Prevalence of and Risk Factors for Morbidity After Elective Left Colectomy

Piessen, Guillaume; Muscari, Fabrice; Rivkine, Emmanuel; Sbaï-Idrissi, Mohamed Saïd; Lorimier, G.; Fingerhut, Abe; Dziri, Chadli; Hay, Jean‐Marie; French, for

doi:10.1001/archsurg.2011.231

Cited by 31 publications

(10 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Large studies have shown that > 10% weight loss prior to surgery and overweight constituted independent risk factors for morbidity after colorectal surgery [16,30]. As in the present report, several investigations [16,25,30,31] recognised that BMI above 25 and obesity were associated with increased risk for surgical complications. Complex procedures were also correlated with higher complication risks in our study, as has been reported by other researchers [32].…”

Section: Discussionsupporting

confidence: 76%

Hospital costs associated with surgical morbidity after elective colorectal procedures: a retrospective observational cohort study in 530 patients

Zoucas

Lydrup

2014

Patient Saf Surg

View full text Add to dashboard Cite

BackgroundPostoperative complications contribute to morbidity and mortality. This study assessed the impact of surgical complications on healthcare resource utilization for patients undergoing elective colorectal procedures.MethodData were obtained on 530 consecutive colorectal operations performed from January 2010 to January 2011. Patient demographics, type of procedure, surgical complications classified as Clavien 1–5, length of stay, 60-day readmission rate, and hospital costs were recorded.ResultsSeventy-five percent of the operations were associated with malignancy, and 26% were pelvic procedures. Thirty-five percent of the patients developed at least one complication, 21% of the complications did not require intervention. The readmission rate was 7.4%. Nine patients died during 60-day post discharge follow up.Median length of stay was 9 (3–34) days in uncomplicated and 16 (4–205) days in complicated cases. Occurrence of any complication at index admission increased total hospital costs 2.1-fold (EUR 25,680 vs. EUR 12,405), with the largest cost differential attributed to wound dehiscence and/or suture line failure requiring reoperation. These increases were primarily due to prolonged hospitalization and ICU expenditures. Readmission resulted in a further increase to an average cost of EUR 12,585 per re-admitted patient.Multivariate analysis showed that BMI > 25, obesity, operation complexity and surgeon significantly affected the risk for complication. Also, hospital costs were significantly increased by any postoperative complications, reoperations, high complexity of surgical procedures and high comorbidity index.ConclusionsReducing morbidity after colorectal procedures improves quality of care and patient safety, and may also substantially reduce hospital costs and increase the efficiency of resource utilization.

show abstract

Section: Discussionsupporting

confidence: 76%

Hospital costs associated with surgical morbidity after elective colorectal procedures: a retrospective observational cohort study in 530 patients

Zoucas

Lydrup

2014

Patient Saf Surg

View full text Add to dashboard Cite

show abstract

“…46-49 Previous studies have reported that the recovered node count is positively associated with specimen length, 14,18,19,21-24 proximal colon cancer, 13,18,19,25,28 larger tumor size, 11,14,18,20 number of vascular pedicles, 50 and higher disease stage. 17,18 However, in those studies, 11,13,14,17-24,28 there were no data on host immune response to tumor, or tumor molecular features, despite possible influence of immune reaction and tumor molecular variables on the node count.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Lymph Node Count in Colorectal Cancer Resections

Morikawa

Tanaka²,

Kuchiba³

et al. 2012

Arch Surg

View full text Add to dashboard Cite

“…Higgens et al ( 12 ) have reported that in patients undergoing elective resection for inflammatory bowel disease, pre-operative weight loss did not adversely affect the post-operative outcome. Piessen et al ( 13 ) have reported that weight loss is not an independent risk factor for morbidity in colon cancer patients who underwent left hemicolectomy. In the present study, the operative morbidity and mortality rates were not significantly different between colon cancer patients with and without BWL.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of unintentional body weight loss in colon cancer patients

et al. 2018

View full text Add to dashboard Cite

The aim of the present study was to investigate whether unintentional body weight loss (BWL) provides additional clinical information in terms of tumor progression and prognosis in non-metastatic colon cancer. In the present study, a total of 2,406 consecutive colon cancer patients without metastasis were retrospectively enrolled. Unintentional BWL was defined as loss of >5% of body weight within the last 6–12 months, or defined subjectively upon fulfillment of at least two of the following: Evidence of change in clothing size and corroboration of the reported weight loss by family or friend. This category was recorded as present (‘with’) or absent (‘without’). Logistic regression analysis was performed to determine the correlation between BWL and the tumor characteristics and post-operative outcomes of patients with colon cancer. The Cox regression model was used to determine the association of BWL with long-term survival of colon cancer patients. A significant association between BWL and tumor location [right vs. left: Odds ratio (OR)=1.62; P<0.001], tumor size (≥5 vs. <5 cm: OR=2.17; P<0.001), and tumor stage based on the tumor-nodes-metastasis system (T3-T4 vs. T1-T2: OR=2.02; P<0.001). Post-operative morbidity and mortality were not significantly influenced by BWL. Multivariate analysis revealed that BWL was significantly associated with overall survival [with vs. without BWL: Hazard ratio (HR)=1.178; P=0.036] and relapse-free survival (with vs. without BWL: HR=1.332; P=0.003). In conclusion, BWL in patients with colon cancer is not just a symptom, but it is also correlated with tumor location, size and depth, and is a prognostic factor for poor outcomes including overall survival and tumor relapse.

show abstract

Prevalence of and Risk Factors for Morbidity After Elective Left Colectomy

Cited by 31 publications

References 56 publications

Hospital costs associated with surgical morbidity after elective colorectal procedures: a retrospective observational cohort study in 530 patients

Hospital costs associated with surgical morbidity after elective colorectal procedures: a retrospective observational cohort study in 530 patients

Predictors of Lymph Node Count in Colorectal Cancer Resections

Prognostic significance of unintentional body weight loss in colon cancer patients

Contact Info

Product

Resources

About