scholarly journals THE MARK OF THE DURATION OF SURGERY ON THE POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH COMPLICATED COLON CANCER

2020 ◽  
Vol 7 (1) ◽  
pp. 149-153
Author(s):  
Raul Mihailov ◽  
Cristina Serban ◽  
Adrian Beznea ◽  
Dorel Firescu ◽  
Georgiana Bianca Constantin ◽  
...  

Postoperative complications are common in patients with complicated colon cancers operated in Emergency. Most complications are those of the sound (suppurations, hematoma, dehiscence), postoperative ileus, anastomotic fistula. The purpose of this study is to evaluate the influence of the duration of the surgery on the postoperative complications in patients with complicated colon tumors, operated in emergency. We made a retrospective study on 451 patients treated for complicated colon cancers in the surgery clinics I and II of the Clinical Emergency County Hospital Galați between 2008 and 2017. In this study, we found all the 3 types of complications of colon tumors, but the most common was the intestinal obstruction. The operations varied from colostomies to subtotal and total colectomies. Most complications occured on the postoperatory days 4-8. The statistical analysis that we made revealed important statistical significance in the correlation of the postoperative complications and the duration of the surgical intervention (p value less than 0,001).The emergency colon cancer surgery has a high rate of postoperative complications, of which the most common are cardio-respiratory, parietal and fistulous. Their occurrence is directly influenced by the duration of the surgery.  

2019 ◽  
Author(s):  
Tesfaye Derseh ◽  
Biniam Minuye ◽  
Mohammed Yusouf ◽  
Tariku Dingeta

Abstract Background Intestinal obstruction is a global problem consuming much in terms of surgical services. It is a common surgical emergency and a significant health problem in Ethiopia. Several factors contribute to poor management outcomes in the case of intestinal obstruction. Post-operative mortality rate ranges from 3% to 30%. Despite this high rate of mortality, there is no recently published literature that has explored Intestinal Obstruction and its associated factors at Chiro General Hospital. Methods Institution based cross-sectional study was conducted among 254 of patients admitted with Intestinal obstruction who treated surgically at Chiro General Hospital. Data were collected using checklists from individual patient cards by trained three BSc nurses from 13 to 18 July 2018 and completeness of data collection was checked every day by the principal Investigator. Data were entered to Epi-Data version 3.1 computer software and exported to SPSS statistical software version 22 for analysis. Bivariable binary logistic regression was used to saw the association between each independent variable and dependent variable. All variables with P-value < 0.2 during bi-variable analyses were considered for multivariable logistic regression analyses. Odds ratio along with 95%CI were estimated to measure the strength of the association. Level of statistical significance was declared at p value less or equal to 0.05. Results In this study the magnitude of unfavorable outcome of Intestinal Obstruction was 21.3% (95% CI: (16.5, 26.4). Age group of 55 years or above [AOR=2.9, 95%CI: (1.03, 8.4)], duration of illness of 24hrs or above [AOR=3.1, 95%CI: (1.03, 9.4)], pre-operative diagnosis of gangrenous SBO & gangrenous LBO [(AOR=3.6, 95%CI: (1.3, 9.8)), (AOR=4.2, 95%CI: (1.3, 13.7))], respectively were significantly associated with unfavorable outcome. Conclusions The magnitude of unfavourable management outcome of patients with Intestinal obstruction who treated surgically in this study was high. Old age, late presentation of illness and gangrenous bowel obstruction were significantly associated with unfavourable management outcome. So that early detection prompt management of patients with Intestinal obstruction reduce the occurrence of unfavourable outcome of patients.


2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 717-717
Author(s):  
Yusuke Nishizawa ◽  
Masaaki Ito ◽  
Norio Saito ◽  
Hiroshi Katayama ◽  
Junki Mizusawa ◽  
...  

717 Background: A randomized controlled trial to confirm the non-inferiority of laparoscopic surgery to open surgery for clinical stage II/III colon cancers in terms of overall survival was conducted. In this ancillary study, we explored the risk factors for postoperative complications of laparoscopic surgery and open surgery. Methods: Eligibility criteria included colon cancer; tumor located in the cecum, ascending, sigmoid, or rectosigmoid colon; T3 or T4 without involvement of other organs; N0-2; and M0. Postoperative complications which were observed from the end of the operation to discharge were graded according to the CTCAE 3.0. Multivariate analysis was performed using logistic regression model. Results: Between October 2004 and March 2009, a total of 1,057 patients from 30 Japanese centers were registered. By per-protocol set, 524 patients underwent open surgery (OPEN) and 533 patients underwent laparoscopic surgery (LAP). Proportion of any grade (G) complication was 18.3% (OPEN 22.3%, LAP 14.3%), G2–G3 was 12.9% (OPEN 13.9%, LAP 11.8%), G3 was 5.3% (OPEN 6.9%, LAP 3.8%) and G4 was none. Postoperative complications (G2-G3) included leakage (OPEN 2.1%, LAP 1.9%), ileus (OPEN:1.5%, LAP:0.9%), and wound complication (OPEN: 0.2%, LAP: none). Multivariate analysis revealed that risk factors for postoperative complications were operation times 240 min or more (p=0.0019, odds ratio [OR] 2.01 [95% CI: 1.30-3.13]) and open surgery (p=0.0001, OR 2.05 [95% CI: 1.41-2.98]). Conclusions: Operation times more than 240 min and open surgery were considered to be the risk factors for postoperative complications for clinical stage II/III colon cancers. Clinical trial information: C000000105.


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.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10003-10003 ◽  
Author(s):  
M. M. Bertagnolli ◽  
C. C. Compton ◽  
D. Niedzwiecki ◽  
R. S. Warren ◽  
S. Jewell ◽  
...  

10003 Background: Colon cancers exhibiting a high level of microsatellite instability (MSI-H) show distinct clinicopathological features, including both better prognosis and reduced response to 5-fluorouracil (5-FU)-based chemotherapy. We investigated the impact of adjuvant chemotherapy containing irinotecan in patients with MSI-H colon cancers. Methods: CALGB protocol 89803 randomized 1264 patients with resected stage III colon cancer to receive post-operative 5-FU and leucovorin (LV) with or without irinotecan. Paraffin blocks containing primary tumor and normal tissue were collected. Microsatellite instablility was assessed using a panel of mono- and di-nucleotide markers. Disease free survival (DFS) was measured from trial entry until documented disease progression or death from any cause. A statistical significance level of 0.2 was used in screening to generate hypotheses regarding MSI status and outcome. Median follow-up at analysis was 3.8 years. Overall C89803 showed no advantage for addition of irinotecan to 5-FU/LV. Results: Patients with and without tumor samples analyzed did not differ by treatment, age, gender, primary site, T-stage, differentiation, # positive nodes, or mucinous type. Of 482 tumors analyzed, 75 (16%) demonstrated MSI-H. MSI-H cancers were more likely to be located in the proximal colon (p<0.0001), of high histologic grade (p<0.0001) and mucinous histology (p<0.0001), and also had increased numbers of tumor-containing lymph nodes (mean # positive nodes/case = 3.5 for MSI Low/Stable vs. 4.7 for MSI-H; p = 0.04). At the time of analysis 143 of 482 patients (36%) analyzed experienced tumor recurrence and/or death due to any cause. For patients with MSI-H tumors, DFS was better in those treated with irinotecan in addition to 5-FU/LV (logrank p=0.18). Among patients with MSI Low/Stable tumors there was no difference in DFS between those treated with and without irinotecan (logrank p =0.39). Conclusions: Early results from CALGB protocol 89803 indicate that addition of postoperative irinotecan to 5-FU/LV may improve DFS in patients with stage III colon cancers that exhibit MSI-H. Longer follow-up is required to confirm this finding. [Table: see text]


2018 ◽  
Vol 20 (12) ◽  
pp. 1078-1087 ◽  
Author(s):  
O. der Hagopian ◽  
M. Dahlberg ◽  
G. Heinius ◽  
J. Nordberg ◽  
J. Gustafsson ◽  
...  

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Diana Malaeb ◽  
Emmanuelle Awad ◽  
Chadia Haddad ◽  
Pascale Salameh ◽  
Hala Sacre ◽  
...  

Abstract Background Both bullying victimization and perpetration were associated with depression, social phobia, physical and psychological child abuse and Internet addiction in Lebanon. The prevalence of bullying in Lebanon is alarming, with 50% of school-aged children and adolescents reporting being bullied at some point. The high rate of both bullying victimization can be reflective of the inefficacy of current prevention and intervention policies in targeting associated problematic individual and contextual factors. The objective of the present study was to analyze factors associated with bullying victimization and validate the Illinois Bully Scale among Lebanese adolescents. Methods This is cross-sectional study that took place between January and May 2019. We enrolled 1810 adolescents between 14 and 17 years of age. The Illinois Bully scale was used to measure bullying victimization. In order to ensure the adequacy of the sample with values greater than 0.8 - an indicator that component or factor analysis was useful for these variables - we used Kaiser-Meyer-Olkin (KMO) measurement. Statistical significance considered if the p-value < 0.05. Results The results showed that 841 (46.5%, CI: 44.1% – 48.7%) participants were classified as having been previously bullied. None of the bullying scale items was removed. Items on the bullying scale converged on a two-factor solution with Eigenvalues greater than 1, accounting for a total of 73.63% of the variance (Factor 1: bullying victimization; Factor 2: bullying perpetration; KMO = 0.899, Bartlett’s sphericity test p < 0.001; αCronbach = 0.955). Having a separate parents (ORa = 3.08), Mild (ORa-4.71) to moderate (ORa = 3.84) internet addiction test, higher social fear (ORa = 1.50), higher psychological abuse (ORa = 3.59), higher child neglect (ORa = 2.21) and physical (ORa = 4.55) abuse were significantly associated with higher odds of being bullied. However, higher social avoidance (ORa = 0.49), poor (ORa = 0.20), fair (ORa = 0.94) and very good (ORa = 0.04) physical activity as compared to sedentary were significantly associated with lower odds of being bullied. Conclusions Our findings attest that bullying victimization is likely to be associated with certain factors such as child abuse of all forms, Internet addiction, social fear and avoidance. In addition, the Illinois Bully Scale was validated in Lebanon. More attention should be paid to students vulnerable to bullying victimization, such as those with environmental or domestic problems, and adolescents with psychological disorders such as behavioral addictions.


2019 ◽  
Author(s):  
Tesfaye Derseh ◽  
Minuye Biniam ◽  
Mohammed Yusouf ◽  
Tariku Dingeta

Abstract Background Intestinal obstruction is a global problem consuming much in terms of surgical services. It is a common surgical emergency and a significant health problem in Ethiopia. Several factors contribute to poor management outcomes in the case of intestinal obstruction. Post-operative mortality rate ranges from 3% to 30%. Despite this high rate of mortality, there is no recently published literature that has explored Intestinal Obstruction and its associated factors at Chiro General Hospital. Methods Institution based cross-sectional study was conducted among 254 of patients admitted with Intestinal obstruction who treated surgically at Chiro General Hospital. Data were collected using checklists from individual patient cards by trained three BSc nurses from 13 to 18 July 2018 and completeness of data collection was checked every day by the principal Investigator. Data were entered to Epi-Data version 3.1 computer software and exported to SPSS statistical software version 22 for analysis. Bivariable binary logistic regression was used to saw the association between each independent variable and dependent variable. All variables with P-value < 0.2 during bi-variable analyses were considered for multivariable logistic regression analyses. Odds ratio along with 95%CI were estimated to measure the strength of the association. Level of statistical significance was declared at p value less or equal to 0.05. Results In this study the magnitude of unfavorable outcome of Intestinal Obstruction was 21.3% (95% CI: (16.5, 26.4). Age group of 55 years or above [AOR=2.9, 95%CI: (1.03, 8.4)], duration of illness of 24hrs or above [AOR=3.1, 95%CI: (1.03, 9.4)], pre-operative diagnosis of gangrenous SBO & gangrenous LBO [(AOR=3.6, 95%CI: (1.3, 9.8)), (AOR=4.2, 95%CI: (1.3, 13.7))], respectively were significantly associated with unfavorable outcome. Conclusions The magnitude of unfavourable management outcome of patients with Intestinal obstruction who treated surgically in this study was high. Old age, late presentation of illness and gangrenous bowel obstruction were significantly associated with unfavourable management outcome. So that early detection prompt management of patients with Intestinal obstruction reduce the occurrence of unfavourable outcome of patients.


Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1745
Author(s):  
Nicolò Tamini ◽  
Davide Bernasconi ◽  
Lorenzo Ripamonti ◽  
Giulia Lo Bianco ◽  
Marco Braga ◽  
...  

(1) Introduction: To date, the sensitivity of the Comprehensive Complication Index (CCI) in a homogeneous cohort of colonic resections for oncologic purposes has not been reported. The present study aims to compare the CCI with the conventional Clavien–Dindo classification (CDC) in colon cancer patients. (2) Methods: The clinical data of patients submitted to an elective colectomy for adenocarcinoma were retrieved from a prospectively maintained database. Postoperative complications and length of stay were reviewed, and CDC and CCI scores were calculated for each patient. The association of the CCI and the CDC with the length of stay, prolongation of stay and readmission rate were assessed and compared. (3) Results: The overall postoperative morbidity was 26.9%. In particular, 157 (20.4%) patients had more than one complication. A strong correlation between the two scoring systems was observed (r = 99.4%; 95%CI: 99.3–99.5%). In multivariate analysis, CCI had a higher predictive ability for all endpoints. Regarding subgroup analysis, the difference between the CCI and CDC was progressively increased when evaluating outcome measures in complicated and multi-complicated patients. (4) Conclusion: Both scoring systems adequately report the overall burden of postoperative complications. The CCI showed a greater ability than the CDC to predict hospital stay, particularly in patients with multiple postoperative complications.


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.


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