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Afonso Gomes I, Moita B, Nunes C. Spatiotemporal Analysis of Breast Cancer Hospitalizations in Portugal in 2002–2016. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2020. [DOI: 10.1159/000508634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Khiari H, Hsairi M. Colorectal cancer incidence and clinicopathological features in northern Tunisia 2007–2009. COLORECTAL CANCER 2017. [DOI: 10.2217/crc-2017-0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. The aim of this study was to determine CRC incidence and to describe clinicopathological features in north Tunisia for the period 2007–2009. The North Tunisia Cancer Registry was the source of data for the identification of patients. The age-standardized incidence rates (ASRs) were respectively 13.6 cases (7.5/100,000 for colon cancer and 6.2 for rectal cancer) and 11.1 cases (6.5/100,000 for colon cancer and 4.4 for rectal cancer) per 100,000 among male and female. The ASR varied widely by regions in northern Tunisia. The most common site in colon cancer was the distal colon comparing to the proximal one (49.0 and 29.9% respectively). Adenocarcinoma was the most common histological type. CRC screening should be strengthened in Tunisia to achieve a reduction of CRC incidence and mortality.
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Affiliation(s)
- Houyem Khiari
- Department of Epidemiology, Salah Azaiez Institute of Tunis, Tunis, Tunisia
| | - Mohamed Hsairi
- Department of Epidemiology, Salah Azaiez Institute of Tunis, Tunis, Tunisia
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[Initial experience in robot-assisted colorectal surgery in Mexico]. CIR CIR 2016; 85:284-291. [PMID: 27855992 DOI: 10.1016/j.circir.2016.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 09/09/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Colorectal surgery has advanced notably since the introduction of the mechanical suture and the minimally invasive approach. Robotic surgery began in order to satisfy the needs of the patient-doctor relationship, and migrated to the area of colorectal surgery. An initial report is presented on the experience of managing colorectal disease using robot-assisted surgery, as well as an analysis of the current role of this platform. MATERIAL AND METHODS A retrospective study was conducted in order to review five patients with colorectal disease operated using a robot-assisted technique over one year in the initial phase of the learning curve. Gender, age, diagnosis and surgical indication, surgery performed, surgical time, conversion, bleeding, post-operative complications, and hospital stay, were analysed and described. A literature review was performed on the role of robotic assisted surgery in colorectal disease and cancer. RESULTS The study included 5 patients, 3 men and 2 women, with a mean age of 62.2 years. Two of them were low anterior resections with colorectal primary anastomoses, one of them extended with a loop protection ileostomy, a Frykman-Goldberg procedure, and two left hemicolectomies with primary anastomoses. The mean operating time was 6hours and robot-assisted 4hours 20minutes. There were no conversions and the mean hospital stay was 5 days. CONCLUSION This technology is currently being used worldwide in different surgical centres because of its advantages that have been clinically demonstrated by various studies. We report the first colorectal surgical cases in Mexico, with promising results. There is enough evidence to support and recommend the use of this technology as a viable and safe option.
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de'Angelis N, Lizzi V, Azoulay D, Brunetti F. Robotic Versus Laparoscopic Right Colectomy for Colon Cancer: Analysis of the Initial Simultaneous Learning Curve of a Surgical Fellow. J Laparoendosc Adv Surg Tech A 2016; 26:882-892. [PMID: 27454105 DOI: 10.1089/lap.2016.0321] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Robotic surgery was introduced to overcome laparoscopic drawbacks. This study aimed to compare the learning curve of robotic-assisted right colectomy (RRC) versus laparoscopic-assisted right colectomy (LRC) for colon cancer with respect to operative times and perioperative outcomes. In addition, the health-related costs associated with both procedures were analyzed and compared. METHODS Between 2012 and 2015, 30 consecutive patients underwent RRC and 50 patients LRC for colon cancer. All procedures were performed by a surgical fellow novice in minimally invasive colorectal surgery. The operative time and the cumulative sum method were used to evaluate the learning curve of RRC versus LRC. RESULTS The mean operative times were 200.5 minutes for RRC and 204.1 minutes for LRC (P = .408) and showed a significant decrease over consecutive procedures (P < .0001). The number of cases necessary to identify a drop in the operative time was 16 for RRC and 25 for LRC. RRC procedures were associated with significantly reduced blood loss (P = .012). Two patients (4%) in the LRC group were converted to laparotomy, whereas no conversion was required in the RRC group. Surgery-related costs were significantly more expensive for RRC, but when combined with the hospitalization-related costs, LRC and RRC did not differ (P = .632). CONCLUSIONS Both robotic and laparoscopic operative times decrease rapidly with practice. However, RRC is associated with a faster learning curve than LRC. The simultaneous development of these two minimally invasive approaches appears to be safe and feasible with acceptable health-related costs.
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Affiliation(s)
- Nicola de'Angelis
- Department of Digestive Surgery, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital , AP-HP, Université Paris Est-UPEC, Créteil, France
| | - Vincenzo Lizzi
- Department of Digestive Surgery, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital , AP-HP, Université Paris Est-UPEC, Créteil, France
| | - Daniel Azoulay
- Department of Digestive Surgery, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital , AP-HP, Université Paris Est-UPEC, Créteil, France
| | - Francesco Brunetti
- Department of Digestive Surgery, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital , AP-HP, Université Paris Est-UPEC, Créteil, France
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Cost-effectiveness of population-based mammography screening strategies by age range and frequency. J Cancer Policy 2014. [DOI: 10.1016/j.jcpo.2014.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Wilson DM, Thomas R, Kovacs Burns KK, Hewitt JA, Osei-Waree J, Robertson S. Canadian rural-urban differences in end-of-life care setting transitions. Glob J Health Sci 2012; 4:1-13. [PMID: 22980372 PMCID: PMC4776943 DOI: 10.5539/gjhs.v4n5p1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Accepted: 06/12/2012] [Indexed: 12/04/2022] Open
Abstract
Few studies have focused on the care setting transitions that occur in the last year of life. A three part mixed-methods study was conducted to gain an understanding of the number and implications or impact of care setting transitions in the last year of life for rural Canadians. Provincial health services utilization data, national online survey data, and local qualitative interview data were analyzed to gain general and specific information for consideration. Rural Albertans had significantly more healthcare setting transitions than urbanites in the last year of life (M=4.2 vs 3.3). Online family respondents reported 8 moves on average occurred for family members in the last year of life. These moves were most often identified (65%) on a likert-type scale as “very difficult,” with the free text information revealing these trips were often emotionally painful for themselves and physically painful for their ill family member. Eleven informants were then interviewed until data saturation, with constant-comparative data analysis conducted for a more in-depth understanding of rural transitions. Moving from place to place for needed care in the last year of life was identified as common and concerning for rural people and their families, with three data themes developing: (a) needed care in the last year of life is scattered across many places, (b) travelling is very difficult for terminally-ill persons and their caregivers, and (c) local rural services are minimal. These findings indicate planning is needed to avoid unnecessary end-of-life care setting transitions and to make needed moves for essential services in the last year of life less costly, stressful, and socially disruptive for rural people and their families.
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Affiliation(s)
- Donna M Wilson
- Faculty of Nursing, University of Alberta, Edmonton, Canada.
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Alasari S, Min BS. Robotic colorectal surgery: a systematic review. ISRN SURGERY 2012; 2012:293894. [PMID: 22655207 PMCID: PMC3359666 DOI: 10.5402/2012/293894] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 01/10/2012] [Indexed: 01/05/2023]
Abstract
Aim. Robotic colorectal surgery may be a way to overcome the limitations of laparoscopic surgery. It is an emerging field; so, we aim in this paper to provide a comprehensive and data analysis of the available literature on the use of robotic technology in colorectal surgery. Method. A comprehensive systematic search of electronic databases was completed for the period from 2000 to 2011. Studies reporting outcomes of robotic colorectal surgery were identified and analyzed. Results. 41 studies (21 case series, 2 case controls, 13 comparative studies 1 prospective comparative, 1 randomized trial, 3 retrospective analyses) were reviewed. A total of 1681 patients are included in this paper; all of them use Da Vinci except 2 who use Zeus. Short-term outcome has been evaluated with 0 mortality and191 total major and minor complications. Pathological results were not analyzed in all studies and only 20 out of 41 provide data about the pathological results. Conclusion. Robotic surgery is safe and feasible option in colorectal surgery and a promising field; however, further prospective randomized studies are required to better define its role.
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Affiliation(s)
- Sami Alasari
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
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Age-Based Differences in Care Setting Transitions over the Last Year of Life. Curr Gerontol Geriatr Res 2011; 2011:101276. [PMID: 21837238 PMCID: PMC3152954 DOI: 10.1155/2011/101276] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 06/15/2011] [Indexed: 11/25/2022] Open
Abstract
Context. Little is known about the number and types of moves made in the last year of life to obtain healthcare and end-of-life support, with older adults more vulnerable to care setting transition issues. Research Objective. Compare care setting transitions across older (65+ years) and younger individuals. Design. Secondary analyses of provincial hospital and ambulatory database data. Every individual who lived in the province for one year prior to death from April 1, 2005 through March 31, 2007 was retained (N = 19, 397). Results. Transitions averaged 3.5, with 3.9 and 3.4 for younger and older persons, respectively. Older persons also had fewer ER and ambulatory visits, fewer procedures performed in the last year of life, but longer inpatient stays (42.7 days versus 36.2 for younger persons). Conclusion. Younger and older persons differ somewhat in the number and type of end-of-life care setting transitions, a matter for continuing research and healthcare policy.
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Leong SPL, Shen ZZ, Liu TJ, Agarwal G, Tajima T, Paik NS, Sandelin K, Derossis A, Cody H, Foulkes WD. Is breast cancer the same disease in Asian and Western countries? World J Surg 2010; 34:2308-24. [PMID: 20607258 PMCID: PMC2936680 DOI: 10.1007/s00268-010-0683-1] [Citation(s) in RCA: 389] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
UNLABELLED A mini-symposium was held in Montreal, Canada, at the International Surgical Week for the Breast Surgical International in 2007 addressing the question whether breast cancer is the same disease in Asian and Western countries. Numerous investigators from Asian and Western countries presented the epidemiologic and clinical outcome data of women with breast cancer. Although there are significant similarities, the striking difference is that the peak age for breast cancer is between 40 and 50 years in the Asian countries, whereas the peak age in the Western countries is between 60 and 70 years. Also, the incidence of breast cancer in Asia is rising and is associated with increased mortality. In the West, although the incidence is increasing, the mortality rate is definitely decreasing. Future prospective data collection from Asian and Western countries may provide further interesting epidemiologic and outcome data regarding the outcome of women with breast cancer from Asian and Western countries. BACKGROUND Whether breast cancer is the same disease in Asian and Western countries was the topic of a 2007 Breast Surgery International symposium at International Surgical Week. METHODS Participating investigators from China, Taiwan, India, Japan, South Korea, Sweden, Canada, and the United States were asked beforehand to provide data on the epidemiology and treatment outcome of women in their countries. RESULTS Comparisons of the epidemiologic and clinical outcome data of women with breast cancer showed significant similarities, but the striking difference is that the peak age is between 40 and 50 years in Asian countries, but is between 60 and 70 years in Western countries. The incidence of breast cancer in Asia is rising and is associated with increased mortality. In the West, although the incidence is also increasing, the mortality rate is definitely decreasing. DISCUSSION Future prospective data collection from Asian and Western countries may provide further interesting epidemiologic and outcome data regarding the outcome of women with breast cancer from Asian and Western countries.
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Affiliation(s)
- Stanley P L Leong
- Department of Surgery, California Pacific Medical Center and Sutter Pacific Medical Foundation, 2340 Clay Street, 2nd Floor, San Francisco, CA 94115, USA.
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Wang J, Boult M, Tyson S, Babidge W, Zorbas H, Kollias J, Roder D, Maddern G. TRENDS IN SURGICAL TREATMENT OF YOUNGER PATIENTS WITH BREAST CANCER IN AUSTRALIA AND NEW ZEALAND. ANZ J Surg 2008; 78:665-9. [DOI: 10.1111/j.1445-2197.2008.04613.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Gagliardi AR, Wright FC, Grunfeld E, Davis D. Colorectal cancer care knowledge mapping: identifying priorities for knowledge translation research. Cancer Causes Control 2008; 19:615-30. [PMID: 18270797 DOI: 10.1007/s10552-008-9126-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Accepted: 01/22/2008] [Indexed: 01/16/2023]
Abstract
OBJECTIVE We do not know the extent and nature of knowledge translation (KT) in oncology. This study examined colorectal cancer (CRC) health services research, and engaged researchers and decision makers in prioritizing KT research gaps. METHODS MEDLINE was searched from 1996 to 2006 for CRC health services research in Canada, Australia, the United Kingdom, and United States. Studies were tabulated by indicator, type of research and country to reveal gaps. Researchers and decision makers prioritized gaps via questionnaire, then generated research questions for top-ranked gaps at a one-day workshop. RESULTS A total of 132 articles were categorized and 29 individuals attended the workshop. We lack knowledge about factors influencing rates of many indicators. Researchers and decision makers prioritized KT research on factors that could either influence the utilization of screening or enhance the quality of surgical outcomes. They acknowledged lack of research capacity and policy support as barriers, and confusion about the concept of KT. CONCLUSIONS Several opportunities were revealed for improving the quality of CRC screening and surgery. Greater coordination of, and support for KT research is required to address these gaps. Further research should evaluate different methods of achieving KT between researchers and decision makers for research planning.
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Affiliation(s)
- Anna R Gagliardi
- Department of Surgery, Faculty of Medicine, University of Toronto, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada.
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Abstract
BACKGROUND Reports on the temporal evolution in lung resection are limited. To elucidate temporal changes in the demographics of lung resections, we analyzed nationally representative data that were collected for the National Hospital Discharge Survey from 1988 to 2002. METHODS Data collected between 1988 and 2002 were analyzed. Patients with International Classification of Diseases, ninth revision, clinical modification, procedure codes for lung resection were included in the sample. Three 5-year time periods were created (1988 to 1992, 1993 to 1997, and 1998 to 2002) to simplify the temporal analysis. Changes in the prevalence of procedures, age, gender, race, length of care, mortality, disposition status, and distribution by hospital size were evaluated. Trends in procedure-related complications were analyzed. RESULTS Between 1988 and 2002, a total of 512,758 lung resections were performed. Comparing the earliest to the most recent time period, we found increases in the average age (61.1 years [range, 1 to 89 years] vs 63.2 years [range, 1 to 91 years], respectively), in the proportion of patients who were female (40.1% vs 49.6%, respectively), and in the proportion of Medicare/Medicaid patients (43.8% vs 49%/4.7% vs 6.7%, respectively). Decreases in the average length of stay (12.9 days [range, 1 to 358 days] vs 9.1 days [range, 1 to 175 days], respectively) and in the proportion of patients discharged to their primary residence (86% vs 79.5%, respectively) were seen. The proportion of patients who had undergone lobectomies compared to other types of lung resection increased. Mortality rates were 5% vs 5.4%, respectively, while the frequency of complications decreased. CONCLUSION We identified temporal changes in lung resection surgery that may help in the construction of health-care policies to address the changing needs of and financial burdens on the health-care system.
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Affiliation(s)
- Stavros G Memtsoudis
- Department of Anesthesiology, Perioperative, and Pain Medicine, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical Center, Boston, MA, USA.
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