Does Intracorporeal Anastomosis Decrease the Rate of Surgical Site Infection in Laparoscopic Colon Cancer Surgery?

Objective This study aimed to compare the surgical site infection (SSI) rates between intracorporeal anastomosis (ICA) and extracorporeal anastomosis (ECA). Summary of background data Laparoscopic surgery is recommended for colonic malignancies because of its superior clinical outcomes and comparable oncologic results. Laparoscopic colectomy with ICA has the advantages of incision length and free extraction site choice. However, ICA may be associated with a risk of SSI due to enterotomy inside the abdominal cavity. Methods We retrospectively analyzed patients with colon cancer who underwent radical surgery at Korea University Ansan Hospital between January 2017 and June 2020. We compared the SSI rates and other clinical variables between the ICA and ECA groups. Results Of the 502 patients who underwent radical surgery for colorectal cancer during the study period, 234 were eligible for inclusion. ECA and ICA were performed in 62.4% and 37.6% of patients, respectively. There were no statistically significant intergroup differences in clinicopathologic variables. The overall SSI rate did not differ between the groups (P = 0.801), but organ/space SSIs were more common in the ICA group than in the ECA group (P = 0.048). Conclusions There was no significant difference in overall SSI or anastomotic leakage (AL) rates between the ICA and ECA groups, but the organ/space SSI rate was higher in the ICA group when AL cases were excluded. Further high-quality studies are needed to assess the risk of organ/space SSIs in the ICA after colon cancer surgery.

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The safety of preoperative amino acid (Elental®) loading in colon cancer surgery: Prospective cohort study.

International Surgery ◽

10.9738/intsurg-d-16-00088.1 ◽

2017 ◽

Cited By ~ 1

Author(s):

Jun Watanabe ◽

Mitsuyoshi Ota ◽

Yusuke Suwa ◽

Shinsuke Suzuki ◽

Hirokazu Suwa ◽

...

Keyword(s):

Insulin Resistance ◽

Colon Cancer ◽

Amino Acid ◽

Surgical Site Infection ◽

Bowel Movement ◽

Cancer Surgery ◽

Site Infection ◽

Incisional Surgical Site Infection ◽

Colon Cancer Surgery ◽

Induction Of Anaesthesia

Abstract Objective: The aim of this prospective study was to evaluate the safety of preoperative amino acid plus CHO drink (Elental®) loading in colon cancer surgery. Summary of Background Data: Prolonged preoperative fasting increases insulin resistance and current evidence recommends carbohydrate drinks 2 hours before surgery. Methods: We prospectively enrolled consecutive patients with a preoperative diagnosis of colon cancer who underwent surgery. The patients received 600 ml of Elental® the night before surgery and 300 ml of Elental® 3 h prior to induction of anaesthesia. Primary endpoint was the safety of preoperative amino acid (Elental®) loading in colon cancer surgery. Safety measurement was anastomotic leakage and aspiration pneumonia. Secondary endpoints were incidence rate of incisional surgical site infection, recovery of bowel movement, length of hospital stay, postoperative nutritional status and insulin resistance. Results: A total of 80 consecutive patients were enrolled in this study from February 2013 to January 2014. The incidence of anastomotic leakage was 3 cases (3.8%) and there were no aspiration pneumonia. The incidence of incisional surgical site infection was 2 cases (2.5%). The median time of ﬁrst ﬂatus, defecation after surgery and postoperative hospital stay was 1 day, 2 days and 6 days. The insulin resistance recovered to a preoperative level after 3 days after surgery. Conclusion: The preoperative amino acid plus CHO drink (Elental®) loading 3h prior to induction of anaesthesia in colon cancer surgery is safe and incisional surgical site infection rate and recovery of bowel movement and insulin resistance are feasible.

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Targeting Surgical Site Infection–Reducing Bundles Selectively to At-Risk Colon Cancer Surgery Populations

JAMA Surgery ◽

10.1001/jamasurg.2017.0506 ◽

2017 ◽

Vol 152 (7) ◽

pp. 690

Author(s):

Daniel Albo

Keyword(s):

At Risk ◽

Colon Cancer ◽

Surgical Site Infection ◽

Cancer Surgery ◽

Site Infection ◽

Colon Cancer Surgery

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Does Transumbilical Incision Influence Surgical Site Infection Rates of the Laparoscopic Sigmoidectomy and Anterior Resection?

The American Surgeon ◽

10.1177/000313481508101223 ◽

2015 ◽

Vol 81 (12) ◽

pp. 1232-1236 ◽

Cited By ~ 2

Author(s):

Masashi Yamamoto ◽

Keitaro Tanaka ◽

Mitsuhiro Asakuma ◽

Keisaku Kondo ◽

Masatsugu Isii ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Laparoscopic Surgery ◽

Surgical Site Infection ◽

Univariate Analysis ◽

Site Infection ◽

Infection Rates ◽

Rectosigmoid Colon ◽

Lower Quadrant ◽

Colon Cancer Surgery

Laparoscopic surgery is widespread and is safe and effective for the management of patients with colorectal cancer. However, surgical site infection (SSI) remains an unresolved complication. The present study investigated the comparative effect of supraumbilical incision versus transumbilical incision (TU) on the incidence of SSI in patients undergoing laparoscopic surgery for colon cancer. Medical records from patients with colorectal cancer who underwent laparoscopic sigmoid and rectosigmoid colon surgeries with either supraumbilical incision (n = 150) or TU (n = 150) were retrospectively reviewed. There was no difference in demographics, comorbidities, or operative variables between the two groups. The transumbilical group and the supraumbilical group were comparable with regards to overall SSI (6.0% vs 4.0%; P = 0.4062), superficial SSI (6.0% vs 3.3%; P = 0.2704), and deep SSI (0% vs 0.7%; P = 0.2385). SSI developed after laparoscopic sigmoid and rectosigmoid colon cancer surgery in 15 (5.0%) of the 300 patients. Of these superficial SSI, all wounds were in the left lower quadrant incision, and the transumbilical port sites did not become infected. Univariate analysis failed to identify any risk factors for SSI. Avoidance of the umbilicus offers no benefit with regard to SSI compared with TU.

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POSTOPERATIVE INTRAABDOMINAL COMPLICATIONS IN COLON CANCER SURGERY COMPLICATED BY BOWEL OBSTRUCTION AND PERFORATION OF THE TUMOR

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2015-174-5-98-104 ◽

2015 ◽

Vol 174 (5) ◽

pp. 98-104 ◽

Cited By ~ 2

Author(s):

S. A. Aliev ◽

E. S. Aliev ◽

B. M. Zeinalov

Keyword(s):

Colon Cancer ◽

Surgical Treatment ◽

Postoperative Complications ◽

Retrospective Analysis ◽

Large Intestine ◽

Bowel Obstruction ◽

Abdominal Cavity ◽

Cancer Surgery ◽

Perioperative Prophylaxis ◽

Colon Cancer Surgery

The article presents a retrospective analysis of the results of surgical treatment of postoperative intraabdominal complications in 42 patients with colon cancer complicated by bowel obstruction and perforation of the tumor. The pyoinflammatory processes such as peritonitis and abscesses of abdominal cavity took a leading place in the structure of postoperative complications according to the authors. Method of «closed» decompression and intraluminal irrigation of the large intestine without wide opening of organ lumen was developed and applied into practice as perioperative prophylaxis of pyoinflammatory processes. These measures allowed reducing the rate of postoperative intraabdominal complications from 19,2 to 7,7%.

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Physical Activity and Its Impact on Colon Cancer Surgery

Case Medical Research ◽

10.31525/ct1-nct03947840 ◽

2019 ◽

Author(s):

Keyword(s):

Physical Activity ◽

Colon Cancer ◽

Cancer Surgery ◽

Colon Cancer Surgery

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Factors associated with diet failure after colon cancer surgery

Surgical Endoscopy ◽

10.1007/s00464-021-08575-y ◽

2021 ◽

Author(s):

Kiho You ◽

Dae Kyung Sohn ◽

Sung Sil Park ◽

Sung Chan Park ◽

Jae Hwan Oh ◽

...

Keyword(s):

Colon Cancer ◽

Cancer Surgery ◽

Factors Associated ◽

Colon Cancer Surgery

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A case of portal venous gas after obstructive transverse colon cancer surgery

Surgical Case Reports ◽

10.1186/s40792-019-0729-z ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Yuichiro Furutani ◽

Chikashi Hiranuma ◽

Masakazu Hattori ◽

Kenji Doden ◽

Yasuo Hashizume

Keyword(s):

Colon Cancer ◽

Conservative Treatment ◽

Anastomotic Leakage ◽

Transverse Colon ◽

Cancer Surgery ◽

Transverse Colon Cancer ◽

Bowel Necrosis ◽

Entire Area ◽

Portal Venous Gas ◽

Colon Cancer Surgery

Abstract Background Portal venous gas has traditionally been considered an inevitable harbinger of death due to its association with bowel necrosis. Recently, an increasing number of cases of portal venous gas have been reported in patients with various clinical conditions and without bowel necrosis. We herein report the case of a patient in whom portal venous gas developed after transverse colon cancer surgery. Case presentation A 69-year-old man who had transverse colon cancer underwent insertion of a transanal ileus tube for decompression. Transverse colon resection was performed on the 11th day after the insertion of the transanal ileus tube. The patient had a high fever on the 6th day after the operation. Computed tomography showed portal venous gas over the entire area of the liver and pneumatosis intestinalis in the wall of the ascending colon. There were no signs of anastomotic leakage or bowel necrosis, so we decided to use conservative therapy with fasting and antibiotics. The portal venous gas disappeared on the 19th day after the operation. The patient was discharged in good condition on the 29th day after the operation. Conclusions Conservative treatment for portal venous gas is reasonable for patients without signs of anastomotic leakage or bowel necrosis. However, it is important to carefully observe patients with portal venous gas during conservative treatment because portal venous gas may be life-threatening.

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