Risk Factors for Complications following Introduction of Radical Surgery for Colon Cancer: A Consecutive Patient Series

Furnes, Bjørg; Storli, Kristian Eeg; Forsmo, Håvard Mjørud; Karliczek, Anne; Eide, Geir Egil; Pfeffer, F.

doi:10.1177/1457496918798208

Cited by 13 publications

(10 citation statements)

References 29 publications

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“…There were several important observations of this study. Firstly, we found that male patients were at higher risk of severe complications after laparoscopic surgery for T3 or T4 rectal cancer than female patients, which was in line with previous studies [ 12 – 14 ]. Saadat et al reported that male gender and chronic pulmonary diseases contributed to reoperation after surgery for rectal cancer [ 15 ].…”

Section: Discussionsupporting

confidence: 92%

Risk Factors for Severe Complications After Laparoscopic Surgery for T3 or T4 Rectal Cancer for Chinese Patients: Experience from a Single Center

Liang

Liu

et al. 2020

Med Sci Monit

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Background Patients with rectal cancer are usually at advanced stage with or beyond serosa invasion in China. Severe complications after laparoscopic rectal surgery leads to prolonged hospitalization and high medical cost. This study aimed to explore risk factors for severe complications after laparoscopic surgery of T3 or T4 rectal cancer. Material/Methods A total of 287 patients diagnosed with T3 or T4 rectal cancer were enrolled from the Department of Gastrointestinal Surgery of Anhui Provincial Hospital from February 2012 to February 2017. Univariate analysis and multivariable logistic regression model were used to analyze the risk factors for severe complications (Clavien-Dindo grade ≥III) after laparoscopic surgery. Results Eighteen patients (6.25%) had severe complications; 15 patients were categorized as Clavien-Dindo grade III, and 3 patients were categorized as Clavien-Dindo grade IV. Univariate analysis showed that male gender, high preoperative white blood cells (WBC), diabetes mellitus, pulmonary dysfunction, and tumor distance from anus were associated with increased risk of severe complications after laparoscopic surgery for rectal cancer. Multivariate analysis showed that preoperative WBC ≥6.9×10 9 /L (OR=5.54 (1.58–19.45), P =0.008), diabetes mellitus (OR=13.07 (3.31–51.67), P =0.000) and pulmonary dysfunction (OR=7.75 (1.69–35.63), P =0.008) were independent risk factors for postoperative severe complications. Conclusions Preoperative high white blood cells, diabetes mellitus and pulmonary dysfunction were independent risk factors for severe complications after laparoscopic surgery for T3 or T4 rectal cancer.

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Section: Discussionsupporting

confidence: 92%

Risk Factors for Severe Complications After Laparoscopic Surgery for T3 or T4 Rectal Cancer for Chinese Patients: Experience from a Single Center

Liang

Liu

et al. 2020

Med Sci Monit

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“…Severe complications were more common in patients who had increased preoperative hospitalizations and who lived in nursing homes. These findings support recent studies from Norway and Japan [32,33] emphasizing the importance of preoperative evaluation of patient's physical and cognitive performance, to prevent complications in colon cancer surgery. In Finland, aged people move to nursing homes when they cannot survive with maximal help at home and most of them have some degree of cognitive impairment.…”

Section: Discussionsupporting

confidence: 89%

Risk factors of short-term survival in the aged in elective colon cancer surgery: a population-based study

Niemeläinen

Huhtala

Ehrlich

et al. 2019

Int J Colorectal Dis

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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.

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“…Increased morbidity has been reported early in the learning curve of surgeons converting to CME. 36,37 It becomes evident that implementation of CME and, in particular, SILS CME should be under supervision.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Single-Incision Versus Multiport Laparoscopic Complete Mesocolic Excision Colectomy for Colon Cancer

et al. 2019

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Background. Our aim was to compare the emerging technique of single-incision laparoscopic surgery complete mesocolic excision (SILS CME) colectomy with the standard multiport laparoscopic CME (MPL CME) colectomy. Methods. MEDLINE (PubMed), Scopus, EMBASE, Ovid, and the Cochrane library were searched. Studies comparing the SILS CME with MPL CME in adults with colon adenocarcinoma were included. The Jadad and Newcastle Ottawa Scales were used to critically appraise the studies. The presence of statistical heterogeneity or publication bias was examined. Results. Seven studies (3 randomized) with a total number of 1344 patients were included (546 SILS CME and 798 MPL CME). No difference was found in anastomotic leakage (odds ratio [OR] = 0.79 [0.31 to 2.03]; P = .63), number of lymph nodes (weighted mean difference [WMD] = 0.85 [−0.97 to 2.66]; P = .36), hospital stay (WMD = 0.01 [−0.19 to 0.20]; P = .96), overall survival (hazard ratio [HR] = 1.19 [0.29 to 4.80]; P = .81), and disease-free survival (HR = 1.30 [0.30 to 5.61]; P = .72). Skin incision was shorter in SILS CME group (WMD = −3.02 [−3.25 to −2.80]; P < .00001) but with no difference in pain reported in postoperative day 1 (standardized mean difference [SMD] = −0.21 [−0.50 to 0.09]; P = .17) or day 2 (SMD = 0.16 [−0.52 to 0.84]; P = .64). Conclusions. SILS CME, although technically more demanding, has equivalent short- and long-term outcomes when compared with MPL CME. Potential benefits in cosmesis or postoperative pain need to be further explored by high-quality randomized controlled trials.

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Risk Factors for Complications following Introduction of Radical Surgery for Colon Cancer: A Consecutive Patient Series

Cited by 13 publications

References 29 publications

Risk Factors for Severe Complications After Laparoscopic Surgery for T3 or T4 Rectal Cancer for Chinese Patients: Experience from a Single Center

Risk Factors for Severe Complications After Laparoscopic Surgery for T3 or T4 Rectal Cancer for Chinese Patients: Experience from a Single Center

Risk factors of short-term survival in the aged in elective colon cancer surgery: a population-based study

A Systematic Review and Meta-Analysis of Single-Incision Versus Multiport Laparoscopic Complete Mesocolic Excision Colectomy for Colon Cancer

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