13 results on '"Flor Lorente B"'
Search Results
2. Nomograms for morbidity and mortality after oncologic colon resection in the enhanced recovery era: results from a multicentric prospective national study
- Author
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Sanchez-Guillen L., Frasson M., Pellino G., Fornes-Ferrer V., Ramos J. L., Flor-Lorente B., Garcia-Granero A., Sierra I. B., Jimenez-Gomez L. M., Moya-Martinez A., Garcia-Granero E., Alvarez R. M. A., Garcia B. M. J., Gonzalez J. M. S., Braithwaite M. M., Martinez E. M., Perez J. A. A., Espi A., Anoro M. T., Scheiding M. M., Diaz O. M., Lindenbaum P. D., Abad A. M., Simo M. R., Rufino J. E., Olabarrieta M. S., Martinez J. V., Banaeres M. L., Villaro F. F., Lucia J. A., Berzosa J. B., Hernandez N. A., Vallverdu F. J. L., Banos P. A. P., Farres R., Villalba J. H., Laso C. A., Alcaide S. M., Alvarado M. N. C., Simo I. R., Garcia J. M., Fadrique A. G., Diago V. A., Septiem J. G., Garcia J. G., Ponchietti L., Navarro M. S. C., Fernandez M. R., Muino R. C., Alvarez D. H., Sanchez P. M., Bienert C. M., Martinez M. T. G., Muzas C. M., Idoate C. P., Andicoechea A., Casado A. P. A., Vila J. V. R., Broto I. G., Collera P., Sebastian A. A., Sanchez-Guillen, L., Frasson, M., Pellino, G., Fornes-Ferrer, V., Ramos, J. L., Flor-Lorente, B., Garcia-Granero, A., Sierra, I. B., Jimenez-Gomez, L. M., Moya-Martinez, A., Garcia-Granero, E., Alvarez, R. M. A., Garcia, B. M. J., Gonzalez, J. M. S., Braithwaite, M. M., Martinez, E. M., Perez, J. A. A., Espi, A., Anoro, M. T., Scheiding, M. M., Diaz, O. M., Lindenbaum, P. D., Abad, A. M., Simo, M. R., Rufino, J. E., Olabarrieta, M. S., Martinez, J. V., Banaeres, M. L., Villaro, F. F., Lucia, J. A., Berzosa, J. B., Hernandez, N. A., Vallverdu, F. J. L., Banos, P. A. P., Farres, R., Villalba, J. H., Laso, C. A., Alcaide, S. M., Alvarado, M. N. C., Simo, I. R., Garcia, J. M., Fadrique, A. G., Diago, V. A., Septiem, J. G., Garcia, J. G., Ponchietti, L., Navarro, M. S. C., Fernandez, M. R., Muino, R. C., Alvarez, D. H., Sanchez, P. M., Bienert, C. M., Martinez, M. T. G., Muzas, C. M., Idoate, C. P., Andicoechea, A., Casado, A. P. A., Vila, J. V. R., Broto, I. G., Collera, P., and Sebastian, A. A.
- Subjects
Male ,medicine.medical_specialty ,Colon ,Colorectal cancer ,Surgical planning ,Nomogram ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Enhanced recovery ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Mortality ,Colectomy ,business.industry ,Mortality rate ,Gastroenterology ,Cancer ,Hepatology ,medicine.disease ,Surgery ,Colon cancer ,Short-term outcome ,Nomograms ,030220 oncology & carcinogenesis ,National study ,030211 gastroenterology & hepatology ,Morbidity ,business ,Length-of-stay - Abstract
Purpose: Predicting postoperative complications and mortality is important to plan the surgical strategy. Different scores have been proposed before to predict them but none of them have been yet implemented into the routine clinical practice because their difficulties and low accuracy with new surgical strategies and enhanced recovery. The main aim of this study is to identify risk factors for postoperative morbidity and mortality after colonic resection (CR) without protective stomas, in order to develop a comprehensive, up-to-date, simple, reliable, and applicable model for the preoperative assessment of patients with colon cancer. Methods: Multivariable analysis was performed to identify risk factors for 60-day morbidity and mortality. Coefficients derived from the regression model were used in the nomograms to predict morbidity and mortality. Results: Three thousand one hundred ninety-three patients from 52 hospitals were included into the analysis. Sixty-day postoperative complications rate was 28.3% and the mortality rate was 3%. In multivariable analysis the independent risk factors for postoperative complications were age, male gender, liver and pulmonary diseases, obesity, preoperative albumin, anticoagulant treatment, open surgery, intraoperative complications, and urgent surgery. Independent risk factors for mortality were age, preoperative albumin anticoagulant treatment, and intraoperative complications. Conclusions: Risk factors for morbidity and mortality after CR for cancer were identified and two easy predictive tools were developed. Both of them could provide important information for preoperative consultation and surgical planning in the time of enhance recovery.
- Published
- 2020
3. Nomograms for morbidity and mortality after oncologic colon resection in the enhanced recovery era: results from a multicentric prospective national study
- Author
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Sanchez-Guillen L, Frasson M, Pellino G, Fornes-Ferrer V, Ramos J, Flor-Lorente B, Garcia-Granero A, Sierra I, Jimenez-Gomez L, Moya-Martinez A, Garcia-Granero E, and Anaco Study Grp
- Subjects
Short-term outcome ,Morbidity ,Mortality ,Length-of-stay ,Nomogram ,Colon cancer - Abstract
Purpose Predicting postoperative complications and mortality is important to plan the surgical strategy. Different scores have been proposed before to predict them but none of them have been yet implemented into the routine clinical practice because their difficulties and low accuracy with new surgical strategies and enhanced recovery. The main aim of this study is to identify risk factors for postoperative morbidity and mortality after colonic resection (CR) without protective stomas, in order to develop a comprehensive, up-to-date, simple, reliable, and applicable model for the preoperative assessment of patients with colon cancer. Methods Multivariable analysis was performed to identify risk factors for 60-day morbidity and mortality. Coefficients derived from the regression model were used in the nomograms to predict morbidity and mortality. Results Three thousand one hundred ninety-three patients from 52 hospitals were included into the analysis. Sixty-day postoperative complications rate was 28.3% and the mortality rate was 3%. In multivariable analysis the independent risk factors for postoperative complications were age, male gender, liver and pulmonary diseases, obesity, preoperative albumin, anticoagulant treatment, open surgery, intraoperative complications, and urgent surgery. Independent risk factors for mortality were age, preoperative albumin anticoagulant treatment, and intraoperative complications. Conclusions Risk factors for morbidity and mortality after CR for cancer were identified and two easy predictive tools were developed. Both of them could provide important information for preoperative consultation and surgical planning in the time of enhance recovery.
- Published
- 2020
4. The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit
- Author
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van der Pool, Anne, Rawlings, Alexandra, Sánchez-Guillén, Luis, Kuiper, Sara, Negoi, Ionut, Buchs, Nicolas, El-Hussuna, Alaa, Battersby, Nick J., Buchs, Nicolas C., Buskens, Christianne, Chaudri, Sanjay, Frasson, Matteo, Gallo, Gaetano, Minaya-Bravo, Ana María, Morton, Dion, Nepogodiev, Dmitri, Pata, Francesco, Singh, Baljit, Zmora, Oded, Perry, Rita, Magill, Laura, Altomare, Donato, Bemelman, Willem, Brown, Steven, Denost, Christianne Buskens Quentin, Knowles, Charles, Laurberg, Søren, Lefevre, Jérémie H., Möeslein, Gabriela, Pinkney, Tom, Vaizey, Carolynne, Bilali, S., Bilali, V., Salomon, M., Cillo, M., Estefania, D., Patron Uriburu, J., Ruiz, H., Farina, P., Carballo, F., Guckenheimer, S., Proud, D., Brouwer, R., Bui, A., Nguyen, B., Smart, P., Warwick, A., Theodore, J. E., Herbst, F., Birsan, T., Dauser, B., Ghaffari, S., Hartig, N., Stift, A., Argeny, S., Unger, L., Strouhal, R., Heuberger, A., Varabei, A., Lahodzich, N., Makhmudov, A., Selniahina, L., Feryn, T., Leupe, T., Maes, L., Reynvoet, E., Van Langenhove, K., Nachtergaele, M., Monami, B., Francart, D., Jehaes, C., Markiewicz, S., Weerts, J., Van Belle, K., Bomans, B., Cavenaile, V., Nijs, Y., Vertruyen, M., Pletinckx, P., Claeys, D., Defoort, B., Muysoms, F., Van Cleven, S., Lange, C., Vindevoghel, K., Wolthuis, A., Todorovic, M., Dabic, S., Kenjic, B., Lovric, S., Vidovic, J., Delibegovic, S., Mehmedovic, Z., Christiano, A., Lombardi, B., Marchiori, M., Tercioti, V., Dardanov, D., Petkov, P., Simonova, L., Yonkov, A., Zhivkov, E., Maslyankov, S., Pavlov, V., Sokolov, M., Todorov, G., Stoyanov, V., Batashki, I., Iarumov, N., Lozev, I., Moshev, B., Slavchev, M., Atanasov, B., Belev, N., Krstev, P., Penkov, R., Šantak, G., Ćosić, J., Previšić, A., Vukušić, L., Zukanović, G., Zelić, M., Kršul, D., Lekić Vitlov, V., Mendrila, D., Orhalmi, J., Dusek, T., Maly, O., Paral, J., Sotona, O., Skrovina, M., Bencurik, V., Machackova, M., Kala, Z., Farkašová, M., Grolich, T., Procházka, V., Hoch, J., Kocian, P., Martinek, L., Antos, F., Pruchova, V., El-Hussuna, A., Ceccotti, A., Madsbøll, T., Straarup, D., Uth Ovesen, A., Christensen, P., Bondeven, P., Edling, P., Elfeki, H., Alexandrovich Gameza, V., Michelsen Bach, S., Zheltiakova, I., Krarup, P. M., Krogh, A., Rolff, H. -C., Lykke, J., Juvik, A. F., Lóven, H. H. K., Marckmann, M., Osterkamp, J. T. F., Madsen, A. H., Worsøe, J., Ugianskis, A., Kjær, M. D., Youn Cho Lee, B., Khalid, A., Kristensen, M. H., El Sorogy, M., Elgeidie, A., Elhemaly, M., El Nakeeb, A., Elrefai, M., Shalaby, M., Emile, S., Omar, W., Sakr, A., Thabet, W., Awny, S., Metwally, I., Refky, B., Shams, N., Zuhdy, M., Lepistö, A., Keränen, I., Kivelä, A., Lehtonen, T., Siironen, P., Rautio, T., Ahonen-Siirtola, M., Klintrup, K., Paarnio, K., Takala, H., Hyöty, M., Haukijärvi, E., Kotaluoto, S. -M., Lehto, K., Tomminen, T., Huhtinen, H., Carpelan, A., Karvonen, J., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Passot, G., D'Alessandro, A., Chouillard, E., Etienne, J. C., Ghilles, E., Vinson-Bonnet, B., Germain, A., Ayav, A., Bresler, L., Chevalier, R., Denost, Q., Didailler, R., Rullier, E., Tiret, E., Chafai, N., Lefevre, J. H., Parc, Y., Sielezneff, I., Mege, D., Lakkis, Z., Barussaud, M., Krones, C., Bock, B., Webler, R., Baral, J., Lang, T., Münch, S., Pullig, F., Schön, M., Hinz, S., Becker, T., Möller, T., Richter, F., Schafmayer, C., Hardt, J., Kienle, P., Crescenti, F., Ahmad, M., Soleiman, Y., Papaconstantinou, I., Gklavas, A., Nastos, K., Theodosopoulos, T., Vezakis, A., Stamou, K., Saridaki, A., Xynos, E., Paraskakis, S., Zervakis, N., Skroubis, G., Amanatidis, T., Germanos, S., Maroulis, I., Papadopoulos, G., Dimitriou, N., Alexandrou, A., Felekouras, E., Griniatsos, J., Karavokyros, I., Papadopoulos, A., Chouliaras, C., Ioannidis, P., Katsounis, D., Kefalou, E., Katsoulis, I. E., Balalis, D., Korkolis, D. P., Manatakis, D., Tzovaras, G., Baloyiannis, I., Mamaloudis, I., Lázár, G., Ábraham, S., Paszt, A., Simonka, Z., Tóth, I., Zaránd, A., Baranyai, Z., Ferreira, G., Harsányi, L., Ónody, P., Banky, B., Burány, Ã., Lakatos, M., Marton, J., Solymosi, A., Besznyák, I., Bursics, A., Papp, G., Saftics, G., Svastics, I., Valsdottir, E., Atladottir, J., Jonsson, T., Moller, P., Sigurdsson, H., Gupta, S. K., Gupta, S., Kaul, N., Mohan, S., Sharma, G., Wani, R., Chowdri, N., Khan, M., Mehraj, A., Parray, F. Q., Coveney, A., Burke, J., Deasy, J., El-Masry, S., Mcnamara, D., Khan, M. F., Cahill, R., Faul, E., Mulsow, J., Shields, C., Kelly, M. E., Bass, G., Martin, S. T., O'Connell, R., Ryan, E., Connelly, T., Ahmad, G., Bukhari, W., Cooke, F., Zmora, O., Gold Deutch, R., Haim, N., Lavy, R., Moscovici, A., Shussman, N., Gefen, R., Marom, G., Pikarsky, A., Weiss, D., Avital, S., Hermann, N., Raguan, B., Slavin, M., White, I., Wasserberg, N., Arieli, H., Gurevich, N., Freund, M. R., Dorot, S., Edden, Y., Halfteck, G., Reissman, P., Pery, R., Tulchinsky, H., Weizman, A., Agresta, F., Curinga, R., Finotti, E., Savino, G., Verza, L. A., Asteria, C. R., Boccia, L., Pascariello, A., Tamini, N., Bugatti, A., Gianotti, L., Totis, M., Vincenti, L., Andriola, V., Giannini, I., Travaglio, E., Balestri, R., Buccianti, P., Roffi, N., Rossi, E., Urbani, L., Mellano, A., Cinquegrana, A., Lauretta, A., Belluco, C., Mistrangelo, M., Allaix, M. E., Arolfo, S., Morino, M., Testa, V., Delrio, P., Pace, U., Rega, D., Scala, D., Gallo, G., Clerico, G., Cornaglia, S., Realis Luc, A., Trompetto, M., Ugolini, G., Antonacci, N., Fabbri, S., Montroni, I., Zattoni, D., D'Urbano, C., Cornelli, A., Viti, M., Inama, M., Bacchion, M., Casaril, A., Impellizzeri, H., Moretto, G., Spinelli, A., Carvello, M., David, G., Di Candido, F., Sacchi, M., Frontali, A., Ceriani, V., Molteni, M., Rosati, R., Aleotti, F., Elmore, U., Lemma, M., Vignali, A., Scabini, S., Casoni Pattacini, G., Luzzi, A., Romairone, E., Marino, F., Lorusso, D., Pezzolla, F., Colombo, F., Baldi, C., Foschi, D., Sampietro, G., Sorrentino, L., Di Saverio, S., Birindelli, A., Segalini, E., Spacca, D., Romano, G. M., Belli, A., Bianco, F., De franciscis, S., Falato, A., Muratore, A., Marsanic, P., Grimaldi, S., Castaldo, N., Ciolli, M. G., Picarella, P., Porfidia, R., Tugnoli, G., Bondurri, A., Cavallo, D., Maffioli, A., Pertusati, A., Pulighe, F., Balestra, F., De Nisco, C., Podda, M., Opocher, E., Longhi, M., Mariani, N. M., Maroni, N., Pisani Ceretti, A., Galleano, R., Aonzo, P., Curletti, G., Reggiani, L., Marconi, M., Del Prete, L., Oldani, M., Pappalardo, R., Zaccone l, S., Scatizzi, M., Baraghini, M., Cantafio, S., Feroci, F., Giani, I., Tutino, R., Cocorullo, G., Gulotta, G., Licari, L., Salamone, G., Sileri, P., Saraceno, F., La Torre, F., Chirletti, P., Coletta, D., De Toma, G., Mingoli, A., Papandrea, M., De Luca, E., Sacco, R., Sammarco, G., Vescio, G., Tonini, V., Bianchini, S., Cervellera, M., Vaccari, S., Cracco, N., Barugola, G., Bertocchi, E., Rossini, R., Ruffo, G., Sartori, A., Clemente, N., De Luca, M., De Luca, A., Scaffidi, G., Lorenzon, L., Balducci, G., Bocchetti, T., Ferri, M., Mercantini, P., Pata, F., Bauce, S., Benevento, A., Bottini, C., Crapa, P. R., Rubbini, M., Anania, G., Carcoforo, P., Cavallesco, G., Feo, C., Yamamoto, T., Sivins, A., Ancans, G., Gerkis, S., Lunis, R., Pcolkins, A., Venskutonis, D., Bradulskis, S., Dainius, E., Subocius, A., Vencius, J., Zeromskas, P., Eismontas, V., Nutautiene, V., Simcikas, D., Tamosiunas, A., Svagzdys, S., Latkauskas, T., Lizdenis, P., Saladzinskas, Z., Tamelis, A., Dulskas, A., Kuliavas, J., Samalavicius, N. E., Poskus, T., Jotautas, V., Mikalauskas, S., Poskus, E., Strupas, K., Zakaria, A. D., Lah, N. N., Wong, M., Zain, W. Z., Zakaria, Z., Mazlan, L., Mohd Azman, Z. A., Sagap, I., Psaila, J., Andrejevic, P., Cini, C., Ellul, S., Pace, K., Ahallat, M., Hamid, M., Hrora, A., Majbar, M. A., Raiss, M., Westerduin, E., Bemelman, W., Buskens, C., Tanis, P., van der Sluis, P. C., Davids, P. H., Pronk, A., Schiphorst, A. H. W., Smakman, N., Zimmerman, D., Koeter, T., Stijns, J., van Loon, Y. -T., Vermaas, M., de Graaf, E., Doornebosch, P., van Hagen, P., van Ruler, O., Toorenvliet, B., Nonner, J., van den Berg, I., van Steensel, L., Vles, W., Melenhorst, J., Orsini, R., Visschers, R., Hoff, C., Blom, R., Marsman, H., Mulder, I., Cense, H., de Castro, S., Demirkiran, A., Hunfeld, M., van Geloven, A., de Groof, J., Hendriks, E., Leeuwenburg, M., van Oorschot, N., Wit, F., Rupert, C., Veldman, P., Keijzers, M., Konsten, J., Den Boer, F., Corver, M., Boerma, E. G., Koolen, L., Martens, M., Van Wijck, K., Ignjatovic, D., Breuer, R., Gurpreet, B., Oresland, T., Tetens Moe, T., Nesbakken, A., Flaaten Backe, I., Wik, T. -A., Radiya, K., Dehli, T., Gjessing, P., Norderval, S., Woll, K., Anwer, M., Qureshi, M. S., Qureshi, A. U., Billah, M., Jawad, M. Y., Raza, A., Urooj, N., Wang, X., Li, L., Jajtner, D., Gasinski, B., Kabiesz, W., Walega, P., Romaniszyn, M., Zawadzki, M., Czarnecki, R., Obuszko, Z., Rzaca, M., Sitarska, M., Silva, P., Duarte, A., Gonçalves, D., Morais, M., Rama, N., Nobre, J., Sales, I., Costa Pereira, J., Costa, S., Costa Pereira, C., Insua, C., Romero, I., Figueiredo, N., Cunha, J., Domingos, H., Vieira, P., Cunha, M., Americano, M., Amorim, E., Rachadell, J., Carvas, J. M., Armas, I., Fernandes, P., Pires, C., Reis, R., Martins, R., Dos Santos, M., Henriques, P., Oliveira, O., Duarte, M., Ferreira, L., Miranda, J., Vilela, N., Corte Real, J., Carlos, S., Frois Borges, M., Moniz Pereira, P., Simões, J., Silva-vaz, P., Bettencourt, V., Gouveia, A., Perez, H., Rainho, R., Bintintan, V., Ciuce, C., Dindelegan, G., Scurtu, R., Seicean, R., Cristian, D., Burcos, T., Grama, F., Mandi, D. M., Richiteanu, G., Miron, A., Calu, V., Enciu, O., Nadragea, M., Parvuletu, R., Mogoanta, S. S., Crafciuc, A., Paitici, S., Negoi, I., Beuran, M., Ciubotaru, C., Prodan, A., Vartic, M., Tomulescu, V., Copaescu, C., Yanishev, A., Abelevich, A., Kokobelyan, A., Lebedeva, M., Luzan, R., Pozdnyakov, A., Cherdancev, D., Mahotin, D., Nesytykh, A., Samsonyuk, V., Pravosudov, I., Ivlev, D., Karachun, A., Lebedev, K., Samsonov, D., Aiupov, R., Feoktistov, D., Garipov, M., Suleymanov, N., Tarasov, N., Rasulov, A., Dzhumabaev, H., Mamedli, Z., Bedzhanyan, A., Popov, D., Sednev, A., Klimenko, A., Semenov, A., Vasilyev, S., Khazov, A., Khanevich, M., Khrykov, G., Katorkin, S., Andreev, P., Chernov, A., Davidova, O., Zhuravlev, A., Achkasov, S., Shakhmatov, D., Shelygin, Y., Sushkov, O., Vardanyan, A., Ilkanich, A., Barbashinov, N., Darvin, V., Onishchenko, S., Voronin, Y., Krivokapić, Z., Barišić, G., Dimitrijević, I., Marković, V., Sekulić, A., Stanojevic, G., Brankovic, B., Nestorovic, M., Pecic, V., Petrovic, D., Kostic, I., Aleksic, A., Dabic, D., Maric, B., Perunicic, V., Radovanovic, Z., Djuric, M., Lukic, D., Radovanovic, D., Cuk, V., Juloski, J., Kenic, M., Krdzic, I., Ngu, J. C., Y. Y., Ng, Teo, N., Korcek, J., Lazorisak, A., Rems, M., Ramovš Trampuš, Å ., Tomazic, A., Grosek, J., Kosir, J., Norcic, G., Vigorita, V., Caceres, N., Casal, E., Ruano, A., Trostchansky, I., Golda, T., Galvez Saldaña, A., Kreisler Moreno, E., Lopez Dominguez, J., Vila Tura, M., Labarga, F., Galvez, P., Maderuelo, V., Suero, C., Bargallo, J., Cayetano, L., Lamas, S., Silva, M. C., Bernal-Sprekelsen, J. C., Gómez, R., Jareño, S., Ríos, A., Vercher, D., García-González, J. -M., Cervera-Aldama, J., Ramos-Prada, J., Santamaría-Olabarrieta, M., Borda, N., Enrriquez-Navascués, J. M., Saralegui, Y., Calero-Lillo, A., Aznar-Puig, S., López-Lara, M. A., Muñoz-Collado, S., Valverde-Sintas, J., Menendez, P., Leon, C., Truan, N., Baldonedo, R., Fernández-Martínez, D., Otero, J., Solar-García, L., Turrado-Rodriguez, V., de Lacy Oliver, F., Lacy Fortuny, A. M., Martin Perez, B., Otero Piñeiro, A. M., Paredes, J., Fernandez, F., Ladra, M. J., Paulos, A., Prieto, D., de Heredia, J. P. Beltrán, Blanco Antona, F., de Andrés Asenjo, B., Ferreras García, C., de Diego, A. Romero, de Laspra, E. Cordoba Diaz, Echazarreta Gallego, E., Elia Guedea, M., Escola, D., Martinez, S., Primo Romaguera, V., Parreño, R., Pastor, L., Rosell, E., Lozoya Trujillo, R., Alós Company, R., Ruiz Carmona, M. D., Solana Bueno, A., Salvans Ruiz, S., Alonso Gonçalves, S., Jiménez- Toscano, M., Pascual Damieta, M., Pera Roman, M., Pellicer-Franco, E. M., Garcia-Marin, J. A., Mengual-Ballester, M., Soria-Aledo, V., Valero-Navarro, G., Vicente-Ruiz, M., Garcia-Zamora, C., Gonzalez-Gil, A., Montoya-Tabares, M. J., Paredes-Quiles, M., Die Trill, J., Abadia, P., Moreno, I., Pina, J. D., Ramos Rubio, D., Escartin, J., Blas, J. L., Fernando, J., Ferrer, R., Garcia Egea, J., Pros, I., Martinez, W., Rius, J., Socías, M., Sabia, D., Castellvi Valls, J., Gonzalez Santin, V., Mompart Garcia, S., Viso Pons, L., Julià, D., Codina-Cazador, A., Farrés, R., Gómez, N., Planellas, P., Cuadrado, M., Camps, I., Rufas, M., Escoll, J., Fermiñán, A., Muriel, P., Sierra, E., Alvarez-Laso, C., Lora, P., Padin, H., Garcia-Septiem, J., Bustamante, C., Jimenez, V., Jimenez-Miramon, J., Ramos, J. L., Gallardo, A. B., Benito, P., Colao, L., Galindo, P., Garcia, C., Forero-Torres, A., Alonso Poza, A., Dieguez Fernandez, B., Gilsanz Martin, C., Hernandez Garcia, M., Rojo López, J. A., Gil López, J. M., González Zunzárren, M., Martínez Alegre, J., Zorrilla Matilla, L. P., Navarro-Sánchez, A., Alcalá Serrano, F. J., López-Fernández, J., Montesdeoca Cabrera, D., Alvarez-Gallego, M., Guevara, J., Pascual Miguelañez, I., Rubio-Perez, I., Gomez Ruiz, M., Alonso Martín, J., Cagigas Fernández, C., Castillo Diego, J., Pando, J. 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Heredia, J, Blanco Antona, F, de Andres Asenjo, B, Ferreras Garcia, C, de Diego, A, de Laspra, E, Echazarreta Gallego, E, Elia Guedea, M, Escola, D, Martinez, S, Primo Romaguera, V, Parreno, R, Pastor, L, Rosell, E, Lozoya Trujillo, R, Alos Company, R, Ruiz Carmona, M, Solana Bueno, A, Salvans Ruiz, S, Alonso Goncalves, S, Jimenez- Toscano, M, Pascual Damieta, M, Pera Roman, M, Pellicer-Franco, E, Garcia-Marin, J, Mengual-Ballester, M, Soria-Aledo, V, Valero-Navarro, G, Vicente-Ruiz, M, Garcia-Zamora, C, Gonzalez-Gil, A, Montoya-Tabares, M, Paredes-Quiles, M, Die Trill, J, Abadia, P, Moreno, I, Pina, J, Ramos Rubio, D, Escartin, J, Blas, J, Fernando, J, Ferrer, R, Garcia Egea, J, Pros, I, Martinez, W, Rius, J, Socias, M, Sabia, D, Castellvi Valls, J, Gonzalez Santin, V, Mompart Garcia, S, Viso Pons, L, Julia, D, Codina-Cazador, A, Farres, R, Gomez, N, Planellas, P, Cuadrado, M, Camps, I, Rufas, M, Escoll, J, Ferminan, A, Muriel, P, Sierra, E, Alvarez-Laso, C, Lora, P, Padin, H, Garcia-Septiem, J, Bustamante, C, Jimenez, V, Jimenez-Miramon, J, Ramos, J, Gallardo, A, Benito, P, Colao, L, Galindo, P, Garcia, C, Forero-Torres, A, Alonso Poza, A, Dieguez Fernandez, B, Gilsanz Martin, C, Hernandez Garcia, M, Rojo Lopez, J, Gil Lopez, J, Gonzalez Zunzarren, M, Martinez Alegre, J, Zorrilla Matilla, L, Navarro-Sanchez, A, Alcala Serrano, F, Lopez-Fernandez, J, Montesdeoca Cabrera, D, Alvarez-Gallego, M, Guevara, J, Pascual Miguelanez, I, Rubio-Perez, I, Gomez Ruiz, M, Alonso Martin, J, Cagigas Fernandez, C, Castillo Diego, J, Pando, J, Maristany, C, Munoz-Duyos, A, Rada-Palomino, A, Vargas-Pierola, H, Pena Ros, E, Benavides Buleje, J, Munoz Camarena, J, Parra Banos, P, Ramirez Faraco, M, Arenal, J, Citores, M, Marcos, J, Sanchez, J, Tinoco, C, Garcia Florez, L, Arias Pacheco, R, Minguez Ruiz, G, Gutierrez Corral, N, Rodriguez Infante, A, Carrillo Lopez, M, Carrasco Prats, M, Lage Laredo, A, Martinez Manzano, A, Rodriguez Garcia, P, Segura-Sampedro, J, Alonso-Hernandez, N, Fernandez Isart, M, Gamundi Cuesta, M, Ochogavia Segui, A, Ibanez, N, Abrisqueta, J, Lujan, J, Gomez Perez, R, Corrales Valero, E, Monje Salazar, C, Sanchiz Cardenas, E, Soler Humanes, R, Jimenez-Rodriguez, R, De la Portilla, F, Diaz Pavon, J, Garcia Cabrera, A, Reyes Diaz, M, Espin, E, Marinello, F, Marti, M, Vallribera, F, Orts Mico, F, Ortin Navarro, M, Perez Climent, M, Serra Diaz, C, Millan, M, Caro, A, Escuder, J, Espina, B, Feliu, F, Climent Aira, A, Estevez Diz, A, Moreno Asencio, M, Varela Mato, A, Vazquez Bouzan, R, Diez-Alonso, M, Villeta-Plaza, R, Guadalajara, H, Alias, D, Garcia Olmo, D, Pastor, C, Valverde, I, Sanchez Romero, A, Gardea, A, Gil Santos, M, Nimmersgern, T, Serrano Paz, P, Romero-Simo, M, Blasco-Segura, T, Caravaca-Garcia, I, Costa-Navarro, D, Zarco-Pleguezuelos, A, Flor-Lorente, B, Garcia-Granero, A, Garcia-Granero, E, Arencibia, B, Alonso, J, Febles, G, Nogues, E, Roque, C, Segelman, J, Nygren, J, Nestler, G, Abraham-Nordling, M, Egenvall, M, Myrelid, P, Jung, B, Loftas, P, Lydrup, M, Azahr, N, Buchwald, P, Mangell, P, Syk, I, Nikberg, M, Carlander, J, Chabok, A, Smedh, K, Tiselius, C, Haapaniemi, S, Benckert, A, Adamina, M, Freil-Lanter, C, Gingert, C, Muller, P, Schafli, J, Regusci, L, Brenna, M, Fasolini, F, Misteli, H, Kirchhoff, P, Oertli, D, Hahnloser, D, Clerc, D, Hubner, M, Ris, F, Chevallay, M, Morel, P, Schiltz, B, Wang, J, Su, W, Huang, C, Ma, C, Tsai, H, Bugra, D, Agalar, F, Baloglu, H, Basoglu, I, Okkabaz, N, Binboga, E, Biricik, A, Celik, A, Yavuz, E, Canda, A, Agalar, C, Fuzun, M, Sokmen, S, Terzi, C, Isik, A, Karip, B, Bilgili, A, Leventoglu, S, Aytac, B, Kucukdiler, E, Yildiz, A, Yuksel, O, Sinan, H, Hancerliogullari, O, Kaymak, S, Kozak, O, Ozer, M, Sarici, I, Akca, O, Kalayci, M, Kara, Y, Agcaoglu, O, Balik, E, Bayram, O, Ozbalci, G, Ozkan, B, Karabacak, U, Sungurtekin, U, Ozgen, U, Demirbas, S, Ozturk, E, Isik, O, Yilmazlar, T, Colak, E, Karagul, S, Kinas, V, Fearnhead, N, Lord, I, Stewart, P, Zammit, M, Arnold, S, Broadhurst, J, Moran, S, Seretis, F, Shabbir, J, Jones, C, Kynaston, J, Vimalachandran, D, Blower, E, Mcfaul, C, Mcwhirter, D, Pilkington, J, Wilson, T, Chowdhary, M, Stubbs, B, Abdalkoddus, M, Lai, C, Thavanesan, N, Yao, C, Agarwal, T, Dindyal, S, Hill, R, Reade, S, Slesser, A, Paterson, H, Balfour, A, Boland, M, Geraghty, A, O'Kelly, J, Patel, P, Tezas, S, Yahia, S, Jadhav, V, Marimuthu, K, Narayanan, A, Piramanayagam, B, Bradley, N, Buchanan, F, Paul, K, Singh, J, Thomson, K, Korsgen, S, Bedford, M, Lee, K, Leong, K, Mcarthur, D, Malik, S, Mohamed, I, Cunha, P, Pilavas, A, Reddy, A, Ahmed, S, Ahmed, A, Voll, J, Velchuru, V, Lal, R, Mirshekar-Syahkal, B, Kassai, M, Aleem, M, Keogh-Bootland, S, Sarmah, P, Keegan, R, Kelkar, A, Sen, P, Oliveira-Cunha, M, Chaudhri, S, Fares, R, Thomas, W, Aslam, M, Boyle, K, Hemingway, D, Miller, A, Norwood, M, Gurjar, S, Al-Saeedi, M, Anandan, L, Sudlow, A, Zampitis, N, Malik, K, Bogdan, M, Smart, C, Iqbal, M, Bailey, S, Lawes, D, Omar, G, Tamhane, R, Evans, M, Ather, S, Lim, J, Nageswaran, H, Taylor, G, Hunt, L, Nicholls, J, Shaikh, I, Muscara, F, O'Brien, J, Photi, E, Stearns, A, Meylemans, D, Cunningham, C, Hompes, R, Tennakoon, A, Kumarasinghe, N, Rao, M, Upanishad, I, Khan, J, Ahmad, N, Shweejawee, Z, Stefan, S, Smart, N, Daniels, I, Gregoir, T, Longstaff, L, Mcdermott, F, Varcada, M, Drami, I, Gala, T, Moggia, E, Ratnatunga, K, Harries, R, Hayes, J, Williams, G, Raymond, T, Bronder, C, Davies, E, Hawkin, P, Ryska, O, Ayral, K, Beveridge, A, Bhowmik, A, Gill, M, Simpson, R, Schofield, A, Mcardle, K, Parmar, M, Williamson, M, Burton, H, Courtney, E, Grant, C, Saracino, A, Newton, K, Epstein, J, Branagan, G, Bignell, M, Symankewicz, M, Zaman, S, Mankotia, R, Siddiqui, Z, Torrance, A, Artioukh, D, Eggleston, M, Gokul, K, Selwyn, D, Warusavitarne, J, Chandrasinghe, P, Grainger, J, Leo, C, Harris, G, Levy, B, Skull, A, Thaha, M, Garg, A, Patel, H, Ramsanahie, A, Mondragon-Pritchard, M, Cuinas Leon, K, Shukla, A, Brewer, H, Fitzgerald, J, Kho, H, Torkington, J, Tate, S, Wheat, J, Smolarek, S, Platt, E, Rossi, B, Tham, J, Knight, J, Richardson, J, Tzivanakis, A, Gregori, M, Ashraf, M, Atif, M, Santos, J, Saffaf, N, Canning, L, Chandratreya, N, Bowen, M, Graham, B, Hamad, Y, Kaubrys, M, Chaudhry, Z, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Gouvas, N, Nicol, D, Pandey, S, Zilvetti, M, Sharma, A, Fatayer, T, Mothe, S, Rahman, M, Curtis, N, Allison, A, Dalton, R, Francis, N, Ockrim, J, Psaras, G, Dudarovaska, H, Marharint, T, Mostovoy, E, Voloshin, S, Kolesnik, O, Makhmudov, D, Altinel, Y, Iqbal, A, Cunningham, L, Go, K, Tan, S, R. Tutino, G. Salamone, L. Licari, G. Cocorullo, G. Gulotta, AGEM - Digestive immunity, Surgery, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, RS: NUTRIM - R2 - Liver and digestive health, and 2017 and 2015 European Society of Coloproctology (ESCP) collaborating, Group
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Laparoscopic surgery ,Male ,Colorectal cancer ,medicine.medical_treatment ,surgery ,0302 clinical medicine ,Postoperative Complications ,Medicine ,Major complication ,Prospective Studies ,Laparoscopy ,SHORT-TERM OUTCOMES ,Colectomy ,Medical Audit ,medicine.diagnostic_test ,Prospective audit ,Gastroenterology ,Middle Aged ,laparoscopic surgery ,Conversion to Open Surgery ,Colon cancer ,Treatment Outcome ,Elective Surgical Procedures ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Colonic surgery ,Adult ,medicine.medical_specialty ,CLINICAL-TRIAL ,NO ,OPEN COLECTOMY ,03 medical and health sciences ,COLORECTAL SURGERY ,Case mix index ,gastrointestinal surgery ,Humans ,rectal cancer ,RECTAL-CANCER ,Aged ,ta3126 ,business.industry ,Elective resection ,medicine.disease ,RANDOMIZED-TRIAL ,OPEN RESECTION ,Surgery ,business - Abstract
BACKGROUND: Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice.METHODS: Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30-day major complication rate, defined as Clavien-Dindo grade III-V.RESULTS: Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (laparoscopic 7.4%, converted 9.7%, open 11.6%, P < 0.001). After case mix adjustment in a multilevel model, only planned open (and not laparoscopic converted) surgery was associated with increased major complications in comparison to laparoscopic surgery (OR 1.64, 1.27-2.11, P < 0.001).CONCLUSIONS: Appropriate laparoscopic conversion should not be considered a treatment failure in modern practice. Conversion does not appear to place patients at increased risk of complications vs planned open surgery, supporting broadening of selection criteria for attempted laparoscopy in elective colonic resection.
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- 2018
5. Predictors of complications and mortality following left colectomy with primary stapled anastomosis for cancer: results of a multicentric study with 1111 patients
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Pellino, G., Frasson, M., García-Granero, A., Granero-Castro, P., Ramos Rodríguez, J. L., Flor-Lorente, B., Bargallo Berzosa, J., Alonso Hernández, N., Labrador Vallverdú, F. J., Parra Baños, P. A., Ais Conde, G., Garcia-Granero, E., Alvarez Rico, Miguel Angel, García Brao, Maria Jesus, Sanchez Gonzalez, Juan Manuel, Braithwaite, Mariela, Martí Martínez, Eva, Álvarez Pérez, Jose Antonio, Espí, Alejandro, Trallero, A., Millán Scheiding, Mónica, Maseda Díaz, Olga, Dujovne Lindenbaum, Paula, Monzón Abad, Andrés, Romero Simó, Manuel, Escoll Rufino, Jordi, Santamaría Olabarrieta, Marta, Viñas Martínez, José, López Bañeres, Manolo, Blesa Sierra, Isabel, Feliú Villaró, Francesc, Lucía, Javier Aguiló, Codina Cazador, Antonio, Villalba, Juan Hernandis, Álvarez Laso, Carlos, Alcaide, Sonia Martínez, Cáceres Alvarado, Maria Nieves, Simó, Ignacio Rey, Montero García, Josep, García Fadrique, Alfonso, Aguilella Diago, Vicente, García Septiem, Javier, García, Jacinto García, Ponchietti, Luca, Carceller Navarro, Maria Soledad, Ramos Fernández, María, Conde Muiño, Raquel, Huerga Álvarez, Daniel, Sánchez, Pablo Menéndez, Maristany Bienert, Carlos, García Martínez, Maria Teresa, Muzas, Celia Moreno, Pastor Idoate, Carlos, Alonso Casado, Adolfo Pedro, Roig Vila, Jose Vicente, Goded Broto, Ignacio, Collera, Pablo, Sebastián, Antonio Arroyo, Pellino, G., Frasson, M., García-Granero, A., Granero-Castro, P., Ramos Rodríguez, J. L., Flor-Lorente, B., Bargallo Berzosa, J., Alonso Hernández, N., Labrador Vallverdú, F. J., Parra Baños, P. A., Ais Conde, G., Garcia-Granero, E., Alvarez Rico, Miguel Angel, García Brao, Maria Jesu, Sanchez Gonzalez, Juan Manuel, Braithwaite, Mariela, Martí Martínez, Eva, Álvarez Pérez, Jose Antonio, Espí, Alejandro, Trallero, A., Millán Scheiding, Mónica, Maseda Díaz, Olga, Dujovne Lindenbaum, Paula, Monzón Abad, André, Romero Simó, Manuel, Escoll Rufino, Jordi, Santamaría Olabarrieta, Marta, Viñas Martínez, José, López Bañeres, Manolo, Blesa Sierra, Isabel, Feliú Villaró, Francesc, Lucía, Javier Aguiló, Codina Cazador, Antonio, Villalba, Juan Hernandi, Álvarez Laso, Carlo, Alcaide, Sonia Martínez, Cáceres Alvarado, Maria Nieve, Simó, Ignacio Rey, Montero García, Josep, García Fadrique, Alfonso, Aguilella Diago, Vicente, García Septiem, Javier, García, Jacinto García, Ponchietti, Luca, Carceller Navarro, Maria Soledad, Ramos Fernández, María, Conde Muiño, Raquel, Huerga Álvarez, Daniel, Sánchez, Pablo Menéndez, Maristany Bienert, Carlo, García Martínez, Maria Teresa, Muzas, Celia Moreno, Pastor Idoate, Carlo, Alonso Casado, Adolfo Pedro, Roig Vila, Jose Vicente, Goded Broto, Ignacio, Collera, Pablo, and Sebastián, Antonio Arroyo
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Male ,medicine.medical_specialty ,Colectomies ,Databases, Factual ,Colorectal cancer ,Colon ,anastomotic leak ,030230 surgery ,Lower risk ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Risk Factors ,Surgical Stapling ,medicine ,Humans ,stapled anastomosi ,postoperative complication ,Prospective Studies ,left colectomy ,Colectomy ,Aged ,business.industry ,Anastomosis, Surgical ,Gastroenterology ,Postoperative complication ,Perioperative ,Middle Aged ,medicine.disease ,Surgery ,Colon cancer ,Parenteral nutrition ,Treatment Outcome ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,Female ,business ,Complication - Abstract
Aim Reports detailing the morbidity-mortality after left colectomy are sparse and do not allow definitive conclusions to be drawn. We aimed to identify risk factors for anastomotic leakage, perioperative mortality and complications following left colectomy for colonic malignancies. Method We undertook a STROBE-compliant analysis of left colectomies included in a national prospective online database. Forty-two variables were analysed as potential independent risk factors for anastomotic leakage, postoperative morbidity and mortality. Variables were selected using the 'least absolute shrinkage and selection operator' (LASSO) method. Results We analysed 1111 patients. Eight per cent of patients had a leakage and in 80% of them reoperation or surgical drainage was needed. A quarter of patients (24.9%) experienced at least one minor complication. Perioperative mortality was 2%, leakage being responsible for 47.6% of deaths. Obesity (OR 2.8, 95% CI 1.00-7.05, P = 0.04) and total parenteral nutrition (TPN) (OR 3.7, 95% CI 1.58-8.51, P = 0.002) were associated with increased risk of leakage, whereas female patients had a lower risk (OR 0.36, 95% CI 0.18-0.67, P = 0.002). Corticosteroids (P = 0.03) and oral anticoagulants (P = 0.01) doubled the risk of complications, which was lower with hyperlipidaemia (OR 0.3, P = 0.02). Patients on TPN had more complications (OR 4.02, 95% CI 2.03-8.07, P = 0.04) and higher mortality (OR 8.7, 95% CI 1.8-40.9, P = 0.006). Liver disease and advanced age impaired survival, corticosteroids being the strongest predictor of mortality (OR 21.5, P = 0.001). Conclusion Requirement for TPN was associated with more leaks, complications and mortality. Leakage was presumably responsible for almost half of deaths. Hyperlipidaemia and female gender were associated with lower rates of complications. These findings warrant a better understanding of metabolic status on perioperative outcome after left colectomy.
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- 2018
6. Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit
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Sánchez-Guillén, L, Nepogodiev, D, Sivrikoz, E, van Elst, T, Minaya, A, Pata, F, Glasbey, J, Pinkney, T, Bhangu, A, El-Hussuna, A, Buchs, N, Buskens, C, Chaudri, S, Frasson, M, Gallo, G, Morton, D, Negoi, I, Singh, B, Zmora, O, Perry, R, Magill, L, Altomare, D, Bemelman, W, Brown, S, Denost, Q, Knowles, C, Laurberg, S, Lefèvre, J, Möeslein, G, Vaizey, C, Bilali, S, Bilali, V, Salomon, M, Cillo, M, Estefania, D, Patron Uriburu, J, Ruiz, H, Farina, P, Carballo, F, Guckenheimer, S, Proud, D, Brouwer, R, Bui, A, Nguyen, B, Smart, P, Warwick, A, Theodore, J, Herbst, F, Birsan, T, Dauser, B, Ghaffari, S, Hartig, N, Stift, A, Argeny, S, Unger, L, Strouhal, R, Heuberger, A, Varabei, A, Lahodzich, N, Makhmudov, A, Selniahina, L, Feryn, T, Leupe, T, Maes, L, Reynvoet, E, Van Langenhove, K, Nachtergaele, M, Monami, B, Francart, D, Jehaes, C, Markiewicz, S, Weerts, J, Van Belle, K, Bomans, B, Cavenaile, V, Nijs, Y, Vertruyen, M, Pletinckx, P, Claeys, D, Defoort, B, Muysoms, F, Van Cleven, S, Lange, C, Vindevoghel, K, Wolthuis, A, Todorovic, M, Dabic, S, Kenjic, B, Lovric, S, Vidovic, J, Delibegovic, S, Mehmedovic, Z, Christiano, A, Lombardi, B, Marchiori, M Jr, Tercioti, V Jr, Dardanov, D, Petkov, P, Simonova, L, Yonkov, A, Zhivkov, E, Maslyankov, S, Pavlov, V, Sokolov, M, Todorov, G, Stoyanov, V, Batashki, I, Iarumov, N, Lozev, I, Moshev, B, Slavchev, M, Atanasov, B, Belev, N, Krstev, P, Penkov, R, Šantak, G, Ćosić, J, Previšić, A, Vukušić, L, Zukanović, G, Zelić, M, Kršul, D, Lekić Vitlov, V, Mendrila, D, Orhalmi, J, Dusek, T, Maly, O, Paral, J, Sotona, O, Skrovina, M, Bencurik, V, Machackova, M, Kala, Z, Farkašová, M, Grolich, T, Procházka, V, Hoch, J, Kocian, P, Martinek, L, Antos, F, Pruchova, V, Ceccotti, A, Madsbøll, T, Straarup, D, Uth Ovesen, A, Christensen, P, Bondeven, P, Edling, P, Elfeki, H, Alexandrovich Gameza, V, Michelsen Bach, S, Zheltiakova, I, Krarup, Pm, Krogh, A, Rolff, Hc, Lykke, J, Juvik, Af, Lóven, Hhk, Marckman, M, Osterkamp, Jtf, Madsen, Ah, Worsøe, J, Ugianskis, A, Kjaer, Md, Youn Cho Lee, B, Khalid, A, Kristensen, Mh, El Sorogy, M, Elgeidie, A, Elhemaly, M, Elnakeeb, A, Elrefai, M, Shalaby, M, Emile, S, Omar, W, Sakr, A, Thabet, W, Awny, S, Metwally, I, Refky, B, Shams, N, Zuhdy, M, Lepistö, A, Keränen, I, Kivelä, A, Lehtonen, T, Siironen, P, Rautio, T, Ahonen-Siirtola, M, Klintrup, K, Paarnio, K, Takala, H, Hyöty, M, Haukijärvi, E, Kotaluoto, Sm, Lehto, K, Tomminen, T, Huhtinen, H, Carpelan, A, Karvonen, J, Rantala, A, Varpe, P, Cotte, E, Francois, Y, Glehen, O, Passot, G, D'Alessandro, A, Chouillard, E, Etienne, Jc, Ghilles, E, Vinson-Bonnet, B, Germain, A, Ayav, A, Bresler, L, Chevalier, R, Didailler, R, Rullier, E, Tiret, E, Chafai, N, Lefevre, J, Parc, Y, Sielezneff, I, Mege, D, Lakkis, Z, Barussaud, M, Krones, C, Bock, B, Webler, R, Baral, J, Lang, T, Münch, S, Pullig, F, Schön, M, Hinz, S, Becker, T, Möller, T, Richter, F, Schafmayer, C, Hardt, J, Kienle, P, Crescenti, F, Ahmad, M, Soleiman, Y, Papaconstantinou, 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O'Brien, J, Photi, E, Stearns, A, Meylemans, D, Cunningham, C, Hompes, R, Tennakoon, A, Kumarasinghe, N, Rao, M, Upanishad, I, Smolarek, S, Platt, E, Rossi, B, Tham, J, Khan, J, Ahmad, N, Shweejawee, Z, Stefan, S, Smart, N, Daniels, I, Gregoir, T, Longstaff, L, Mcdermott, F, Varcada, M, Drami, I, Gala, T, Moggia, E, Ratnatunga, K, Harries, R, Hayes, J, Williams, G, Raymond, T, Bronder, C, Davies, E, Hawkin, P, Ryska, O, Ayral, K, Beveridge, A, Bhowmik, A, Gill, M, Simpson, R, Schofield, A, Mcardle, K, Parmar, M, Williamson, M, Burton, H, Courtney, E, Grant, C, Saracino, A, Newton, K, Epstein, J, Branagan, G, Bignell, M, Symankewicz, M, Zaman, S, Mankotia, R, Siddiqui, Z, Torrance, A, Artioukh, D, Eggleston, M, Gokul, K, Selwyn, D, Warusavitarne, J, Chandrasinghe, P, Grainger, J, Leo, C, Harris, G, Levy, B, Skull, A, Thaha, M, Garg, A, Patel, H, Ramsanahie, A, Mondragon-Pritchard, M, Cuinas Leon, K, Shukla, A, Brewer, H, Fitzgerald, J, Kho, H, Torkington, J, Tate, S, Wheat, J, Knight, J, Richardson, J, Tzivanakis, A, Gregori, M, Ashraf, M, Atif, M, Santos, J, Saffaf, N, Canning, L, Chandratreya, N, Bowen, M, Graham, B, Hamad, Y, Kaubrys, M, Chaudhry, Z, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Gouvas, N, Nicol, D, Pandey, S, Zilvetti, M, Sharma, A, Fatayer, T, Mothe, S, Rahman, M, Curtis, N, Allison, A, Dalton, R, Francis, N, Ockrim, J, Psaras, G, Dudarovaska, H, Marharint, T, Mostovoy, E, Voloshin, S, Kolesnik, O, Makhmudov, D, Altinel, Y, Iqbal, A, Cunningham, L, Go, K, Tan, S, Surgery, R. Tutino, G. Salamone, L. Licari, G. Cocorullo, G. Gulotta, European Society of Coloproctology (ESCP) Cohort Studie, and Tonini V, Cervellera M, Vaccari S
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Male ,Medical audit ,Treatment outcome ,anastomotic leak ,030230 surgery ,0302 clinical medicine ,Postoperative Complications ,Prospective Studies ,Multi centre ,emergency surgery ,Prospective cohort study ,Colectomy ,Medical Audit ,Proctectomy ,Proctectomy/adverse effects ,Prospective audit ,Primary anastomosis ,Anastomosis, Surgical ,Gastroenterology ,Middle Aged ,surgical complications ,Europe ,Treatment Outcome ,colon cancer ,gastrointestinal surgery ,rectal cancer ,Surgery ,surgical outcomes ,030220 oncology & carcinogenesis ,Postoperative Complications/etiology ,Female ,Colectomy/adverse effects ,Emergency Treatment/adverse effects ,Adult ,medicine.medical_specialty ,Adolescent ,surgical outcome ,Left sided ,NO ,03 medical and health sciences ,Young Adult ,surgical complication ,medicine ,Humans ,Emergency Treatment ,Colorectal resection ,Aged ,ta3126 ,Anastomosis, Surgical/methods ,business.industry ,General surgery ,Surgical Stomas ,Surgical Stomas/statistics & numerical data ,Settore MED/18 - Chirurgia Generale ,Multivariate Analysis ,business - Abstract
Introduction: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. Methods: A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (>16years) who underwent emergency (unplanned, within 24h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5). Results: From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83–2.79, P=0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43–11.02, P=0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur. Conclusions: Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications.
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- 2018
7. Predictors of complications and mortality following left colectomy with primary stapled anastomosis for cancer: results of a multicentric study with 1111 patients
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Pellino, G, Frasson, M, Garcia-Granero, A, Granero-Castro, P, Rodriguez, JLR, Flor-Lorente, B, Berzosa, JB, Hernandez, NA, Vallverdu, FJL, Banos, PAP, Conde, GA, Garcia-Granero, E, and ANACO Study Grp
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stapled anastomosis ,anastomotic leak ,postoperative complication ,left colectomy ,Colon cancer - Abstract
Aim Reports detailing the morbidity-mortality after left colectomy are sparse and do not allow definitive conclusions to be drawn. We aimed to identify risk factors for anastomotic leakage, perioperative mortality and complications following left colectomy for colonic malignancies. Method Results We undertook a STROBE-compliant analysis of left colectomies included in a national prospective online database. Forty-two variables were analysed as potential independent risk factors for anastomotic leakage, postoperative morbidity and mortality. Variables were selected using the 'least absolute shrinkage and selection operator' (LASSO) method. We analysed 1111 patients. Eight per cent of patients had a leakage and in 80% of them reoperation or surgical drainage was needed. A quarter of patients (24.9%) experienced at least one minor complication. Perioperative mortality was 2%, leakage being responsible for 47.6% of deaths. Obesity (OR 2.8, 95% CI 1.00-7.05, P = 0.04) and total parenteral nutrition (TPN) (OR 3.7, 95% CI 1.58-8.51, P = 0.002) were associated with increased risk of leakage, whereas female patients had a lower risk (OR 0.36, 95% CI 0.18-0.67, P = 0.002). Corticosteroids (P = 0.03) and oral anticoagulants (P = 0.01) doubled the risk of complications, which was lower with hyperlipidaemia (OR 0.3, P = 0.02). Patients on TPN had more complications (OR 4.02, 95% CI 2.03-8.07, P = 0.04) and higher mortality (OR 8.7, 95% CI 1.8-40.9, P = 0.006). Liver disease and advanced age impaired survival, corticosteroids being the strongest predictor of mortality (OR 21.5, P = 0.001). Conclusion Requirement for TPN was associated with more leaks, complications and mortality. Leakage was presumably responsible for almost half of deaths. Hyperlipidaemia and female gender were associated with lower rates of complications. These findings warrant a better understanding of metabolic status on perioperative outcome after left colectomy.
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- 2018
8. Laparoscopy may decrease morbidity and length of stay after elective colon cancer resection, especially in frail patients: results from an observational real-life study
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Cerdán Santacruz C, Frasson M, Flor-Lorente B, Ramos Rodríguez JL, Trallero Anoro M, Millán Scheiding M, Maseda Díaz O, Dujovne Lindenbaum P, Monzón Abad A, García-Granero Ximenez E, and ANACO Study Group
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Short-term outcome ,Laparoscopic surgery ,Morbidity ,Mortality ,Observational multicenter study ,Length-of-stay ,Colon cancer - Abstract
Advantages of laparoscopic approach in colon cancer surgery have been previously demonstrated in controlled, randomized trials and in retrospective analysis of large administrative databases. Nevertheless, evidence of these advantages in prospective, observational studies from real-life settings is scarce. This is a prospective, observational study, including a consecutive series of patients that underwent elective colonic resection for cancer in 52 Spanish hospitals. Pre-/intraoperative data, related to patient, tumor, surgical procedure, and hospital, were recorded as well as 60-day post-operative outcomes, including wound infection, complications, anastomotic leak, length of stay, and mortality. A univariate and multivariate analysis was performed to determine the influence of laparoscopy on short-term post-operative outcome. A sub-analysis of the effect of laparoscopy according to patients' pre-operative risk (ASA Score I-II vs. III-IV) was also performed. 2968 patients were included: 44.2% were initially operated by laparoscopy, with a 13.9% conversion rate to laparotomy. At univariate analysis, laparoscopy was associated with a decreased mortality (p = 0.015), morbidity (p < 0.0001), wound infection (p < 0.0001), and post-operative length of stay (p < 0.0001). At multivariate analysis, laparoscopy resulted as an independent protective factor for morbidity (OR 0.7; p = 0.004), wound infection (OR 0.6; p < 0.0001), and length of post-operative stay (Effect-2 days; p < 0.0001), compared to open approach. These advantages were more relevant in high-risk patients (ASA III-IV), even if the majority of them were operated by open approach (67.1%). In a real-life setting, laparoscopy decreases wound infection rate, post-operative complications, and length of stay, especially in ASA III-IV patients.
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- 2017
9. Risk factors for anastomotic leak and postoperative morbidity and mortality after elective right colectomy for cancer: results from a prospective, multicentric study of 1102 patients
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Frasson M, Granero-Castro P, Rodriguez J, Flor-Lorente B, Braithwaite M, Martinez E, Perez J, Cazador A, Espi A, Garcia-Granero E, and ANACO Study Grp
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Postoperative mortality ,Colorectal surgery ,Wound infection ,Right colectomy ,Anastomotic leak ,Primary anastomosis ,Ileocolic anastomosis ,Colon cancer ,Postoperative complication ,Colon resection - Abstract
Studies focused on postoperative outcome after oncologic right colectomy are lacking. The main objective was to determine pre-/intraoperative risk factors for anastomotic leak after elective right colon resection for cancer. Secondary objectives were to determine risk factors for postoperative morbidity and mortality. Fifty-two hospitals participated in this prospective, observational study (September 2011-September 2012), including 1102 patients that underwent elective right colectomy. Forty-two pre-/intraoperative variables, related to patient, tumor, surgical procedure, and hospital, were analyzed as potential independent risk factors for anastomotic leak and postoperative morbidity and mortality. Anastomotic leak was diagnosed in 93 patients (8.4 %), and 72 (6.5 %) of them needed radiological or surgical intervention. Morbidity, mortality, and wound infection rates were 29.0, 2.6, and 13.4 %, respectively. Preoperative serum protein concentration was the only independent risk factor for anastomotic leak (p < 0.0001, OR 0.6 per g/dL). When considering only clinically relevant anastomotic leaks, stapled technique (p = 0.03, OR 2.1) and preoperative serum protein concentration (p = 0.004, OR 0.6 g/dL) were identified as the only two independent risk factors. Age and preoperative serum albumin concentration resulted to be risk factors for postoperative mortality. Male gender, pulmonary or hepatic disease, and open surgical approach were identified as risk factors for postoperative morbidity, while male gender, obesity, intraoperative complication, and end-to-end anastomosis were risk factors for wound infection. Preoperative nutritional status and the stapled anastomotic technique were the only independent risk factors for clinically relevant anastomotic leak after elective right colectomy for cancer. Age and preoperative nutritional status determined the mortality risk, while laparoscopic approach reduced postoperative morbidity.
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- 2016
10. Risk Factors for Anastomotic Leak After Colon Resection for Cancer Multivariate Analysis and Nomogram From a Multicentric, Prospective, National Study With 3193 Patients
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Frasson M, Flor-Lorente B, Jl, Rodríguez, Granero-Castro P, Hervás D, Ma, Alvarez Rico, Mj, Brao, Jm, Sánchez González, and Garcia-Granero E
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nomogram ,colon cancer ,risk factor ,anastomotic leak ,colon resection - Abstract
Objective: To determine pre-/intraoperative risk factors for anastomotic leak after colon resection for cancer and to create a practical instrument for predicting anastomotic leak risk. Background: Anastomotic leak is still the most dreaded complication in colorectal surgery. Many risk factors have been identified to date, but multicentric prospective studies on anastomotic leak after colon resection are lacking. Methods: Fifty-two hospitals participated in this prospective, observational study. Data of 3193 patients, operated for colon cancer with primary anastomosis without stoma, were included in a prospective online database (September 2011-September 2012). Forty-two pre-/intraoperative variables, related to patient, tumor, surgical procedure, and hospital, were analyzed as potential independent risk factors for anastomotic leak (60-day follow-up). A nomogram was created to easily predict the risk of anastomotic leak for a given patient. Results: The anastomotic leak rate was 8.7%, and widely varied between hospitals (variance of 0.24 on the logit scale). Anastomotic leak significantly increased mortality (15.2% vs 1.9% in patients without anastomotic leak, P < 0.0001) and length of hospitalization (median 23 vs 7 days in uncomplicated patients, P < 0.0001). In the multivariate analysis, the following variables were independent risk factors for anastomotic leak: obesity [P = 0.003, odds ratio (OR) = 2.7], preoperative serum total proteins (P = 0.03, OR = 0.7 per g/dL), male sex (P = 0.03, OR = 1.6), ongoing anticoagulant treatment (P = 0.05, OR = 1.8), intraoperative complication (P = 0.03, OR = 2.2), and number of hospital beds (P = 0.04, OR = 0.95 per 100 beds). Conclusions: Anastomotic leak after colon resection for cancer is a frequent, relevant complication. Patients, surgical technique, and hospital are all important determining factors of anastomotic leak risk.
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- 2015
11. Pathological evaluation of mesocolic resection quality and ex vivo methylene blue injection: what is the impact on lymph node harvest after colon resection for cancer?
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Frasson M, Faus C, Garcia-Granero A, Puga R, Flor-Lorente B, Cervantes A, Navarro S, and Garcia-Granero E
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Lymph node excision ,Methylene blue ,Staging ,Pathological methodology ,Colon cancer - Abstract
Although the National Quality Forum has endorsed the harvest of =12 lymph nodes as a standard quality indicator for colon cancer surgery, this minimum quantity is not reached in many centers.
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- 2012
12. Anastomotic leakage after colon cancer resection: does the individual surgeon matter?
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Marinello, F. G., Baguena, G., Lucas, E., Frasson, M., Hervás, D., Flor‐Lorente, B., Esclapez, P., Espí, A., and García‐Granero, E.
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SURGICAL anastomosis ,COLON cancer treatment ,COLON surgery ,SURGICAL excision ,SURGICAL complications - Abstract
Aim Anastomotic leakage is one of the most feared complications after colonic resection. Many risk factors for anastomotic leakage have been reported, but the impact of an individual surgeon as a risk factor has scarcely been reported. The aim of this study was to assess if the individual surgeon is an independent risk factor for anastomotic leakage in colonic cancer surgery. Method This was a retrospective analysis of prospectively collected data from patients who underwent elective resection for colon cancer with anastomosis at a specialized colorectal unit from January 1993 to December 2010. Anastomotic leaks were diagnosed according to standardized criteria. Patient and tumour characteristics, surgical procedure and operating surgeons were analysed. A logistic regression model was used to discriminate statistical variation and identify risk factors for anastomotic leakage. Results A total of 1045 patients underwent elective colon cancer resection with primary anastomosis. Anastomotic leakage occurred in 6.4% of patients. Ileocolic anastomosis had an anastomotic leakage rate of 7.2%, colo-colonic/colorectal anastomosis 5.2% and ileorectal anastomosis 12.7%, with intersurgeon variability. The independent risk factors associated with anastomotic leakage were the use of perioperative blood transfusion ( OR 2.83, CI 1.59-5.06, P < 0.0001) and the individual surgeon performing the procedure ( OR up to 8.44, P < 0.0001). Conclusion In addition to perioperative blood transfusion, the individual surgeon was identified as an important risk factor for anastomotic leakage. Efforts should be made to reduce performance variability amongst surgeons. [ABSTRACT FROM AUTHOR]
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- 2016
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13. Observational cross-sectional study of compliance with the fast track protocol in elective surgery for colon cancer in Spain.
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Alcántara-Moral, Manuel, Serra-Aracil, X., Gil-Egea, M., Frasson, M., Flor-Lorente, B., and Garcia-Granero, E.
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MEDICAL protocols ,PATIENT compliance ,COLON cancer ,GASTROENTEROLOGY ,ONCOLOGY - Abstract
Purpose: The purpose of this study was to establish the degree of compliance with the fast track (enhanced recovery) protocol in habitual clinical practice and to determine which measures are fundamental for achieving the results obtained by applying the entire protocol. Methods: Observational, cross-sectional, multicenter trial was conducted. Participating hospitals prospectively recorded data from at least ten consecutive patients undergoing surgery for colon cancer who were applied some or all of the items comprising the enhanced recovery protocol. The data were analyzed both globally and dividing the sample into the two groups of patients. Results: Data on 363 patients from 25 hospitals were recorded, one hundred seventy-three in the 'non-fast track' group and 190 in the 'fast track' group. The non-fast track group complied with a mean of 5.4 (±1.8) items and the fast track group with a mean of 8.4 (±1.8) items. The mean functional hospital stay was 7.3 (±5.1) days in the non-fast track group and 6.2 (±5.1) days in the fast track group ( p < 0.05). Morbidity was 31.1 % in the fast track group and 24.3 % in the non-fast track group, though the differences were not statistically significant. The only prognostic factors that have an impact on improving the results are measures against hypothermia and mobilization before 24 h. Conclusion: Compliance with the enhanced recovery protocol is not exhaustive in habitual clinical practice. However, greater compliance was associated with shorter hospital stay without any increase in morbidity. The only items clearly associated with reduced functional hospital stay were measures against hypothermia and mobilization before 24 h. [ABSTRACT FROM AUTHOR]
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- 2014
- Full Text
- View/download PDF
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