Risk factors for pulmonary complications after emergency abdominal surgery

Serejo, Livia Goreth Galvão; Silva‐Júnior, Francisco Pereira da; Bastos, João Paulo Catunda; Bruin, Gabriela Sales de; Mota, Rosa Maria Salani; Bruin, Pedro Felipe Carvalhedo de

doi:10.1016/j.rmed.2006.07.015

Cited by 76 publications

(60 citation statements)

References 27 publications

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“…2,11,58 Though in our study the overall morbidity was (38%), pulmonary complication (30%), wound infection (28%) which was attributed to the fact that all cases were actually upper abdominal surgery restricting vital capacity in early post-operative periods in spite of analgesia support and thus adding to pulmonary complications. 59 Wound infection rate was 28% in our study while an infection rate of 15-40% and overall post-operative complication in various studies ranged from 17-63%. [60][61][62][63] Though mortality figure in our patients was 14% over a period of 30 days but it escalated to 40 % with Boey score of 3 where all risk factors were present.…”

Section: Discussionmentioning

confidence: 53%

Improving outcome in perforated peptic ulcer emergency surgery by Boey scoring

2016

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Section: Discussionmentioning

confidence: 53%

Improving outcome in perforated peptic ulcer emergency surgery by Boey scoring

2016

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“…Pneumonia was the primary cause of death in our study. Respiratory complications often occur after major abdominal surger y [27][28][29][30] , particularly in advanced age patients like ours.…”

Section: Discussionmentioning

confidence: 99%

Colonoscopic perforation: A report from World Gastroenterology Organization endoscopy training center in Thailand

Lohsiriwat¹,

Sujarittanakarn²,

Akaraviputh³

et al. 2008

WJG

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AIM:To determine the incidence of colonoscopic perforation (CP), and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization (WGO) Endoscopy Training Center in Thailand. METHODS: All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok were reviewed. Incidence of CP, patients' characteristics, endoscopic information, intraoperative findings, management and outcomes were analyzed. RESULTS: A total of 17 357 endoscopic procedures of the colon (13 699 colonoscopies and 3658 flexible sigmoidoscopies) were performed in Siriraj hospital over a 9-year period. Fifteen patients (0.09%) had CP: 14 from colonoscopy and 1 from sigmoidoscopy. The most common site of perforation was in the sigmoid colon (80%), followed by the transverse colon (13%). Perforations were caused by direct trauma from either the shaft or the tip of the endoscope (n = 12, 80%) and endoscopic polypectomy (n = 3, 20%). All patients with CP underwent surgical management: primary repair (27%) and bowel resection (73%). The mortality rate was 13% and postoperative complication rate was 53%. CONCLUSION: CP is a rare but serious complication following colonoscopy and sigmoidoscopy, with high rates of morbidity and mortality. Incidence of CP was 0.09%. Surgery is still the mainstay of CP management.

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“…23,24 The improvement in local control conferred by radiation may result in decreasing the number of repeated abdominal surgeries with its associated morbidity and mortality. 25 Collectively, these reasons partially argue that, given a sufficiently large sample size, radiotherapy may indeed improve survival in a patient population with a relatively high risk of local failure as seen in NRA-STS.…”

Section: Discussionmentioning

confidence: 99%

Utilization pattern and survival outcomes of adjuvant therapies in high‐grade nonretroperitoneal abdominal soft tissue sarcoma: A population‐based study

Green

Jabbour

DeLaney

et al. 2017

Asia-Pac J Clncl Oncology

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Summary: Nonretroperitoneal abdominal soft tissue sarcoma (NRA-STS) is a rare disease characterized by poor outcomes with limited data supporting its management. Our study indicates that adjuvant radiotherapy was associated with improved survival in high-grade NRA-STS, and higher radiotherapy doses may accentuate this benefit. AbstractBackground: Nonretroperitoneal abdominal soft tissue sarcoma (NRA-STS) is a rare disease with limited data supporting its management. Our study aimed to reveal the utilization patterns of adjuvant therapy and its potential survival benefits using the National Cancer Data Base. Materials:The analysis included patients with resected high-grade NRA-STS. Chi-square analysis was used to evaluate distribution of patient and tumor-related factors within treatment groups.The Kaplan-Meier and Cox proportional hazards model were utilized to evaluate overall survival according to treatment approach. Multivariate analysis was used to determine the impact of these factors on patients' outcome. Matched propensity score analysis was implemented to control for imbalance of confounding variables. Results:At median follow-up of 49 months, 5-year overall survival improved from 46% without adjuvant radiation therapy to 52% (P = 0.009) with radiotherapy delivery with a 30% reduction in hazard of death (95% confidence interval = 0.58-0.84). On multivariate analysis, age <50, tumor <8 cm, negative margins and radiotherapy delivery were significant predictors of improved survival. Chemotherapy was not associated with significant survival improvement (Hazard Ratios[HR]: 0.89, P = 0.28). Conclusion:Adjuvant radiotherapy was associated with improved survival in high-grade NRA-STS. Chemotherapy was not associated with a survival improvement; however, further studies are needed to refine treatment strategies.

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Risk factors for pulmonary complications after emergency abdominal surgery

Abstract: Pulmonary complications are frequent among patients undergoing abdominal emergency surgery and lead to increased length of hospital stay and death rate. Older age, abnormal BMI, upper or upper/lower abdominal incision and multiple procedures are predictors of PPC in this setting.

Cited by 76 publications

References 27 publications

Improving outcome in perforated peptic ulcer emergency surgery by Boey scoring

Improving outcome in perforated peptic ulcer emergency surgery by Boey scoring

Colonoscopic perforation: A report from World Gastroenterology Organization endoscopy training center in Thailand

Utilization pattern and survival outcomes of adjuvant therapies in high‐grade nonretroperitoneal abdominal soft tissue sarcoma: A population‐based study

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