Relaparotomy in colorectal cancer surgery – Do any factors influence the risk of mortality? A case controlled study

Mik, Michał; Magdzinska, Justyna; Dziki, Łukasz; Tchórzewski, Marcin; Trzciński, Radzisław; Dziki, Adam

doi:10.1016/j.ijsu.2014.09.001

Cited by 19 publications

(14 citation statements)

References 18 publications

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“…In the present study an overall postoperative 30-day mortality rate of 2⋅4 per cent was observed for all patients, comparable with previous population-based studies 11,12,23 -25 evaluating mortality risk in patients undergoing elective colorectal cancer resection (1⋅8-3⋅5 per cent). Previous reported relaparotomy rates after surgery for colorectal cancer range from 5⋅8 to 7⋅2 per cent 26 , in accordance with the present study.…”

Section: Discussionsupporting

confidence: 93%

National cohort study on postoperative risks after surgery for submucosal invasive colorectal cancer

et al. 2018

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Background The decision to perform surgery for patients with T1 colorectal cancer hinges on the estimated risk of lymph node metastasis, residual tumour and risks of surgery. The aim of this observational study was to compare surgical outcomes for T1 colorectal cancer with those for more advanced colorectal cancer. Methods This was a population‐based cohort study of patients treated surgically for pT1–3 colorectal cancer between 2009 and 2016, using data from the Dutch ColoRectal Audit. Postoperative complications (overall, surgical, severe complications and mortality) were compared using multivariable logistic regression. A risk stratification table was developed based on factors independently associated with severe complications (reintervention and/or mortality) after elective surgery. Results Of 39 813 patients, 5170 had pT1 colorectal cancer. No statistically significant differences were observed between patients with pT1 and pT2–3 disease in the rate of severe complications (8·3 versus 9·5 per cent respectively; odds ratio (OR) 0·89, 95 per cent c.i. 0·80 to 1·01, P = 0·061), surgical complications (12·6 versus 13·5 per cent; OR 0·93, 0·84 to 1·02, P = 0·119) or mortality (1·7 versus 2·5 per cent; OR 0·94, 0·74 to 1·19, P = 0·604). Male sex, higher ASA grade, previous abdominal surgery, open approach and type of procedure were associated with a higher severe complication rate in patients with pT1 colorectal cancer. Conclusion Elective bowel resection was associated with similar morbidity and mortality rates in patients with pT1 and those with pT2–3 colorectal carcinoma.

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Section: Discussionsupporting

confidence: 93%

National cohort study on postoperative risks after surgery for submucosal invasive colorectal cancer

et al. 2018

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“…In some cases, the presence of AL results in an increased percentage of surgical reinterventions in order to treat complications such as generalized peritonitis. According to Mik et al [ 21 ], anastomotic failure strongly influences the incidence of re-laparotomy.…”

Section: Discussionmentioning

confidence: 99%

Safety of anastomotic techniques and consequences of anastomotic leakage in patients with colorectal cancer: a single surgeon experience

Élthes

Sala²,

Neagoe³

et al. 2020

Medicine and Pharmacy Reports

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Introduction. Colorectal cancer is a common type of malignant disease of the digestive tract. Anastomotic leakage (AL) still represents a serious complication in gastrointestinal surgery, associated with high morbidity and mortality. Methods. We conducted a retrospective case-control study and analyzed a single surgeon's data about 359 patients treated for colorectal cancer. Patients were divided as follows: Study Group (patients with AL - 37 patients) and Control Group (patients without AL - 322 patients). Surgical and anastomotic technique-related information was processed. Results. Surgical procedures for right sided colon tumors resulted in a significantly lower rate of anastomotic leakage (P = 0.0231). For left sided colectomies end to end handsewn double layer anastomosis presented decreased odds (OR = 0.176). For sigmoid segmental resection end to end anastomotic techniques developed low rate of fistula formation (handsewn - OR = 0.593, stapled – OR = 0.685). Performing Dixon type surgical interventions, anastomotic techniques seemed without influence on anastomotic leak appearance (handsewn and stapled), although distal anastomoses were identified as significant risk factors for fistula formation (P = 0.0017). In order to perform subtotal colectomy, side to side sutures (handsewn and stapled) seemed safe choices for anastomotic procedure (P = 0.0073). Patient with anastomotic leakage suffered a significantly longer hospital stay (P = 0.0079), presented higher rate of surgical reintervention (P=0.0001), increased mortality (P=0.0001) and elevated hospitalization costs (P=0.0079). Conclusion. Postoperative complications like anastomosis leakage significantly increase hospitalization period, necessity of surgical reintervention, mortality and financial costs. In order to avoid these unpleasant events, bowel anastomoses require standardization during surgery.

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“…Релапаротомію визначають як повторне розкриття черевної порожнини у перші 60 днів після хірургічного втручання на органах черевної порожнини. Релапаротомія, проведена у першу 21 добу після хірургічного втручання, визначається як рання релапаротомія, після 21 добипізня [3]. Найбільш частою причиною ранніх релапаротомій є ускладнення, пов'язані з першою операцією, такі як кровотеча, перитоніт, евентерація, а причиною пізніх релапаротомійзлукова кишкова непрохідність [1, 3,5,6].…”

Section: матеріали та методи дослідженьunclassified

“…Це свідчить про необхідність подальшого удосконалення як технічних аспектів оперативних втручань,так і антибактеріальної терапії QUESTIONS OF GASTROINTESTINAL TRACT інтраабдомінальної інфекції. Наші дані співпадають з даними літератури [2,3,4,5].…”

Section: матеріали та методи дослідженьunclassified

Relaparotomy in the Treatment of Intra-Abdominal Complications of Abdominal Surgery

Syplyviy¹,

Кryvoruchko²,

Ievtushenko³

et al. 2020

Khark. Surg. Sch.

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Summary. Relaparotomy in the treatment of postoperative complications of abdominal surgery remains a complex problem in modern surgery. Purpose: to study the causes of relaparotomy after surgical operations on the abdominal organs, depending on the nature of the first surgical intervention. Material and Methods: A retrospective analysis of the performance of 74 relaparotomies after surgical treatment of abdominal pathology was performed. The first surgical intervention was performed because of acute cholecystitis (11 patients), choledocholithiasis (4), acute destructive appendicitis (8), perforated stomach or duodenal ulcers (8), strangulated hernia (5), adhesive intestinal obstruction (9), perforation of thin or colon (7), obstruction of the colon of tumor origin (19). Indications for relaparotomy were peritonitis, early adhesive intestinal obstruction, intraperitoneal bleeding. Conclusions: Complications associated with intra-abdominal infection — peritonitis, peritonitis due to insolvency of anastomotic sutures, is the most common cause of relaparotomy after operations on the abdominal organs, requires improvement of both technology of operations and antibacterial therapy. Relaparotomy is a life-saving surgery in the development of intra-abdominal complications, but it is associated with a greater risk of mortality.

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Relaparotomy in colorectal cancer surgery – Do any factors influence the risk of mortality? A case controlled study

Abstract: Patients after relaparotomy for complications of colorectal cancer surgery are at very high risk of mortality. Particularly male gender, older age, poor general condition and anastomotic complications are the risk factors of high mortality.

Cited by 19 publications

References 18 publications

National cohort study on postoperative risks after surgery for submucosal invasive colorectal cancer

National cohort study on postoperative risks after surgery for submucosal invasive colorectal cancer

Safety of anastomotic techniques and consequences of anastomotic leakage in patients with colorectal cancer: a single surgeon experience

Relaparotomy in the Treatment of Intra-Abdominal Complications of Abdominal Surgery

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