data. Results A total of 386 patients (mean 84.0 years, range 80–96, 56% female) were included. Male gender (46% vs 35%, p = 0.03), higher BMI (51% vs 37%, p = 0.02), diabetes mellitus (51% vs 37%, p = 0.02), coronary artery disease (52% vs 36%, p = 0.003) and rheumatic diseases (67% vs 39%, p = 0.03) were related to higher risk of complications. The severe complications were more common in patients with increased preoperative hospitalizations (31% vs 15%, p = 0.05) and who lived in nursing homes (30% vs 17%, p = 0.05). The 30-day and 1-year mortality rates were 6.0% and 15% for all the patients compared with 30% and 45% in patients with severe postoperative complications (p < 0.001). Severe postoperative complications were the only significant patient-related variable affecting 1-year mortality (OR 9.60, 95% CI 2.33–39.55, p = 0.002). Conclusions The ability to identify preoperatively patients at high risk of decreased survival and thus prevent severe postoperative complications could improve overall outcome of aged colon cancer patients.


2008 ◽  
Vol 6 (4) ◽  
pp. 0-0
Author(s):  
Giedrė Rudinskaitė ◽  
Narimantas Evaldas Samalavičius ◽  
Renatas Tikuišis

Giedrė Rudinskaitė1, Narimantas Evaldas Samalavičius2, Renatas Tikuišis31, 2 Vilniaus universiteto Onkologijos instituto Abdominalinės ir bendrosios chirurgijosir onkologijos skyrius, Santariškių g. 1, LT-08660 Vilnius3 Vilniaus universiteto Onkologijos instituto Intensyviosios terapijos ir anesteziologijos skyrius,Santariškių g. 1, LT-08660 VilniusEl paštas: [email protected] Nors minimaliai invaziniu būdu operuojama daugelis neonkologinių ligų, laparoskopinės kolorektalinio vėžio chirurgijos pripažinimas yra daug mažesnis. Priežastis buvo tokie veiksniai kaip operacijos technikos sudėtingumas, kaina, operacijos trukmė, ilga mokymosi kreivė ir rūpestis onkologiniu saugumu. Chirurgų bendruomenei užtruko daugiau nei dešimt metų įteisinti laparoskopinį kolorektalinio vėžio gydymo metodą: jis yra saugus, pacientams užtikrina visus laparoskopinės chirurgijos pranašumus. Duomenys taip pat parodė, kad išgyvenamumas po laparoskopinės ir laparotominės gaubtinės žarnos vėžio rezekcijos nesiskiria. Tyrimai, nagrinėjantys išgyvenamumą po tiesiosios žarnos vėžio laparoskopinės rezekcijos, buvo pradėti vėliau ir 5 metų išgyvenamumo rezultatai dar negauti. Šioje apžvalgoje pateikiami iki šiol gauti ir metaanalizės būdu išnagrinėti kolorektalinio vėžio laparoskopinių operacijų rezultatai Reikšminiai žodžiai: gaubtinės žarnos vėžys, tiesiosios žarnos vėžys, laparoskopinė rezekcija A comparison of laparoscopic and open colorectal cancer surgery Giedrė Rudinskaitė1, Narimantas Evaldas Samalavičius2, Renatas Tikuišis31, 2 Abdominal and General Surgical Oncology Department, Institute of Oncology,University of Vilnius, Santariškiu str. 1, LT-08660 Vilnius, Lithuania3 Intensive Care and Anestesiology Department, Institute of Oncology, University of Vilnius,Santariškių str. 1, LT-08660 Vilnius, LithuaniaE-mail: [email protected] Although minimally invasive surgery has been accepted for a variety of disorders, laparoscopic resection of colorectal cancer surgery gained much less acceptance. The reasons were the factors such as technical complexity, cost, duration of surgery, the long learning curve and concerns about oncologic safety. It took the surgical community more than a decade to admit that the laparoscopic optikon for colorectal cancer is legitimate: it is safe, and it provides the patients with the advantages of minimally invasive surgery. Data indicate that there are no oncologic differences between laparoscopic and open resections for the treatment of primary colon cancer. Initiated later than for colon cancer, the 5-year survival evaluation of the use of laparoscopy in rectal cancer is still ongoing. This review presents recently published metaanalyses of colorectal cancer laparoscopic surgery. Keywords: cancer of colon, rectal cancer, laparoscopic resection


2011 ◽  
Vol 202 (5) ◽  
pp. 528-531 ◽  
Author(s):  
Sonia T. Orcutt ◽  
Christy L. Marshall ◽  
Celia N. Robinson ◽  
Courtney J. Balentine ◽  
Daniel A. Anaya ◽  
...  

Author(s):  
Stephen Gerfer ◽  
Kaveh Eghbalzadeh ◽  
Elmar Kuhn ◽  
Thorsten Wahlers ◽  
Sarah Brinkschröder ◽  
...  

Abstract Background The role of conventional surgical aortic valve replacement (SAVR) is increasingly questioned since the indication for transcatheter aortic valve implantations (TAVIs) is currently extended. While the number of patients referred to SAVR decreases, it is unclear if SAVR should be performed by junior resident surgeons in the course of a heart surgeons training. Methods Patients with isolated aortic valve replacement (AVR) were analyzed with respect to the surgeon's qualification. AVR performed by resident surgeons was compared with AVR by senior surgeons. The collective was analyzed with respect to clinical short-term outcomes comparing full sternotomy (FS) with minimally invasive surgery and ministernotomy (MS) with right anterior thoracotomy (RAT) after a 1:1 propensity score matching. Results The 30-day all-cause mortality was 2.3 and 3.4% for resident versus senior AVR groups, cerebrovascular event rates were 1.1 versus 2.6%, and no cases of significant paravalvular leak were detected. Clinical short-term outcomes between FS and minimally invasive access, as well after MS and RAT were comparable. Conclusion Our current data show feasibility and safety of conventional SAVR procedure performed by resident surgeons in the era of TAVI. Minimally invasive surgery should be trained and performed in higher volumes early in the educational process as it is a safe treatment option.


2010 ◽  
Vol 200 (5) ◽  
pp. 632-635 ◽  
Author(s):  
Christy L. Marshall ◽  
G. John Chen ◽  
Celia N. Robinson ◽  
Courtney J. Balentine ◽  
Daniel A. Anaya ◽  
...  

2011 ◽  
Vol 166 (2) ◽  
pp. 182-188 ◽  
Author(s):  
Celia N. Robinson ◽  
Courtney J. Balentine ◽  
Christy L. Marshall ◽  
Jonathan A. Wilks ◽  
Daniel Anaya ◽  
...  

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