The role of laparoscopy in emergency colorectal surgery

Alselaim, Nahar; Altoub, Haifa A; Alhassan, Mohammed K; Alhussain, Raghad M; Alsubaie, Abdullah A; Almomen, Farah A; Almutairi, Abrar M; Gheshayan, Sultanah F Bin

doi:10.15537/smj.2022.43.12.20220658

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…This was a retrospective cohort study based on a dataset from a previously published study. 23 The data-set included 241 patients who underwent ECRS from July 2016 to July 2021 at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. KAMC is a large tertiary care center that undertakes the care of National Guard affiliates across Saudi Arabia.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with 30-day mortality and morbidity in patients undergoing emergency colorectal surgery

Alselaim,

Alsemari,

Alyabsi

et al. 2023

Ann Saudi Med

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BACKGROUND: The 30-day period following emergency colorectal surgery (ECRS) is associated with high mortality and morbidity. There is a lack of data assessing factors associated with outcomes of ECRS in the Saudi population. OBJECTIVES: Assess factors associated with 30-day postoperative mortality and complications following ECRS DESIGN: Retrospective cohort study SETTING: Single tertiary care center, Riyadh, Saudi Arabia PATIENTS AND METHODS: Demographic characteristics (age, sex, diagnosis, American Society of Anesthesiologists classification, pre-operative septic state, smoking, and comorbidities), operative characteristics (urgency, diverting ostomy, and procedure performed), and postoperative characteristics (length of stay, 30-day mortality, intensive care unit [ICU] admission, ICU length of stay, surgical site infection [SSI], readmission, reoperation, and complications) were collected from electronic medical records. Univariate logistic regression was used to evaluate association with the outcome measures (30-day mortality and postoperative complications). Multivariate logistic regression was applied to evaluate independent variables. MAIN OUTCOME MEASURE: Thirty-day postoperative mortality and morbidity SAMPLE SIZE: 241 patients RESULTS: Among 241 patients, 145 (60.2%) were men, and 80 (33.2%) patients were between 50–64 years of age. The most common indication for surgery was malignancy 138 (57%). The overall complication rate was 26.6% and the 30-day mortality rate was 11.2%. Left hemicolectomy was the most commonly performed procedure, performed in 69 (28.6%) patients. Patients between the age of 65–74 had an increased odds of death within 30 days (OR 5.25 [95% CI 1.03–26.5]) on univariate analysis. Preoperative sepsis was associated with a fourfold increase in the likelihood of 30-day mortality (OR 4.44, 95% CI 1.21–16.24, P =.024) on multivariate analysis. The likelihood of hospital re-admission increased by fivefold in patients who developed a postoperative complication (OR 5.33, 95% CI 1.30–21.78, P =.02). CONCLUSION: Preoperative sepsis was independently associated with 30-day mortality in patients undergoing ECRS, while the likelihood of hospital readmission increased in patients with postoperative complications. Expeditious control of sepsis in the emergency surgical setting by both surgical and medical interventions may reduce the likelihood of postoperative mortality. Establishing discharge protocols for postoperative ECRS patients is advocated. LIMITATIONS: Retrospective design, small sample size, and single setting

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Section: Methodsmentioning

confidence: 99%

Factors associated with 30-day mortality and morbidity in patients undergoing emergency colorectal surgery

Alselaim,

Alsemari,

Alyabsi

et al. 2023

Ann Saudi Med

Self Cite

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“…Laparoscopic procedures have a negative impact on the mechanical properties of the lung owing to pneumoperitoneum, changes in the patient's position, and positive pressure mechanical ventilation [6,7]. Pneumoperitoneum and the Trendelenburg position affect respiratory system function [8].…”

Section: Introductionmentioning

confidence: 99%

Restoration of Pulmonary Compliance after Laparoscopic Gynecologic Surgery Using a Recruitment Maneuver

Griva,

Talliou,

Rougeris

et al. 2024

JPM

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Background/Objectives: This study aimed to investigate the hypothesis that an alveolar recruitment maneuver can restore lung compliance to initial values after laparoscopic gynecological surgery. Methods: A total of 31 patients who underwent laparoscopic gynecological surgery were enrolled. Protective mechanical ventilation was applied, and the radial artery was catheterized in all patients. An alveolar recruitment maneuver (incremental and decremental positive end-expiratory pressure) was applied ten minutes after the release of pneumoperitoneum. The respiratory mechanics and blood gas results were recorded at eight different time points: after induction of anesthesia (T1), in the lithotomy position (T2), in the Trendelenburg position (T3), 10 and 90 min after insufflation of carbon dioxide (T4 and T5), in the supine position (T6), after desufflation (T7), and 10 min after an alveolar recruitment maneuver at the end of surgery (T8). Results: Pneumoperitoneum and the Trendelenburg position caused a decline of 15 units in compliance (T7 vs. T1; p < 0.05) compared to baseline. After the alveolar recruitment maneuver, compliance increased by 17.5% compared with the mean value of compliance at time T1 (T8 vs. T1; p < 0.05). The recruitment maneuver had favorable results in patients with low initial compliance (41.5 mL/cmH2O, IQR: 9.75 mL/cmH2O), high Body Mass Index 30.32 kg/m2 (IQR: 1.05 kg/m2), and high initial plateau airway pressure (16.5 cmH2O, IQR: 0.75 cmH2O). Conclusions: Lung compliance does not return to initial values after performing laparoscopic gynecological procedures. However, after the release of pneumoperitoneum, an alveolar recruitment maneuver is beneficial as it improves compliance and gas exchange.

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The role of laparoscopy in emergency colorectal surgery

Cited by 2 publications

References 21 publications

Factors associated with 30-day mortality and morbidity in patients undergoing emergency colorectal surgery

Factors associated with 30-day mortality and morbidity in patients undergoing emergency colorectal surgery

Restoration of Pulmonary Compliance after Laparoscopic Gynecologic Surgery Using a Recruitment Maneuver

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