Causes and management of bleeding during laparoscopic colorectal cancer surgery

<p class="Abstract">In this paper, the causes of bleeding during laparoscopic colorectal surgery and the measures to solve it are discussed. 386 cases of laparoscopic colorectal cancer surgery in our hospital from January to December 2015 were selected. There were 17 cases of bleeding during surgery, which accounted for 4.4% of the total amount. 2 cases were converted to laparotomy, and 15 cases were surgery via laparoscopy. In the surgical process, improper surgery, lack of good laparoscopic anatomical structure of the cognitive level, and congenital anatomic variation may have caused the accidental bleeding during surgery. Corresponding measures should be taken to stop accidental bleeding. </p>

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Robotic Colorectal Cancer Surgery. How to Reach Expertise? A Single Surgeon-Experience

Journal of Personalized Medicine ◽

10.3390/jpm11070621 ◽

2021 ◽

Vol 11 (7) ◽

pp. 621

Author(s):

Michele Manigrasso ◽

Sara Vertaldi ◽

Pietro Anoldo ◽

Anna D’Amore ◽

Alessandra Marello ◽

...

Keyword(s):

Colorectal Cancer ◽

Operative Time ◽

Laparoscopic Colorectal Surgery ◽

Laparoscopic Group ◽

Cancer Surgery ◽

Robotic Approach ◽

Colorectal Cancer Surgery ◽

Significant Difference ◽

Surgeon Experience ◽

Colorectal Resections

The complexity associated with laparoscopic colorectal surgery requires several skills to overcome the technical difficulties related to this procedure. To overcome the technical challenges of laparoscopic surgery, a robotic approach has been introduced. Our study reports the surgical outcomes obtained by the transition from laparoscopic to robotic approach in colorectal cancer surgery to establish in which type of approach the proficiency is easier to reach. Data about the first consecutive 15 laparoscopic and the first 15 consecutive robotic cases are extracted, adopting as a comparator of proficiency the last 15 laparoscopic colorectal resections for cancer. The variables studied are operative time, number of harvested nodes, conversion rate, postoperative complications, recovery outcomes. Our analysis includes 15 patients per group. Our results show that operative time is significantly longer in the first 15 laparoscopic cases (p = 0.001). A significantly lower number of harvested nodes was retrieved in the first 15 laparoscopic cases (p = 0.003). Clavien Dindo I complication rate was higher in the first laparoscopic group, but without a significant difference among the three groups (p = 0.09). Our results show that the surgeon needed no apparent learning curve to reach their laparoscopic standards. However, further multicentric prospective studies are needed to confirm this conclusion.

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Quality of Life of Patients After Colorectal Cancer Surgery in Soba University Hospital, Sudan: A Cross-Sectional Study

10.21203/rs.3.rs-1221124/v1 ◽

2022 ◽

Author(s):

Mohammed A. Adam ◽

Alaa A. Salih ◽

Abubaker E.A Koko ◽

Sami Altalib ◽

Ali Yasen Yasen MohamedAhmed ◽

...

Keyword(s):

Quality Of Life ◽

Colorectal Cancer ◽

Radiation Therapy ◽

Colorectal Surgery ◽

Cancer Surgery ◽

Sub Saharan Africa ◽

University Hospital ◽

Colorectal Cancer Surgery ◽

Cross Sectional

Abstract Background: Colorectal surgery is reported to have significant effects on patients, both physically and psychologically. On other hand, infections are found to be a major risk factor in Sudan and Sub-Saharan Africa such as intestinal Schistosoma colitis, especially those presenting with sigmoid colonic adenocarcinoma.Aim of the study: To assess the quality of life of patients after colorectal cancer surgery and the effect of the stoma on their life.Methods: A descriptive cross-sectional hospital-based study was done at Soba University Hospital. A sample of 72 patients with colorectal cancer who had undergone colorectal surgery was fully covered and interviewed using the SF-36 Quality of life standard questionnaire.Results: The total sample was 72 with a mean age of 51.1 ± 14.6 years. 79% were married, 70% were working, with free business being the most encountered occupation (36.1%). However, only 48.6% were still employed at the time of surgery. Regarding the mental health component, there was a significant difference in social functioning domain mean scores between patients who were employed and unemployed patients. Where the physical functioning and role physical domains were found to differ significantly with the different educational attainment of patients. Patients who did not undergo radiation therapy reported higher mean scores of role limitation due to physical problems, compared to patients who received radiation therapy.Conclusion: Our result found the quality of life was affected negatively in terms of the level of pain and presence of colostomy with sexual activity affection but the other parameters were not strongly affected.

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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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Insufficient Post-operative Energy Intake Is Associated With Failure of Enhanced Recovery Programs After Laparoscopic Colorectal Cancer Surgery: A Prospective Cohort Study

Frontiers in Nutrition ◽

10.3389/fnut.2021.768067 ◽

2021 ◽

Vol 8 ◽

Author(s):

Shuang Liu ◽

Sheng Zhang ◽

Zike Li ◽

Meng Li ◽

Yujie Zhang ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Colorectal Surgery ◽

Energy Intake ◽

Enhanced Recovery ◽

Laparoscopic Colorectal Surgery ◽

Colorectal Cancer Surgery ◽

Failure Group ◽

Factors Associated ◽

Operative Activity

Background: Although enhanced recovery after surgery (ERAS) has been proven to be beneficial after laparoscopic colorectal surgery, some of the patients may fail to complete the ERAS program during hospitalization. This prospective study aims to evaluate the risk factors associated with ERAS failure after laparoscopic colorectal cancer surgery.Methods: This is a prospective study from a single tertiary referral hospital. Patients diagnosed with colorectal cancer who met the inclusion criteria were included in this study. Demographic and clinicopathological characteristics were collected. Post-operative activity time and 6-min walking distance (6MWD) were measured. Patients were divided into ERAS failure group and ERAS success according to decreased post-operative activity and 6MWD. Factors associated with ERAS failure were investigated by univariate and multivariate analysis.Results: A total of 91 patients with colorectal cancer were included. The incidence of ERAS failure is 28.6% among all patients. Patients in ERAS failure group experienced higher rate of post-operative ileus and prolonged hospital stay (p < 0.001). Multivariate analysis revealed that older age (p = 0.006), body mass index ≥25.5 kg/m2 (p = 0.037), smoking (p = 0.002), operative time (p = 0.048), and post-operative energy intake <18.5 kcal/kg•d (p = 0.045) were independent risk factors of ERAS failure after laparoscopic colorectal surgery.Conclusions: Our findings indicated that a proportion of patients may fail the ERAS program after laparoscopic colorectal surgery. We for the first time showed that post-operative energy intake was an independent risk factor for ERAS failure. This may provide evidence for further investigation on precise measurement of nutritional status and selected high-risk patients for enhanced nutrition support.

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