Search

Background/aim: Early postoperative small bowel obstruction (EPSBO) prolongs hospital stays after surgery. This study aimed to evaluate the risk factors for EPSBO associated with colorectal cancer resection., Patients and Methods: We retrospectively compared the clinical variables of patients with EPSBO (n=37) and those without (n=812) after primary tumor resection for colorectal cancer at our hospital between January 2010 and December 2015., Results: In multivariate analysis, significant differences between the two groups was found in male sex, open surgery, and defunctioning ileostomy (DI) placement (p=0.024, p<0.0001, and p=0.023, respectively), but not for colostomy placement. Of 16 patients with DI who developed EPSBO, 13 (81.3%) cases resulted from obstruction of the stomal outlet., Conclusion: Male sex, open surgery, and DI placement are risk factors for EPSBO after colorectal cancer resection. For patients with placement of DI, obstruction of the stomal outlet should be carefully considered., (Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: To determine the superiority of the laparoscopic vs. open technique for colorectal cancer surgery., Patients and Methods: We performed a retrospective analysis of consecutive patients who underwent curative surgery by laparoscopic colectomy (LC) or open colectomy (OC) for colon cancer. The patients were classified into two groups: as LC group and OC group. We retrospectively assessed clinical characteristics, intraoperative and postoperative outcomes and long-term outcomes between the two groups by univariate analysis., Results: The LC group had significantly less intraoperative blood loss, complications, and shorter post-operative hospital stay than the OC group. The overall survival of Stage II in the LC group is significantly longer than the OC group. DFS of Stage III in the LC group was significantly longer than the OC group., Conclusion: LC showed more favorable results in both short-term and long-term outcomes than OC., (Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: In colon surgery, the anastomotic method is generally selected by surgeon's preferences or by local conditions. In this study, we retrospectively analyzed anastomotic complications to assess safe methods of anastomosis in colonic resection., Patients and Methods: We retrospectively analyzed a total of 684 cases, performed between July 2003 and June 2013 in our Hospital. Anastomosis complications, such as leakage, stricture and bleeding, were analyzed in relation to the three methods of anastomosis, hand-sewn (HS), functional end-to-end (FEEA) and triangulating anastomosis (TRI)., Results: Univariate analysis indicated that the incidence of leakage was significantly lower in laparoscopic surgeries (p=0.034) and TRI (p=0.047). The results of the multivariable analysis indicated that anastomotic leakage was significantly less with TRI (p=0.029)., Conclusion: In colon surgery, TRI seems to be associated with a low risk of anastomotic leakage compared to HS and FEEA., (Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: The aim of this study was to evaluate the necessity of thoracic epidural analgesia (TEA) as enhanced recovery after surgery (ERAS) programs for laparoscopic colorectal surgery (LC)., Patients and Methods: We retrospectively compared between perioperative outcomes of patients who underwent LC with TEA (n=31) and with multimodal analgesia (MMA) (n=31). Furthermore, we also evaluated the patients' satisfaction by a questionnaire survey to the nurses., Results: The only numeric rating scale (NRS) score on post-operative day (POD) 1 of the MMA group was significantly higher than that in the TEA group (p=0.002). In multivariate analysis, the factors that demonstrated significant correlation with hospital stay did not include analgesia. The 74% of the nurses felt equal or higher analgesic effect in the MMA group and interestingly, 84% of them answered that they would choose MMA if they were to undergo LC., Conclusion: TEA may not be necessary for ERAS in LC., (Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: Laparoscopic surgery has made possible anterior resections with small incisions suitable for creating stomas. We retrospectively compared surgical results and stomal complications between transumbilical defunctioning ileostomy (TDI) and conventional defunctioning ileostomy (CDI) in laparoscopic anterior resections for rectal cancer., Patients and Methods: We compared patients who underwent laparoscopic anterior resection with TDI (n=47) with those undergoing CDI (n=27) for rectal cancer between February 2011 and January 2015., Results: For the initial operations, the TDI group had significantly less intraoperative blood loss (30.3 ml vs. 117.0 ml; p=0.014). For stomal closure, the TDI group experienced significantly fewer wound infections (2 vs. 8 cases; p=0.002) and bowel obstructions (none vs. 3 cases; p=0.039). No significant differences in stomal complication rates were observed., Conclusion: TDI is associated with better surgical results and fewer complications than CDI after laparoscopic anterior resection for rectal cancer., (Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

Background/aim: The aim of this study was to evaluate the usefulness of circulating tumor cells (CTCs) after preliminary chemotherapy for prediction of response to further anticancer therapy in patients with initially unresectable metastatic colorectal cancer., Patients and Methods: CTCs from 14 consecutive patients with Kirsten rat sarcoma viral oncogene homolog (KRAS) wild-type colorectal cancer with synchronous or metachronous unresectable metastatic lesions were measured using the CellSearch system between January 2009 and December 2011. CTCs were measured before and after chemotherapy. The regimen consisted of four courses (three months) of oxaliplatin with oral S-1 (SOX) + panitumumab., Results: Ten (71%) out of all patients had no detectable CTCs after chemotherapy. Eight out of these ten patients received further chemotherapy, and liver metastases were completely resected in the other two patients; none of these patients died of cancer within a year after starting chemotherapy. The remaining four patients with CTCs continued to have CTCs after chemotherapy, and all four of these patients died of cancer within eight months after starting chemotherapy. The prognosis of the patients who had no detectable CTCs after the chemotherapy was significantly better than that of those who had CTCs even after the chemotherapy (p<0.01)., Conclusion: CTCs after preliminary chemotherapy may be useful in predicting the response to further anticancer therapy.