The Association of Coloproctology of Great Britain and Ireland Study of Large Bowel Obstruction Caused by Colorectal Cancer

Tekkis, Paris; Kinsman, Robin; Thompson, Michael R.; Stamatakis, J. D.

doi:10.1097/01.sla.0000130723.81866.75

Cited by 292 publications

(256 citation statements)

References 16 publications

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“…Several studies have found the rates of morbidity and mortality in emergent colorectal surgery as 15-50% and 6-15%, respectively. These rates are reported as 4-14% and 1-7% in elective CRC surgery operations, respectively (30)(31)(32). The postoperative complication rate in our patients with emergent surgery was 91.1%, while this rate was 23.9% in the group with elective surgery, and the morbidity rate was higher in emergent patients.…”

mentioning

confidence: 48%

An evaluation of treatment results of emergency versus elective surgery in colorectal cancer patients

Bayar

Yılmaz

Akıncı

et al. 2016

UCD

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Objective: Colorectal cancer is still one of the most common causes of cancer related deaths in the world despite improvements in diagnosis and treatment modalities, and application of community-based screening methods. Symptoms of colorectal cancer are non-specific and usually manifest following local progression. A number of patients with advanced stage colorectal cancer present to emergency departments with obstruction as the first sign of disease without any previous symptoms. This presentation is an indication for emergency surgery that has a high rate of morbidity and mortality. In this study, we aimed to determine the factors associated with early diagnosis and survival by comparing postoperative results of colorectal cancer patients who underwent surgery under emergency or elective situation. Material and Methods:Files of colorectal patients treated between 2009-2013 were retrospectively analyzed. Data on patient age, gender, operation type, intraoperative results, length of hospital stay, co-morbidities, postoperative complications and pathological results were evaluated and compared.Results: There was no statistical difference between groups in terms of age, gender, and pathology results (p>0.05). The difference between groups in terms of postoperative length of hospital stay, presence of co-morbid diseases, pathological stage, and postoperative complications was statistically significant (p<0.05). Length of hospital stay, advanced stage on admission, complications such as surgical site infection, evisceration, and anastomosis leakage rates were higher in patients in the emergency surgery group. Conclusion:Risk groups should be determined in order to diagnose colorectal cancer patients at an early stage while they are still asymptomatic, and this information should be incorporated into effective screening programs. This approach will be beneficial to treatment outcomes, complication rates, length of hospital stay, and survival and treatment results. INTRODUCTIONColorectal cancer (CRC) is one of the most frequent cancers with more than one million people worldwide being diagnosed with CRC annually, which is the most common gastrointestinal tract cancer (1). The majority of these neoplasms are endoluminal adenocarcinoma derived from the mucosa, and over 95% of CRC patients benefit from surgery or colonoscopic interventions for premalignant polyps with early diagnosis (2). Despite advances in diagnosis and treatment and dissemination of communitybased screening, colorectal cancer remains to be one of the main reasons of cancer-related deaths in the world (3).

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confidence: 48%

An evaluation of treatment results of emergency versus elective surgery in colorectal cancer patients

Bayar

Yılmaz

Akıncı

et al. 2016

UCD

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“…The number of emergency surgical procedures in our study was zero since the few patients who presented as emergencies were stabilized and later referred for elective surgery. This decrease in morbidity and mortality rates among emergency patients treated electively was described by Tekkis et al where mortality rates were reduced from 20 to 12.9% in patients treated for obstructive colorectal cancer [13].…”

Section: Discussionmentioning

confidence: 57%

“…When applied specifically to colorectal surgery, these scoring systems have been found to overpredict mortality in elective surgical procedures and to underpredict mortality in elderly patients and in cases of emergency surgery [9][10][11][12]. This fact led to the development, in 2004, of the CR-POSSUM, which is specific for colorectal surgery [13]. It seems to be the most accurate scoring system, compared with the previous ones [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Analysis of POSSUM score and postoperative morbidity in patients with rectal cancer undergoing surgery

Valentí

Hernández-Lizoain

Baixauli

et al. 2008

Langenbecks Arch Surg

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Background The Physiological and Operative Severity Score for the enUmeration of Mortality andmorbidity (POSSUM) and later modifications (P-POSSUM y CRPOSSUM) have been used to predictmorbidity and mortality rates among patients with rectal cancer undergoing surgery. These calculations needsome adjustment, however. The aim of this study was to assess the applicability of POSSUM to a group ofpatients with rectal cancer undergoing surgery, analysing surgical morbidity by means of several variables. Methods between January 1995 and December 2004, 273 consecutive patients underwent surgery forrectal cancer. Information was gathered about the patients, tumour and therapy. To assess the predictioncapacity of POSSUM, subgroups for analysis were created according to variables related to operativemorbidity and mortality. Results The global morbidity rate was 23.6% (31.2% predicted by POSSUM). The mortality rate was 0.7% (6.64, 1.95 and 2.08 predicted by POSSUM, P-POSSUM and CR-POSSUM respectively). POSSUMpredictions may be more accurate for patients younger than 51 years, older than 70 years, with low anaesthetic risk (ASA I/II), DUKES stage C and D, surgery duration of less than 180 minutes and for thosereceiving neoadjuvant therapy. Conclusion POSSUM is a good instrument to make results between different institutions and publicationcomparable. We found prediction errors for some variables related to morbidity. Modifications of surgicalvariables and specifications for neoadjuvant therapy as well as physiological variables including life stylemay improve future prediction of surgical risk. More research is needed to identify further potential riskfactors for surgical complications.

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“…These data also represent cases by type, but only those cases in which an obstruction (malignant large bowel) occurs and only for types Duke's B, C and Stage D (Tekkis et al 2004). We, therefore, define Z 3k , N 3 , Y 3k (x) and n 3 (x) and assume multinomial distributions similarly to the j = 2 case.…”

Section: Obstructed Cases Bymentioning

confidence: 99%

Calibration of Stochastic Computer Simulators Using Likelihood Emulation

Oakley

Youngman

2017

Technometrics

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We calibrate a stochastic computer simulation model of "moderate" computational expense. The simulator is an imperfect representation of reality, and we recognize this discrepancy to ensure a reliable calibration. The calibration model combines a Gaussian process emulator of the likelihood surface with importance sampling. Changing the discrepancy specification changes only the importance weights, which lets us investigate sensitivity to different discrepancy specifications at little computational cost. We present a case study of a natural history model that has been used to characterize UK bowel cancer incidence. Datasets and computer code are provided as supplementary material.

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The Association of Coloproctology of Great Britain and Ireland Study of Large Bowel Obstruction Caused by Colorectal Cancer

Cited by 292 publications

References 16 publications

An evaluation of treatment results of emergency versus elective surgery in colorectal cancer patients

An evaluation of treatment results of emergency versus elective surgery in colorectal cancer patients

Analysis of POSSUM score and postoperative morbidity in patients with rectal cancer undergoing surgery

Calibration of Stochastic Computer Simulators Using Likelihood Emulation

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