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Colon cancer – evaluation of complications and risks of planned resections


Authors: M. Škrovina 1,2;  M. Straka 1;  E. Holášková 1;  J. Bartoš 1;  M. Migrová 1;  P. Anděl 1;  L. Adamčík 1;  M. Duda 1,4;  R. Soumarová 3;  I. Selingerová 5
Authors‘ workplace: Chirurgické oddělení, Nemocnice Nový Jičín, a. s., Komplexní onkologické centrum Nový Jičín primář: MUDr. M. Škrovina, Ph. D. 1;  I. chirurgická klinika, LF UP a FN Olomouc, přednosta: Prof. MUDr. Č. Neoral, CSc. 2;  Onkologické oddělení, Nemocnice Nový Jičín, a. s., Komplexní onkologické centrum Nový Jičín primář: Doc. MUDr. R. Soumarová, Ph. D., MBA 3;  II. chirurgická klinika, LF UP a FN Olomouc, přednosta: Prof. MUDr. P. Bachleda, CSc. 4;  Ústav matematiky a statistiky, PřF MU Brno, ředitel: Prof. RNDr. J. Rosický, DrSc. 5
Published in: Rozhl. Chir., 2014, roč. 93, č. 6, s. 311-316.
Category: Original articles

Overview

Introduction:
Resection procedures for colorectal cancer are burdened with a relatively high number of complications. The aim of this study is to define risk factors associated with the development of postoperative complications based on retrospective data analysis.

Material and methods:
From January 1

st 2007 to December 31st 2012, 1093 patients underwent surgery for colorectal cancer. Retrospectively, we selected a group of 406 patients who underwent planned, elective colon resection for colon cancer. Open surgery was performed in 158 patients (38.9%), laparoscopic resection in 248 patients (61.1%). Based on initial staging of the disease, there were 85 patients (20.9%) in stage I, 137 patients (33.8%) in stage II, 110 patients (27.1%) in stage III and 74 patients (18.2%) in stage IV. Postoperative complications were evaluated according to Clavien – Dindo classification.

Results:
Grade I complications were observed in 34 patients (8.4%), grade II in 25 patients (6.2%), grade III in 43 patients (10.6%), grade IV in 7 patients (1.7%) and grade V in 8 patients (2.0%). The highest incidence of complications was observed in left colon resection procedures (41.1%), open resections (39.8%), procedures lasting longer than 301 minutes (50%), patients older than 81 years (41.6%) and in procedures performed by the youngest, less experienced surgeon (40.6%).

Conclusion:
Our results confirmed that the type and approach of surgical procedure, patient’s age and surgeon’s experience are risk factors associated with a higher incidence of postoperative complications. High-risk surgical patients should be operated on by experienced surgeon who regularly performs a high number of resection procedures.

Key words:
colon cancer – complications


Sources

1. Škrovina M, Czudek S, Adamčík L, Vaňko R. Chirurgické komplikácie laparoskopickej kolektómie u pacientov s kolorektálnym karcinómom. Rozhl Chir 2005;84:533–38.

2. Dostalík J. Laparoskopická kolorektální chirurgie. Presstempus, 2004:43–46.

3. Beck DE, Roberts PL, Rombeau JL, Stamos MJ, Wexner DS. The ASCRS Manual of Colon and Rectal Surgery. Springer Science + Business Media 2009:199–223.

4. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205–13.

5. Sobin LH, Gospodarowicz MK, Wittekind Ch. TNM klasifikace zhoubných novotvarů. 7. vydání 2009, česká verze 2011. Wiley-Blackwell 2011:88–92.

6. Kirchhoff P, Clavien PA, Hahnloser D. Complications in colorectal surgery: risk factors and preventive strategies. Patient Saf Surg 2010;4:5.

7. Ohtani H, Tamamori Y, Arimoto Y, Nishiguchi Y, Maeda K, et al. A meta-analysis of the short- and long-term results of randomized controlled trials that compared laparoscopy-assisted and conventional open surgery for colorectal cancer. J Cancer 2011;2:425–34.

8. Allardyce RA, Bagshaw PF, Frampton CM, Frizelle FA, Hewett PJ, et al. Australasian Laparoscopic Colon Cancer Study Group. Australasian laparoscopic colon cancer study shows that elderly patients may benefit from lower postoperative complication rates following laparoscopic versus open resection. Br J Surg 2010;97:86–91.

9. Grosso G, Biondi A, Marventano S, Mistretta A, Calabrese G, et al. Major postoperative complications and survival for colon cancer elderly patients. BMC Surg 2012;12 Suppl 1:S20.

10. Lipska MA, Bissett IP, Parry BR, Merrie AE. Anastomotic leakage after lower gastrointestinal anastomosis: men are at a higher risk. ANZ J Surg 2006;76:579–85.

11. Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 2009;10:44–52.

12. Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, et al. Clinical Outcomes of Surgical Therapy Study Group. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg 2007;246:655–62.

13. Harmon JW, Tang DG, Gordon TA, et al. Hospital volume can serve as a surrogate for surgeon volume for achieving excellent outcomes in colorectal resection. Ann Surg 1999;230:404–11.

14. Schrag D, Panageas KS, Riedel E, Cramer LD, Guillem JG, et al. Hospital and surgeon procedure volume as predictors of outcome following rectal cancer resection. Ann Surg 2002;236:583–92.

Labels
Surgery Orthopaedics Trauma surgery
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