Factors affecting morbidity, mortality and survival in patients undergoing surgery for rectal cancer in a district general hospital

Macadam, Robert; Yeomans, Neil; Wilson, Joel; Case, W. G.; White, C.; Lovegrove, John; Lyndon, P J

doi:10.1308/003588405x51155

Cited by 6 publications

(5 citation statements)

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“…In the literature, the rate of postoperative mortality has been reported to be 3-8%. 27 , 28 The mortality rates in Group 1 and Group 2 of the present study were 5% and 8%, respectively, and these rates were consistent with findings in the literature. Although there was no significant difference in these mortality rates, mortality was high in Group 2 ( Table 1 ).…”

Section: Discussionsupporting

confidence: 92%

Effects of COVID-19 pandemic on colorectal cancer surgery

et al. 2022

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BACKGROUND: The coronavirus disease-19 pandemic has changed the course of diseases that require emergency surgery. OBJECTIVE: To evaluate the effect of the COVID-19 pandemic on colorectal cancer disease stage. DESIGN AND SETTING: Retrospective analysis in the city of Rize, Turkey. METHODS: This was a comparative analysis on two groups of patients with various symptoms who underwent surgical colorectal cancer treatment. Group 1 comprised patients operated between March 11, 2019, and December 31, 2019; while group 2 comprised patients at the same time of the year during the COVID-19 pandemic. RESULTS: Groups 1 and 2 included 56 and 48 patients, respectively. The rate of presentation to the emergency service was higher in Group 2 (P < 0.02). The stage of the pathological lymph nodes and the rate of liver metastasis was higher in Group 2 (P < 0.004 and P < 0.041, respectively). The disease stage was found to be more advanced in Group 2 (P < 0.005). The rate of postoperative complications was higher in Group 2 (P < 0.014). CONCLUSION: The presentation of patients with suspicious findings to the hospital was delayed, due both to the fear of catching COVID-19 and to the pandemic precautions that were proposed and implemented by healthcare authorities worldwide. Among the patients who presented to the hospital with emergency complaints and in whom colorectal cancer was detected, their disease was at a more advanced stage and thus a higher number of emergency oncological surgical procedures were performed on those patients.

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Section: Discussionsupporting

confidence: 92%

Effects of COVID-19 pandemic on colorectal cancer surgery

et al. 2022

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“…Several tumour‐related factors have been correlated with CRM positivity. Advanced TNM stage had an obvious relationship with a higher possibility of CRM involvement [2,10,15,16,24–26]. Other than direct tumour extension, involvement of the CRM may occur as a result of the presence of metastatic lymph node, foci of microvascular invasion or tumour budding.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing circumferential resection margin in rectal cancer

et al. 2013

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Aim Abdominoperineal excision (APR) has been associated with higher circumferential resection margin (CRM) involvement and local recurrence rates than extralevator APR for low rectal cancer. This study aimed to evaluate the CRMs in APR and low anterior resection (LAR) specimens and to identify factors influencing CRM involvement. Method All pathological specimens from consecutive patients with rectal cancer who underwent curative resection at the Cleveland Clinic Florida, from January 2000 to July 2010, were reviewed by two pathologists. Demographics, tumour characteristics, operative data, postoperative pathology and Dworak’s tumour regression grade were compared between specimens with positive and negative CRMs. Results One‐hundred and fifty‐four patients underwent curative APR (n = 65) or LAR (n = 69). Mean tumour size was 3.6 cm, and mean distance from the dentate line was 5.4 cm. Nine (6.8%) patients had a positive CRM (n = 6 APR, n = 3 LAR), which was associated with tumour size > 5.9 cm (P = 0.002), a distance of ≤ 2.6 cm from the dentate line (P = 0.013), microvascular invasion (P = 0.009), perineural invasion (P < 0.001), number of positive lymph nodes (P = 0.046) and incomplete total mesorectal excision (TME) (P < 0.001). APR specimens were three times more likely than LAR specimens to have an incomplete mesorectum (9.8%vs 2.9%, P = 0.322). Conclusions Factors associated with a positive CRM were tumour size > 5.9 cm, a distance of ≤ 2.6 cm from the dentate line, incomplete TME, number of positive nodes and microvascular and perineural invasion. The incidence of a positive CRM was not significantly different between LAR and APR (n = 3 LAR and n = 6 APR).

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“…Jagoditsch ve ark., [27] rektum kanseri için cerrahi uygulanan 597 hastada kan transfüzyon durumunu, transfüzyonun tipini (otolog veya allogenik) ve ünite sayısını kaydetmişler ve sonuçta kan transfüzyonu ile postoperatif 60 günlük mortalite arasında anlamlı şekilde ilişkili bulmuşlar, kan ünite sayısı ve tipinin onkolojik sonuca etkisi olmadığını bildirmişlerdir. Macadam ve ark.nın [28] yaptığı çalışmada 30 günlük mortalite, artmış postoperatif kan transfüzyon miktarı ile ilişkili bulunmuştur. Çalışmamızda ise preoperatif kan tranfüzyonun mortalite ile peroperatif kan transfüzyonun ise hem mortalite ve hem de morbidite üzerine anlamlı etkisi olduğu bulundu.…”

Section: Discussionunclassified

“…[1] Macadam ve ark. [28] total mezorektal eksizyon yapılan rektal adenokarsinomlu 61 hastayı retrospektif olarak incelemişlerdir, 30 günlük mortalite oranını %8.3 olarak bulmuşlar ve toplam 89 komplikasyon geliştiğini gözlemişlerdir. Çalışmamızda da benzer olarak total mezorektal eksizyon yapılan hastalarda 30 günlük mortalite oranı %10.2 olarak bulundu.…”

Section: Discussionunclassified

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Mortality and morbidity after surgery for cancer of the rectum in a non-specialized hospital.

Saylam¹,

Çomçalı²,

Vural³

et al. 2012

Istanbul Tip Derg

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Bu çalışmada spesifikleşmenin olmadığı bir hastanede, rektum kanseri nedeniyle operasyon uygulanan hastalarda postoperatif komplikasyon ve mortalite gelişimi üzerine etkili risk faktörlerini araştırmayı amaçladık. Gereç ve Yöntem: Ocak 1999-Ocak 2008 tarihleri arasında kliniğimizde operasyon uygulanan ve rektum kanseri tanısı patolojik olarak doğrulanan tüm hastalar geriye dönük olarak incelendi. Ardışık olarak tanı konan 75 primer rektum kanserli hasta çalışmaya alındı. Bulgular: Mortalite ve morbidite etkilenen faktörler ileri yaş, düşük albümin düzeyi, perioperatif kan transfüzyonu ve postoperatif yoğun bakım desteği (p<0.05) idi. Sistemik hastalık varlığı, anemi, ameliyat öncesi beslenme desteği ve postoperatif komplikasyonlar gelişmesi ile mortalite arasında anlamlı ilişki bulundu (p<0.05). Cinsiyet, sigara alışkanlığı, ASA skoru, bağırsak temizliği, ileostomili veya ileostomisiz AAR ve tümörün evresi ile mortalite ve morbidite arasında istatistiksel olarak anlamlı ilişki bulunmadı (p>0.05). Sonuç: Tümör ile ilişkili faktörler ve seçilen cerrahi prosedür bağımsız olarak rektum kanseri için cerrahi sonrası mortalite ve morbidite ile ilişkili değildir. Bu nedenle cerrahi için hasta seçiminde hastanın klinik durumu üzerine odaklanılmalıdır. Hasta sayısının az olmasına rağmen sonuçlarımız spesifik merkezlerinkine benzerdir; hastaların klinik durumu mortalite ve morbiditenin en önemli nedenidir.

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Factors affecting morbidity, mortality and survival in patients undergoing surgery for rectal cancer in a district general hospital

Abstract: Surgical outcomes in lower volume hospitals are comparable with those reported by larger centres.

Cited by 6 publications

References 0 publications

Effects of COVID-19 pandemic on colorectal cancer surgery

Effects of COVID-19 pandemic on colorectal cancer surgery

Factors influencing circumferential resection margin in rectal cancer

Mortality and morbidity after surgery for cancer of the rectum in a non-specialized hospital.

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