scholarly journals Role of surgical resection in treatment of pancreatic adenocarcinoma

2011 ◽  
Vol 64 (9-10) ◽  
pp. 448-452 ◽  
Author(s):  
Pavle Milosevic ◽  
Matilda Djolaji ◽  
Djordje Milosevic ◽  
Nada Ikonic ◽  
Ana Popovic ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Surgical Resection ◽  
Postoperative Morbidity ◽  
Therapeutic Option ◽  
Postoperative Mortality ◽  
The Body ◽  
Morbidity Rate ◽  
Mortality And Morbidity ◽  
Average Survival ◽  
Clinical Center

Introduction. Pancreatic adenocarcinoma is the fifth leading cause of death from malignant diseases. The total five-year rate is bellow 5%, but in patients who underwent pancreatic resection, the fiveyear rate may be up to 20%. Surgical resection is still the only therapeutic option that offers the possibility of cure. In recent decades, the perioperative mortality rate has been significantly reduced in the institutions performing a number of these operations per year and has become less than 5%. Postoperative morbidity remains high. Material and Methods. The results of surgical resection in the treatment of pancreatic adenocarcinoma have been analyzed. A retrospective study included the patients operated at the Department for Abdominal, Endocrine and Transplantation surgery, Clinical Center of Vojvodina. Results. In the period from February 1st 1998 to February 1st 2007 a total of 67 patients with pancreatic adenocarcinoma underwent resection. The average age of patients was 58.81?1.42 years. There were 44 (65.7%) male and 23 (34.3%) female patients. The most common locations of cancer were the head, then the body and the tail of the pancreas and they were found in 57 (85.1%) cases, 7 (10,4%) cases and 3 (4,47%) cases, respectively. The postoperative mortality appeared in 3 (4.47%) cases and postoperative morbidity in 21 (31.3%) cases. The average survival was 22.89? 3.87 months, the median being 9.0?2.18 months. The five-year survival rate was 13.5%. Conclusion. For patients with pancreatic cancer, surgical resection still remains the only chance of cure. These procedures are performed with acceptable postoperative mortality and morbidity rate. The percentage of cured patients is still unsatisfactorily low.

30-Day Postoperative Morbidity of Emergency Surgery for Obstructive Right- and Left-Sided Colon Cancer in Obese Patients: A Multicenter Cohort Study of the French Surgical Association

2019 ◽  
Vol 37 (2) ◽  
pp. 111-118
Author(s):  
Laurent Genser ◽  
Gilles Manceau ◽  
Diane Mege ◽  
Valérie Bridoux ◽  
Zaher Lakkis ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Emergency Surgery ◽  
Postoperative Morbidity ◽  
Postoperative Mortality ◽  
Hemodynamic Instability ◽  
Normal Weight ◽  
Obese Patients ◽  
Multicenter Cohort Study ◽  
Mortality And Morbidity ◽  
Cardiovascular Comorbidity

Background: Emergency surgery impairs postoperative outcomes in colorectal cancer patients. No study has assessed the relationship between obesity and postoperative results in this setting. Objective: To compare the results of emergency surgery for obstructive colon cancer (OCC) in an obese patient population with those in overweight and normal weight patient groups. Methods: From 2000 to 2015, patients undergoing emergency surgery for OCC in French surgical centers members of the French National Surgical Association were included. Three groups were defined: normal weight (body mass index [BMI] < 25.0 kg/m2), overweight (BMI 25.0–29.9 kg/m2), and obese (BMI ≥30.0 kg/m2). Results: Of 1,241 patients, 329 (26.5%) were overweight and 143 (11.5%) were obese. Obese patients had significantly higher American society of anesthesiologists score, more cardiovascular comorbidity and more hemodynamic instability at presentation. Overall postoperative mortality and morbidity were 8 and 51%, respectively, with no difference between the 3 groups. For obese patients with left-sided OCC, stoma-related complications were significantly increased (8 vs. 5 vs. 15%, p = 0.02). Conclusion: Compared with lower BMI patients, obese patients with OCC had a more severe presentation at admission but similar surgical management. Obesity did not increase 30-day postoperative morbidity except stoma-related complications for those with left-sided OCC.

scholarly journals The Outcome of Complex Hepato-Pancreato-Biliary Surgery for Elderly Patients: A Propensity Score Matching Analysis

2018 ◽  
Vol 36 (4) ◽  
pp. 323-330 ◽  
Author(s):  
Kosei Takagi ◽  
Yuzo Umeda ◽  
Ryuichi Yoshida ◽  
Daisuke Nobuoka ◽  
Takashi Kuise ◽  
...  
Keyword(s):  
Risk Factors ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Postoperative Morbidity ◽  
Postoperative Mortality ◽  
Elderly Group ◽  
Postoperative Outcomes ◽  
Mortality And Morbidity ◽  
Propensity Score Matching Analysis

Background/Aims: Postoperative mortality and morbidity rates after hepato-pancreato-biliary (HPB) surgery remain high, and the number of elderly patients requiring such surgery has been increasing. This study aimed to investigate postoperative outcomes of complex HPB surgery for elderly patients. Methods: We retrospectively reviewed perioperative data of 721 patients who underwent complex HPB surgery between 2010 and 2015. The patients were divided into 2 groups: elderly (≥75 years) and non-elderly (< 75 years). Surgical outcomes of both groups were compared after propensity score-matching analysis. Subsequently, risk factors for serious postoperative morbidity were identified by multivariate analysis. Results: Before matching, the elderly group (n = 170) had more comorbidities, such as cardiovascular and renal disease, than the non-elderly group (n = 551). Matching yielded elderly (n = 170) and non-elderly groups (n = 170) with similar preoperative backgrounds. The mortality and morbidity rates did not differ significantly between the groups. In multivariate analyses, operative time (OR 1.79; p = 0.005) and blood loss (OR 1.66; p = 0.03) were identified as independent risk factors for serious postoperative morbidity, whereas older age did not have a predictive impact (OR 1.16; p = 0.52). Conclusions: Although elderly ­patients had more comorbidities and higher incidences of postoperative mortality and several complications before matching, their postoperative outcomes were equivalent to those of non-elderly patients after matching.

High Neutrophil to Lymphocyte Ratio Is Associated With Symptomatic and Ruptured Thoracic Aortic Aneurysm

Angiology ◽  
2018 ◽  
Vol 69 (8) ◽  
pp. 686-691 ◽  
Author(s):  
Fabien Lareyre ◽  
Juliette Raffort ◽  
Duy Le ◽  
Hon Lai Chan ◽  
Thomas Le Houerou ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Postoperative Morbidity ◽  
Surgical Repair ◽  
Postoperative Mortality ◽  
Postoperative Outcome ◽  
Neutrophil To Lymphocyte Ratio ◽  
Mortality And Morbidity ◽  
Lymphocyte Ratio ◽  
Significant Difference

The predictive value of the neutrophil to lymphocyte ratio (NLR) has been demonstrated in several cardiovascular diseases. The aim of our study was to investigate the association between the preoperative NLR and aneurysm characteristics as well as 30-day postoperative morbidity and mortality in patients with thoracic aortic aneurysm (TAA) undergoing aortic surgical repair. Consecutive patients (n = 75) with TAA were retrospectively included over a 10-year period. Clinical characteristics, aneurysm characteristics, and 30-day postoperative outcome were recorded. The median age of patients was 71 (67-80) years. The median preoperative NLR was 3.5 (2.3-5.8). The proportion of asymptomatic TAA was significantly lower in patients with an NLR > 3.5 compared with those with an NLR < 3.5 (52.6% vs 75.7%; P = .054). The proportion of patients with pain or with ruptured TAA was significantly higher in patients with an NLR > 3.5 compared with those with NLR < 3.5 (42.1% vs 16.2%; P = .022 and 26.3% vs 2.7%; P = .007, respectively). No significant difference was observed regarding the 30-day overall postoperative mortality and morbidity. The preoperative NLR did not correlate with TAA diameter. A high preoperative NLR is significantly associated with symptomatic and ruptured TAA, suggesting a potential interest as a marker and/or player in the disease.

Neuraxial Anesthesia and Postoperative Mortality and Morbidity

2018 ◽  
pp. 225-229
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Postoperative Morbidity ◽  
Postoperative Mortality ◽  
Mortality And Morbidity ◽  
Neuraxial Blockade ◽  
Study Results ◽  
Wide Range

This case focuses on the effects of neuraxial blockade on postoperative mortality and morbidity by asking the question: What are the effects of neuraxial blockade with epidural or spinal anesthesia on postoperative morbidity and mortality? This systematic review examined all trials with randomization to intraoperative neuraxial blockade (with epidural or spinal anesthesia) or no neuraxial blockade for which data were available before January 1, 1997. The study included 9,559 patients over 141 included trials. Study results demonstrated that neuraxial blockade reduces morbidity and postoperative complications in a wide range of patients, independent of surgery type, choice of neuraxial technique, or use of general anesthesia.

scholarly journals LncRNA ZFAS1 promotes pancreatic adenocarcinoma metastasis by sponging miR-3924 via RHOA/ROCK2 pathway

2020 ◽  
Author(s):  
jinyang Liu ◽  
yaqin Zhu ◽  
Chunlin Ge
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Underlying Mechanism ◽  
Bioinformatic Analysis ◽  
Expression Level ◽  
Morbidity Rate ◽  
Mortality And Morbidity ◽  
The Past ◽  
Competing Endogenous Rnas

Abstract Background : the mortality and morbidity rate of pancreatic adenocarcinoma has been increasing during the past two decades, mechanisms in pancreatic adenocarcinoma progression are in urgent need of research. LncRNA ZFAS1 has been demonstrated as an oncogene in some cancers, but its function and mechanism in pancreatic adenocarcinoma still remain unclear. Methods : ZFAS1 expression level was predicted in pancreatic adenocarcinoma by bioinformatic analysis, the expression level of ZFAS1 in pancreatic adenocarcinoma tissues and cell lines were further investigated by qRT-PCR and ISH. The functions of ZFAS1 on pancreatic adenocarcinoma in vitro and in vivo were investigated according to bioinformatic analysis. Dual luciferase report assays investigated the binding of ZFAS1/miR-3924 and miR-3924/ROCK2, rescue assays further investigated the underlying mechanism. Results: ZFAS1 was predicted and further experimental verified to be over-expressed in pancreatic adenocarcinoma. ZFAS1 silence showed the inhibition to pancreatic adenocarcinoma metastasis in vitro and in vivo. The competing endogenous RNAs mechanism of ZFAS1 was also demonstrated. Conclusions : Our results demonstrated the promotion of ZFAS1 to pancreatic adenocarcinoma metastasis and suggested its candidacy as a novel regulator of ROCK2.

scholarly journals The Incidence of Adolescent Pregnancy at Clinic of Gynecology and Obstetrics of Clinical Center Kragujevac

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Marija Bicanin Ilic ◽  
Aleksandra Dimitrijevic
Keyword(s):  
Health Care ◽  
Adolescent Pregnancy ◽  
Apgar Score ◽  
Morbidity Rate ◽  
Fetal Mortality ◽  
Mortality And Morbidity ◽  
Gynecology And Obstetrics ◽  
Clinical Center ◽  
Significant Difference ◽  
Number Of Births

Abstract Adolescent pregnancy belongs to a group of high-risk pregnancies with high maternal and fetal mortality and morbidity rate with high prevalence globally (11%). The aim of this observational study is to show the incidence of adolescent deliveries in relation to the total number of births in the twelve-year period from 2007 to 2019 at the Department of Gynecology and Obstetrics of Clinical Center in Kragujevac from medical protocols and patients’ medical records. By evaluating the data of our research, we noticed a continuing decrease in the percentage of adolescents that give births each year. The total number of births in our clinic in this twelve-year period was 26544, and the number of teenage deliveries was 390 (1.74%), which is in accordance with the results of a similar research which was conducted in our clinic in the period from 2002 to 2007 (16.1%). However, despite the increase in the number of caesarean sections, Apgar score of newborn babies was similar to the results of previous tests - 8.31 which proves that the increase in caesarean sections is not correlated with growth of Apgar score. The average pregnancy duration of adolescents is similar as in the previous five-year period (37.5 w.g.), while in the general population of pregnant women it is 39.2 w.g which represents a statistically significant difference. The main causes of poor outcomes of adolescent pregnancies are biological immaturity of mothers, poor health care, that comes from poor socio-demographic conditions, as well as emotional stress. It is necessary to change the attitude of society towards these young people, give them support in the environment they live and provide them with better health care and social treatment.

scholarly journals RISK FACTORS FOR SEVERE POSTOPERATIVE COMPLICATIONS AFTER GASTRECTOMY FOR GASTRIC AND ESOPHAGOGASTRIC JUNCTION CANCERS

2019 ◽  
Vol 32 (4) ◽  
Author(s):  
Enrique NORERO ◽  
Jose Luis QUEZADA ◽  
Jaime CERDA ◽  
Marco CERONI ◽  
Cristian MARTINEZ ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Esophagogastric Junction ◽  
Postoperative Morbidity ◽  
Postoperative Mortality ◽  
Tumor Location ◽  
Morbidity Rate ◽  
Severe Morbidity ◽  
Siewert Type Ii ◽  
D2 Lymph Node Dissection

ABSTRACT Background: Gastrectomy is the main treatment for gastric and Siewert type II-III esophagogastric junction (EGJ) cancer. This surgery is associated with significant morbidity. Total morbidity rates vary across different studies and few have evaluated postoperative morbidity according to complication severity. Aim: To identify the predictors of severe postoperative morbidity. Methods: This was a retrospective cohort study from a prospective database. We included patients treated with gastrectomy for gastric or EGJ cancers between January 2012 and December 2016 at a single center. Severe morbidity was defined as Clavien-Dindo score ≥3. A multivariate analysis was performed to identify predictors of severe morbidity. Results: Two hundred and eighty-nine gastrectomies were performed (67% males, median age: 65 years). Tumor location was EGJ in 14%, upper third of the stomach in 30%, middle third in 26%, and lower third in 28%. In 196 (67%), a total gastrectomy was performed with a D2 lymph node dissection in 85%. Two hundred and eleven patients (79%) underwent an open gastrectomy. T status was T1 in 23% and T3/T4 in 68%. Postoperative mortality was 2.4% and morbidity rate was 41%. Severe morbidity was 11% and was mainly represented by esophagojejunostomy leak (2.4%), duodenal stump leak (2.1%), and respiratory complications (2%). On multivariate analysis, EGJ location and T3/T4 tumors were associated with a higher rate of severe postoperative morbidity. Conclusion: Severe postoperative morbidity after gastrectomy was 11%. Esophagogastric junction tumor location and T3/T4 status are risk factors for severe postoperative morbidity.

Intestinal operations during surgical procedures for epithelial ovarian cancer

1994 ◽  
Vol 4 (5) ◽  
pp. 320-323 ◽  
Author(s):  
R. Fontanelli ◽  
F. Raspagliesi ◽  
D. Paladini ◽  
V. Ntousias
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Postoperative Morbidity ◽  
Postoperative Mortality ◽  
Advanced Ovarian Cancer ◽  
Morbidity Rate ◽  
Intestinal Surgery

Fifty-two intestinal operations were performed during 45 laparatomies in 43 non-obstructed ovarian cancer patients. The histology of the tumor was serous in 29/43 cases (67.5%). The gross postoperative morbidity rate was 15.5% and postoperative mortality rate 6.9%. The 5-year survival was 28.3%, and was not affected by the time of intestinal surgery (during the first or following laparotomies). As a result, intestinal surgery in advanced ovarian cancer patients is feasible without an undue increase in morbidity. However, it must be carefully tailored because, though contributing to the quality of life of these patients, it does not seem to affect their survival, at least in this retrospective series.

scholarly journals Therapeutic Option in Patients over 60 Years with Esophageal and Esocardial Cancer

2014 ◽  
Vol 60 (1) ◽  
pp. 19-21
Author(s):  
Roșca C ◽  
Molnar C ◽  
Popa D ◽  
Serac G ◽  
Gherghinescu M ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Statistical Significance ◽  
Postoperative Mortality ◽  
Tumor Location ◽  
Palliative Surgery ◽  
Mortality And Morbidity ◽  
Group I ◽  
Therapeutic Attitude ◽  
Location Type ◽  
Type Of Surgery

Abstract Background: Treatment of esophageal and esocardial cancer in patients over 60 years involves a particular management. Considering the comorbidities specific to this category of patients, recent data from the literature indicate an increased incidence of mortality and morbidity following therapy. Material and method: We retrospectively studied a group of 55 patients admitted to the Surgical Clinic I of the County Emergency Clinical Hospital Tîrgu Mureș, in the January 1st, 2007 - December 31st, 2011 period, diagnosed with esophageal and esocardial cancer. Patients were divided into two groups: group I under the age of 60 years, and group II over this age. Inclusion criteria were age, diagnosis (tumor location), and we followed a series of parameters: demographics, type of surgery, the biological profile of patients, immediate postoperative morbidity and mortality. Results: No statistically significant differences were observed in terms of demographics: gender (p = 0.78), area of origin (p = 0.69). The number of hospitalization days (p = 0.20) was influenced by the type of surgery, as well as pre- and postoperative comorbidities. Immediate postoperative mortality was 16.56%, the differences between the two groups was not statistically significant (p = 0.58). Parameters with statistical significance were found to be: age (p <0.0001), tumor location, type of surgery (p = 0.0031) and radical versus palliative surgery (p = 0.03). Conclusions: Therapeutic attitude in patients over 60 years should be correlated with specific particularities to this category. Selection of patients for surgery and type of surgery is dictated by the patient's condition and quantified by anesthesia and surgery team

scholarly journals Age Criteria As Operative Mortality Predictor After Modified Blalock-Taussig Shunt

2019 ◽  
Vol 40 (1) ◽  
Author(s):  
Muammar Riyandi ◽  
Oktavia Lilyasari ◽  
Dafsah Arifa Juzar ◽  
Budi Rahmat
Keyword(s):  
Body Weight ◽  
Mortality Rate ◽  
Postoperative Morbidity ◽  
Operative Mortality ◽  
Simple Procedure ◽  
Morbidity Rate ◽  
Mechanical Ventilator ◽  
Mortality And Morbidity ◽  
Mortality Predictors ◽  
Blalock Taussig Shunt

Background: Modified Blalock-Taussig shunt (MBTS) is considered as a simple procedure but has a considerable operative mortality rate. Patient’s characteristics who underwent MBTS in Indonesia is quite different than other country. There was no predictor of operative mortality has been identified in Indonesian.Objectives: To compare mortality rate based on age criteria and to identify mortality and morbidity predictors after MBTS procedure.Methods: A retrospectively cohort study was conducted on 400 patients who underwent MBTS at National cardiovascular center Harapan Kita (NCCHK) between January 2013 and december 2017.Results: There were 32,1% death at age ≤ 28 days, 19,9% at age 29-365 days, 3,6% at age 366-1825 days and 8% at age > 1825 days. Body weight < 3 kg, haematocrite level > 45% before procedure and activated partial thromboplastine time level (aPTT) < 60 seconds were operative mortality  predictors. Postoperative morbidity rate was 32,9%. Packed red cell  transfusion (PRC) more than 6 ml/kg, mechanical ventilator use before procedure, prostaglandin E1 use before procedure, aPTT level less than 60 seconds after procedure were identified as postoperative morbidity predictors.Conclusion: Operative mortality rate significantly different among age criteria but it was not proven as an operative mortality predictors. Body weight < 3 kg increase mortality rate and haematocrite level higher than 45% and aPTT level less than 60 seconds decrease mortality rate. Postoperative morbidity predictors were PRC transfusion more than 6ml/kg, mechanical ventilator use before procedure, prostaglandine E1 use and aPTT level less than 60 seconds.

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