Safety of elective colorectal cancer surgery: Non‐surgical complications and colectomies are targets for quality improvement

Abstract

Severe complication rates were lower in CC patients than in RC patients; however, the risk of dying following a severe complication was twice as high in CC patients, regardless of differences in characteristics between the groups. Efforts should be made to improve recognition and management of postoperative (non-)surgical complications, especially in colon cancer surgery.

Non-surgical complications after laparoscopic and open surgery for colorectal cancer − A systematic review of randomised controlled trials

“…2,3,40,41 Non-surgical morbidity has been identified as a potential target for further improvements. 14,19 Although no useful comparisons could be made for some non-surgical adverse events, our systematic review demonstrates a decrease in cardiac morbidity following laparoscopic surgery for colon cancer.…”

“…Cardiac and pulmonary complications are associated with a considerable increase in mortality and health care costs, 14e18 and have been advocated as a target for quality improvement in elective colorectal surgery. 19 Since most studies on laparoscopic surgery for colorectal cancer have focused on surgical or oncologic outcome, it is unclear if laparoscopic surgery leads to a reduction of cardiac and pulmonary morbidity. Therefore, we set out to investigate the incidence of non-surgical complications in randomised trials on laparoscopic resections for colorectal cancer and to assess whether possible benefits of less invasive surgery on non-surgical complications are similar for older and younger patients.…”

Cytoreductive surgery and HIPEC offers similar outcomes in patients with rectal peritoneal metastases compared to colon cancer patients: a matched case control study

“…These results emphasize that patients with rectal PM can safely undergo CRS þ HIPEC with an equal risk of morbidity and mortality as patients with colonic PM with comparable characteristics. This is in contrast with the nonmetastasized setting, in which rectal cancer surgery is associated with more morbidity compared to colon cancer surgery [6,29,30]. This is probably explained by the fact that morbidity after CRS þ HIPEC is mainly caused by the cytoreduction and HIPEC component.…”

Palliative resection of the primary tumor is associated with improved overall survival in incurable stage IV colorectal cancer: A nationwide population‐based propensity‐score adjusted study in the Netherlands

“…Since postoperative mortality is especially high in elderly patients (15% in patients aged >75 years), careful consideration before opting for surgical intervention seems necessary . The 30‐day mortality of 8.6% after elective resection is much higher than the 2.6–4.8% reported in population‐based studies for colorectal surgery in stage I–III CRC . The same goes for the 9% mortality in systemically treated patients, compared to mortality reported in clinical trials for metastatic CRC patients .…”