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Song JY, Cao J, Mao J, Wang JL. Effect of rapid rehabilitation nursing on improving clinical outcomes in postoperative patients with colorectal cancer. World J Gastrointest Surg 2024; 16:2119-2126. [PMID: 39087108 PMCID: PMC11287703 DOI: 10.4240/wjgs.v16.i7.2119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/07/2024] [Accepted: 06/06/2024] [Indexed: 07/22/2024] Open
Abstract
BACKGROUND Surgical resection is the cornerstone treatment for colorectal cancer. Rapid rehabilitation care predicated on evidence-based medical theory aims to improve postoperative nursing care, subsequently reducing the physical and mental traumatic stress response and helping patients who undergo surgery recover rapidly. AIM To assess the effect of rapid rehabilitation care on clinical outcomes, including overall postoperative complications, anastomotic leaks, wound infections, and intestinal obstruction in patients with colorectal cancer. METHODS We searched the PubMed, Web of Science, Embase, Elsevier Science Direct, and Springer Link databases from January 1, 2010, to January 1, 2024, to screen eligible studies on rapid rehabilitation care among patients who underwent colorectal cancer surgery. Patients were screened based on the inclusion and exclusion criteria. RevMan 5.4 software was used for statistical analysis of the data. RESULTS Twelve studies were enrolled, which included 2420 patients. The results showed that rapid rehabilitation care decreased the incidence of overall postoperative complications (OR: 0.44, 95%CI: 0.26-0.74, P = 0.002), anastomotic leaks (OR: 0.68, 95%CI: 0.41-1.12, P = 0.13), wound infections (OR: 0.45, 95%CI: 0.29-0.72, P = 0.0007), and intestinal obstruction (OR: 0.54, 95%CI: 0.34-0.86, P = 0.01) compared to conventional care. Further trials and studies are needed to confirm these results. CONCLUSION Rapid rehabilitation care decreased the occurrence of postoperative complications, anastomotic leaks, wound infections, and intestinal obstruction compared to conventional care in patients who underwent colorectal surgery. Therefore, promoting the application of rapid rehabilitation care in clinical practice cannot be overemphasized.
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Affiliation(s)
- Jing-Yan Song
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jing Cao
- Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jian Mao
- Information Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jiang-Lian Wang
- Department of Oncology, Yunyang County People's Hospital, Chongqing 400016, China
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Yeo I, Yoo MW, Park SJ, Moon SK. [Postoperative Imaging Findings of Colorectal Surgery: A Pictorial Essay]. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2024; 85:727-745. [PMID: 39130784 PMCID: PMC11310425 DOI: 10.3348/jksr.2021.0004n] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 05/29/2023] [Accepted: 12/20/2023] [Indexed: 08/13/2024]
Abstract
Postoperative colorectal imaging studies play an important role in the detection of surgical complications and disease recurrence. In this pictorial essay, we briefly describe methods of surgery, imaging findings of their early and late complications, and postsurgical recurrence of cancer and inflammatory bowel disease.
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Rodriguez-Rodriguez AM, De la Fuente-Costa M, Escalera-de la Riva M, Perez-Dominguez B, Paseiro-Ares G, Casaña J, Blanco-Diaz M. AI-Enhanced evaluation of YouTube content on post-surgical incontinence following pelvic cancer treatment. SSM Popul Health 2024; 26:101677. [PMID: 38766549 PMCID: PMC11101902 DOI: 10.1016/j.ssmph.2024.101677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/15/2024] [Accepted: 04/25/2024] [Indexed: 05/22/2024] Open
Abstract
Background Several pelvic area cancers exhibit high incidence rates, and their surgical treatment can result in adverse effects such as urinary and fecal incontinence, significantly impacting patients' quality of life. Post-surgery incontinence is a significant concern, with prevalence rates ranging from 25 to 45% for urinary incontinence and 9-68% for fecal incontinence. Cancer survivors are increasingly turning to YouTube as a platform to connect with others, yet caution is warranted as misinformation is prevalent. Objective This study aims to evaluate the information quality in YouTube videos about post-surgical incontinence after pelvic area cancer surgery. Methods A YouTube search for "Incontinence after cancer surgery" yielded 108 videos, which were subsequently analyzed. To evaluate these videos, several quality assessment tools were utilized, including DISCERN, GQS, JAMA, PEMAT, and MQ-VET. Statistical analyses, such as descriptive statistics and intercorrelation tests, were employed to assess various video attributes, including characteristics, popularity, educational value, quality, and reliability. Also, artificial intelligence techniques like PCA, t-SNE, and UMAP were used for data analysis. HeatMap and Hierarchical Clustering Dendrogram techniques validated the Machine Learning results. Results The quality scales presented a high level of correlation one with each other (p < 0.01) and the Artificial Intelligence-based techniques presented clear clustering representations of the dataset samples, which were reinforced by the Heat Map and Hierarchical Clustering Dendrogram. Conclusions YouTube videos on "Incontinence after Cancer Surgery" present a "High" quality across multiple scales. The use of AI tools, like PCA, t-SNE, and UMAP, is highlighted for clustering large health datasets, improving data visualization, pattern recognition, and complex healthcare analysis.
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Affiliation(s)
- Alvaro Manuel Rodriguez-Rodriguez
- Physiotherapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), University of Oviedo, 33011, Oviedo, Spain
| | - Marta De la Fuente-Costa
- Physiotherapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), University of Oviedo, 33011, Oviedo, Spain
- Faculty of Medicine and Health Sciences, University of Oviedo, 33006, Oviedo, Spain
| | - Mario Escalera-de la Riva
- Physiotherapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), University of Oviedo, 33011, Oviedo, Spain
- Faculty of Medicine and Health Sciences, University of Oviedo, 33006, Oviedo, Spain
| | - Borja Perez-Dominguez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010, Valencia, Spain
| | - Gustavo Paseiro-Ares
- Psychosocial Intervention and Functional Rehabilitation Research Group, Faculty of Physiotherapy, University of A Coruña, 15006, Coruña, Spain
| | - Jose Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010, Valencia, Spain
| | - Maria Blanco-Diaz
- Physiotherapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), University of Oviedo, 33011, Oviedo, Spain
- Faculty of Medicine and Health Sciences, University of Oviedo, 33006, Oviedo, Spain
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Yanagisawa T, Tatematsu N, Horiuchi M, Migitaka S, Yasuda S, Itatsu K, Kubota T, Sugiura H. Responsiveness and minimal clinically important difference of the 6-minute walk distance in patients undergoing colorectal cancer surgery. Support Care Cancer 2024; 32:382. [PMID: 38789578 DOI: 10.1007/s00520-024-08596-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/21/2024] [Indexed: 05/26/2024]
Abstract
PURPOSE This study aimed to clarify the responsiveness and minimal clinically important difference (MCID) of the 6-minute walk distance (6MWD) from before and 1 week after surgery in patients with colorectal cancer (CRC). METHODS This retrospective cohort study enrolled 97 patients with primary CRC scheduled for surgery. An anchor-based approach estimated the MCID of the 6MWD, with postoperative physical recovery and EuroQol 5-dimension 5L questionnaire assessments serving as anchors. Effect size (ES) and standardized response mean (SRM) of the 6MWD were calculated to evaluate responsiveness, and the receiver operating characteristic (ROC) curve was used to estimate the MCID of the 6MWD. RESULTS Of the 97 patients, 72 were included in the analysis. The absolute value of ES and SRM of the 6MWD were 0.69 and 0.91, respectively. The ROC curve indicated that the optimal cut-off values for estimating the MCID of the 6MWD were -60 m (area under the curve [AUC] = 0.753 [95% CI: 0.640-0.866]) and -75 m (AUC = 0.870 [95% CI: 0.779-0.961]) at each anchor. CONCLUSION From before to 1 week after surgery, the responsiveness of the 6MWD was favorable, and the MCID of the 6MWD was -75 to -60 m in patients with CRC.
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Affiliation(s)
- Takuya Yanagisawa
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-kitamachi, Kita-ku, Nagoya, Aichi, 462-0802, Japan
| | - Noriatsu Tatematsu
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-minami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan.
| | - Mioko Horiuchi
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-kitamachi, Kita-ku, Nagoya, Aichi, 462-0802, Japan
| | - Saki Migitaka
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-kitamachi, Kita-ku, Nagoya, Aichi, 462-0802, Japan
| | - Shotaro Yasuda
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-kitamachi, Kita-ku, Nagoya, Aichi, 462-0802, Japan
| | - Keita Itatsu
- Department of Surgery, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-kitamachi, Kita-ku, Nagoya, Aichi, 462-0802, Japan
| | - Tomoyuki Kubota
- Department of Breast Surgery, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-kitamachi, Kita-ku, Nagoya, Aichi, 462-0802, Japan
| | - Hideshi Sugiura
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-minami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan
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Zhang L, Wu Q, Wang X, Zhu X, Shi Y, Wu CJJ. Factors impacting early mobilization according to the Enhanced Recovery After Surgery guideline following gastrointestinal surgery: A prospective study. Geriatr Gerontol Int 2024; 24:234-239. [PMID: 38169113 DOI: 10.1111/ggi.14799] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/30/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
AIM Evidence shows that early mobilization according to the Enhanced Recovery After Surgery guideline promotes postoperative recovery in gastrointestinal cancer patients undergoing gastrointestinal surgery. However, compliance with the guideline in clinical settings remains low. This study aimed to investigate the factors influencing early mobilization after surgery. METHODS A prospective research design was used. Data from 470 patients with gastrointestinal cancer who underwent gastrointestinal surgery between February 2021 and July 2022 were collected. RESULTS More than half (53.6%) of the patients met the criteria for early mobilization. Females (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.02-2.29), age 〉70 years (OR, 1.76; 95% CI, 1.09-2.86), low level of education (OR, 1.98; 95% CI, 1.12-3.95), and ≥4 catheters (OR, 1.86; 95% CI, 1.25-2.76) were barriers to early mobilization. CONCLUSIONS Sex, age, education, and the number of catheters were found to be significant factors associated with non-early mobilization after gastrointestinal surgery. Geriatr Gerontol Int 2024; 24: 234-239.
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Affiliation(s)
- Lin Zhang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qian Wu
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiayun Wang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoping Zhu
- School of Nursing, University of Tongji, Shanghai, China
| | - Yan Shi
- School of Nursing, University of Tongji, Shanghai, China
| | - Chiung-Jung Jo Wu
- School of Health, University of the Sunshine Coast, Petrie, Queensland, Australia
- Royal Brisbane and Women's Hospital (RBWH), Herston, Queensland, Australia
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Rodriguez-Rodriguez AM, De la Fuente-Costa M, Escalera-de la Riva M, Domínguez-Navarro F, Perez-Dominguez B, Paseiro-Ares G, Casaña-Granell J, Blanco-Diaz M. Assessing the Quality of YouTube's Incontinence Information after Cancer Surgery: An Innovative Graphical Analysis. Healthcare (Basel) 2024; 12:243. [PMID: 38255130 PMCID: PMC10815186 DOI: 10.3390/healthcare12020243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Prostate and colorectum cancers rank among the most common cancers, and incontinence is a significant postsurgical issue affecting the physical and psychological well-being of cancer survivors. Social media, particularly YouTube, has emerged as a vital source of health information. While YouTube offers valuable content, users must exercise caution due to potential misinformation. OBJECTIVE This study aims to assess the quality of publicly available YouTube videos related to incontinence after pelvic cancer surgery. METHODS A search on YouTube related to "Incontinence after cancer surgery" was performed, and 108 videos were analyzed. Multiple quality assessment tools (DISCERN, GQS, JAMA, PEMAT, and MQ-VET) and statistical analyses (descriptive statistics and intercorrelation tests) were used to evaluate the characteristics and popularity, educational value, quality, and reliability of these videos, relying on novel graphical representation techniques such as Sankey and Chord diagrams. RESULTS Strong positive correlations were found among quality rating scales, emphasizing agreement. The performed graphical analysis reinforced the reliability and validity of quality assessments. CONCLUSIONS This study found strong correlations among five quality scales, suggesting their effectiveness in assessing health information quality. The evaluation of YouTube videos consistently revealed "high" quality content. Considering the source is mandatory when assessing quality, healthcare and academic institutions are reliable sources. Caution is advised with ad-containing videos. Future research should focus on policy improvements and tools to aid patients in finding high-quality health content.
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Affiliation(s)
- Alvaro Manuel Rodriguez-Rodriguez
- Physiotherapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), University of Oviedo, 33003 Oviedo, Spain or (A.M.R.-R.); (M.D.l.F.-C.); (M.E.-d.l.R.); (M.B.-D.)
| | - Marta De la Fuente-Costa
- Physiotherapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), University of Oviedo, 33003 Oviedo, Spain or (A.M.R.-R.); (M.D.l.F.-C.); (M.E.-d.l.R.); (M.B.-D.)
- Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain
| | - Mario Escalera-de la Riva
- Physiotherapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), University of Oviedo, 33003 Oviedo, Spain or (A.M.R.-R.); (M.D.l.F.-C.); (M.E.-d.l.R.); (M.B.-D.)
- Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain
| | - Fernando Domínguez-Navarro
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (F.D.-N.); (J.C.-G.)
| | - Borja Perez-Dominguez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (F.D.-N.); (J.C.-G.)
| | - Gustavo Paseiro-Ares
- Psychosocial Intervention and Functional Rehabilitation Research Group, Faculty of Physiotherapy, University of A Coruña, 15008 Coruna, Spain;
| | - Jose Casaña-Granell
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (F.D.-N.); (J.C.-G.)
| | - María Blanco-Diaz
- Physiotherapy and Translational Research Group (FINTRA-RG), Institute of Health Research of the Principality of Asturias (ISPA), University of Oviedo, 33003 Oviedo, Spain or (A.M.R.-R.); (M.D.l.F.-C.); (M.E.-d.l.R.); (M.B.-D.)
- Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain
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Liu Y, Liu Z, Zhang L, Zhang Y, Zhang N, Han Y, Shen L. Preoperative 6-minute walk distance is associated with postoperative complications in patients undergoing laparoscopic gastrointestinal cancer surgery. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107139. [PMID: 37948791 DOI: 10.1016/j.ejso.2023.107139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/30/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE The 6-min walk test (6MWT) is a simple and valid method to evaluate cardiopulmonary function. We performed this prospective study in patients undergoing laparoscopic gastrointestinal cancer surgery to explore the association between preoperative 6MWT performance and overall postoperative complications. METHODS This study was registered at clinicaltrials.gov (NCT03711526). The study consecutively enrolled patients receiving laparoscopic gastrointestinal cancer surgery in our institution. All patients performed the 6MWT upon recruitment and received 30 days of postoperative follow-up. The primary outcome was overall complications, defined by ≥ grade I Clavien-Dindo (CD) classification (2004) complications. Multivariable logistic regression was used to test the association of 6-min walk distance (6MWD) with the outcome. RESULTS A total of 184 patients were included in the final analyses. In the 37 (20.1 %) patients with overall complications, the mean (standard deviation) preoperative 6MWD was 469.1 (86.8) m. In patients with no complications, the 6MWD was 502.6 (90.2) m. The mean difference was 33.5 m (95 % confidence interval, 1.3, 65.7; P = 0.042). A longer preoperative 6MWD was associated with a lower odds of developing postoperative complications (odds ratio, 0.994 per meter increase; 95 % confidence interval, 0.989, 0.999; p = 0.023). CONCLUSION This study indicated an association between the preoperative 6MWD and postoperative complications in patients undergoing laparoscopic gastrointestinal cancer surgery.
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Affiliation(s)
- Yuchao Liu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zijia Liu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Liangyan Zhang
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuelun Zhang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ningchen Zhang
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Han
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Le Shen
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yanagisawa T, Tatematsu N, Horiuchi M, Migitaka S, Yasuda S, Itatsu K, Kubota T, Sugiura H. Prolonged preoperative sedentary time is a risk factor for postoperative ileus in patients with colorectal cancer: a propensity score-matched retrospective study. Support Care Cancer 2023; 32:54. [PMID: 38129532 DOI: 10.1007/s00520-023-08271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE This study aimed to investigate the association between prolonged preoperative sedentary time (ST) and postoperative ileus (POI) after adjusting for confounders in patients with colorectal cancer (CRC). METHODS This single-center retrospective study enrolled 155 consecutive patients who underwent surgery for primary CRC. A diagnosis of POI was made by the surgeons if the Clavien-Dindo classification (CD) grade is ≥ 2 within 30 days after surgery. Preoperative ST was assessed using the International Physical Activity Questionnaire usual week short version (Japanese version). Patients were classified into two groups (ST < 6 h/day and ST ≥ 6 h/day) based on results from the questionnaire, and data were analyzed using a propensity score-matching strategy to adjust for confounders. In addition, receiver operating characteristic (ROC) curve analysis was performed to identify the optimal cutoff value of preoperative ST for predicting POI. RESULTS Of the 155 patients, 134 were included in the analysis. POI occurred in 16 (11.9%) patients of overall patients and 11 (12.5%) of the 88 matched patients. The logistic regression analysis after propensity score-matching showed that prolonged preoperative ST (ST ≥ 6 h/day) was associated with POI (odds ratio 5.40 (95% confidence interval: 1.09 - 26.60), p = 0.038). The ROC curve analysis indicated that the optimal cutoff value of preoperative ST for predicting POI was 6 h/day. CONCLUSION Prolonged preoperative ST is a risk factor for POI in patients with CRC. Therefore, reducing preoperative ST may play an important role in preventing POI.
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Affiliation(s)
- Takuya Yanagisawa
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Noriatsu Tatematsu
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-Ku, Nagoya, Aichi, 461-8673, Japan.
| | - Mioko Horiuchi
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Saki Migitaka
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Shotaro Yasuda
- Department of Rehabilitation, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Keita Itatsu
- Department of Surgery, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Tomoyuki Kubota
- Department of Breast Surgery, Kamiiida Daiichi General Hospital, 2-70 Kamiiida-Kitamachi, Kita-Ku, Nagoya, Aichi, 462-0802, Japan
| | - Hideshi Sugiura
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-Ku, Nagoya, Aichi, 461-8673, Japan
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Yao Q, Fu YY, Sun QN, Ren J, Wang LH, Wang DR. Comparison of intracorporeal and extracorporeal anastomosis in left hemicolectomy: updated meta-analysis of retrospective control trials. J Cancer Res Clin Oncol 2023; 149:14341-14351. [PMID: 37516674 DOI: 10.1007/s00432-023-05091-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND The feasibility and effectiveness of selecting an intracorporeal or extracorporeal technique in left hemicolectomy remain poorly understood. This meta-analysis aimed to evaluate the difference between the two approaches regarding intraoperative and postoperative outcomes. METHODS A thorough exploration of online databases (PubMed, Embase, Cochrane, and Web of Science) was executed to identify randomized controlled trials, cohort studies, and case control studies. The outcomes contained four aspects: intraoperative outcomes, postoperative complications, postoperative patient conditions, and postoperative outcomes. All of these data were analyzed using RevMan 5.4. Seven retrospective control trials (intracorporeal, 396 patients; extracorporeal, 426 patients) were evaluated. RESULTS Compared to the extracorporeal group, the intracorporeal group demonstrated superiority in incision length (P = 0.005), overall complications (P = 0.01), time to first flatus (P < 0.001), time to first stool (P = 0.005), time to first diet (P < 0.001) and hospital stay duration (P = 0.001). CONCLUSIONS The intracorporeal technique is associated with superiority over the extracorporeal technique in reducing postoperative complications, promoting postoperative recovery of gastrointestinal function, and reducing hospital stay duration.
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Affiliation(s)
- Qing Yao
- Dalian Medical University, Dalian, 116044, China
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China
- Yangzhou, Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, 225001, China
| | - Ya-Yan Fu
- Medical College of Yangzhou University, Yangzhou, 225001, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China
- Yangzhou, Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, 225001, China
| | - Qian-Nan Sun
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China
- Yangzhou, Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, 225001, China
| | - Jun Ren
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China
- Yangzhou, Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, 225001, China
| | - Liu-Hua Wang
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China
- Yangzhou, Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, 225001, China
| | - Dao-Rong Wang
- Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China.
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China.
- Yangzhou, Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, 225001, China.
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Kim D, Lee JH, Cho ES, Shin SJ, Lee HS, Koh HH, Lee KY, Kang J. Clinical Significance of Combining Preoperative and Postoperative Albumin-Bilirubin Score in Colorectal Cancer. Cancer Res Treat 2023; 55:1261-1269. [PMID: 37080608 PMCID: PMC10582552 DOI: 10.4143/crt.2022.1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/14/2023] [Indexed: 04/22/2023] Open
Abstract
PURPOSE Albumin-bilirubin (ALBI) score is a well-known prognostic factor for various diseases, including colorectal cancer (CRC). However, little is known about the significance of postoperative ALBI score changes in patients with CRC. MATERIALS AND METHODS A total of 723 patients who underwent surgery were enrolled. Preoperative ALBI (ALBI-pre) and postoperative ALBI (ALBI-post) scores were divided into low and high score groups. ALBI-trend was defined as a combination of four groups comprising the low and high ALBI-pre and ALBI-post score groups. Kaplan-Meier survival curves were used to compare the overall survival (OS) between the different ALBI groups. The Cox proportional hazards model was used to examine the independent relevant factors of OS. Stratification performance was compared between the different ALBI groupings using Harrell's concordance index (C-index). RESULTS ALBI-pre, ALBI-post, and ALBI-trend score groups were significant prognostic factors of OS in the univariable analysis. However, multivariable analysis showed that ALBI-trend was an independent prognostic factor while ALBI-pre and ALBI-post were not. The C-index of ALBI-trend (0.622; 95% confidence interval [CI], 0.587 to 0.655) was higher than that of ALBI-pre (0.589; 95% CI, 0.557 to 0.621; bootstrap mean difference, 0.033; 95% CI, 0.013 to 0.057) and ALBI-post (0.575; 95% CI, 0.545 to 0.605; bootstrap mean difference, 0.047; 95% CI, 0.024 to 0.074). CONCLUSION Combining ALBI-pre and ALBI-post scores is an independent prognostic factor of OS and shows superior predictive power compared to ALBI-pre or ALBI-post alone in patients with CRC.
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Affiliation(s)
- Doyoun Kim
- Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun-Suk Cho
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Su-Jin Shin
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostatistic Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Hwa-Hee Koh
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kang Young Lee
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jeonghyun Kang
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Yu DM, Wu CX, Sun JY, Xue H, Yuwen Z, Feng JX. Prediction model of stress ulcer after laparoscopic surgery for colorectal cancer established by machine learning algorithm. World J Gastrointest Surg 2023; 15:1978-1985. [PMID: 37901722 PMCID: PMC10600766 DOI: 10.4240/wjgs.v15.i9.1978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/25/2023] [Accepted: 07/19/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Patients with colorectal cancer (CRC) are prone to stress ulcer after laparoscopic surgery. The analysis of risk factors for stress ulcer (SU) in patients with CRC is important to reduce mortality and improve patient prognosis. AIM To identify risk factors for SU after laparoscopic surgery for CRC, and develop a nomogram model to predict the risk of SU in these patients. METHODSThe clinical data of 135 patients with CRC who underwent laparoscopic surgery between November 2021 and June 2022 were reviewed retrospectively. They were divided into two categories depending on the presence of SUs: The SU group (n = 23) and the non-SU group (n = 112). Univariate analysis and multivariate logistic regression analysis were used to screen for factors associated with postoperative SU in patients undergoing laparoscopic surgery, and a risk factor-based nomogram model was built based on these risk factors. By plotting the model's receiver operating characteristic (ROC) curve and calibration curve, a Hosmer-Lemeshow goodness of fit test was performed. RESULTS Among the 135 patients with CRC, 23 patients had postoperative SU, with an incidence of 17.04%. The SU group had higher levels of heat shock protein (HSP) 70, HSP90, and gastrin (GAS) than the non-SU group. Age, lymph node metastasis, HSP70, HSP90, and GAS levels were statistically different between the two groups, but other indicators were not statistically different. Logistic regression analysis showed that age ≥ 65 years, lymph node metastasis, and increased levels of HSP70, HSP90 and GAS were all risk factors for postoperative SU in patients with CRC (P < 0.05). According to these five risk factors, the area under the ROC curve for the nomogram model was 0.988 (95%CI: 0.971-1.0); the calibration curve demonstrated excellent agreement between predicted and actual probabilities, and the Hosmer-Lemeshow goodness of fit test revealed that the difference was not statistically significant (χ2 = 0.753, P = 0.999), suggesting that the nomogram model had good discrimination, calibration, and stability. CONCLUSION Patients with CRC aged ≥ 65 years, with lymph node metastasis and elevated HSP70, HSP90, GAS levels, are prone to post-laparoscopic surgery SU. Our nomogram model shows good predictive value.
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Affiliation(s)
- Dong-Mei Yu
- School of Nursing, Hebei University of Traditional Chinese Medicine, Shijiazhuang 050000, Hebei Province, China
| | - Chun-Xiao Wu
- Department I of Anorectal, Hebei Traditional Chinese Medicine Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Jun-Yi Sun
- Department of Inspection Center, Hebei Traditional Chinese Medicine Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Hui Xue
- School of Nursing, Hebei University of Traditional Chinese Medicine, Shijiazhuang 050000, Hebei Province, China
| | - Zhe Yuwen
- Department of Perivascular, Hebei Traditional Chinese Medicine Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Jiang-Xue Feng
- Department I of Anorectal, Hebei Traditional Chinese Medicine Hospital, Shijiazhuang 050000, Hebei Province, China
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12
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Jiang ZJ, Peng XD, Wei ZQ, Tang G. Effects of chronic liver disease on the outcomes of simultaneous resection of colorectal cancer with synchronous liver metastases: a propensity score matching study. Front Surg 2023; 10:1184887. [PMID: 37732162 PMCID: PMC10507906 DOI: 10.3389/fsurg.2023.1184887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction Given the rising prevalence of chronic liver disease (CLD), it is increasingly important to understand its impact on surgical outcomes. Our aim was to evaluate the impact of CLD on short-term outcomes in patients with colorectal cancer and synchronous liver metastases undergoing simultaneous surgery. Methods We retrospectively reviewed patients with colorectal cancer and liver metastases who underwent simultaneous resection between January 2013 and June 2022. Patients were divided into the CLD and non-CLD groups. Data regarding short-term surgical outcomes were compared between the two groups. Results A total of 187 patients were included. After propensity score matching, there were 42 patients in each group, and the basic characteristics of the two groups were similar. Patients with CLD had a significantly greater incidence of postoperative complications (47.6% vs. 26.2%; P = 0.042). The operation times of the CLD and non-CLD groups were similar (297 vs. 307.5 min, P = 0.537), and the blood loss was comparable between the two groups (250 vs. 155 ml, P = 0.066). No significant differences were observed between the two groups in pneumonia (P > 0.999), urinary infection rate (P > 0.999), ileus rate (P = 0.474), wound infection rates (P > 0.999), abdominal infection rate (P = 0.533), anastomotic leakage rate (P > 0.999), digestive hemorrhage rate (P > 0.999), bile leakage rate (P > 0.999), hepatic hemorrhage rate (P > 0.999), reoperation rate (P > 0.999), intensive care rate (P > 0.999), or severe liver failure (P > 0.999). There were no deaths in the two groups. CLD significantly prolonged the length of hospital stay (P = 0.011). Discussion CLD is an important factor affecting postoperative complications in patients with colorectal cancer liver metastases undergoing simultaneous surgery. Considering the large number of patients with CLD in China, more attention and medical care should be provided to patients with CLD who require simultaneous resection of colorectal cancer with synchronous liver metastases.
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Affiliation(s)
- Zheng-Jie Jiang
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xu-Dong Peng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zheng-Qiang Wei
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Gang Tang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Biliary Surgical Department of West China Hospital, Sichuan University, Chengdu, China
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13
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Zhang Y, Zhu Y. Development and validation of risk prediction model for sarcopenia in patients with colorectal cancer. Front Oncol 2023; 13:1172096. [PMID: 37576879 PMCID: PMC10416104 DOI: 10.3389/fonc.2023.1172096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Objectives Sarcopenia is associated with a poor prognosis in patients with colorectal cancer. However, the clinical factors that lead to colorectal cancer patients with sarcopenia are still unclear. The objective of this study is to develop and validate a nomogram for predicting the occurrence of sarcopenia and to provide healthcare professionals with a reliable tool for early identification of high-risk patients with colorectal cancer associated sarcopenia. Methods A total of 359 patients diagnosed with colorectal cancer from July 2021 to May 2022 were included. All patients were randomly divided into a training (n = 287) cohort and a validation cohort (n = 72) at the ratio of 80/20. Univariate and multivariate logistic analysis were performed to evaluate the factors associated with sarcopenia. The diagnostic nomogram of sarcopenia in patients with colorectal cancer was constructed in the training cohort and validated in the validation cohort. Various evaluation metrics were employed to assess the performance of the developed nomogram, including the ROC curve, calibration curve, and Hosmer-Lemeshow test. Results Smoking history, drinking history, diabetes, TNM stage, nutritional status, and physical activity were included in the nomogram for the prediction of sarcopenia. The diagnostic nomograms demonstrated excellent discrimination, with AUC values of 0.971 and 0.922 in the training and validation cohorts, respectively. Moreover, the calibration performance of the nomogram is also excellent, as evidenced by the Hosmer-Lemeshow test result of 0.886. Conclusions The nomogram consisting of preoperative factors was able to successfully predict the occurrence of sarcopenia in colorectal cancer patients, aiding in the early identification of high-risk patients and facilitating timely implementation of appropriate intervention measures.
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Affiliation(s)
- Ying Zhang
- College of Nursing, Qingdao University, Qingdao, China
| | - Yongjian Zhu
- College of Nursing, Qingdao University, Qingdao, China
- Nursing Department, Yantai Yuhuangding Hospital, Yantai, China
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14
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Tang G, Pi F, Qiu YH, Wei ZQ. Postoperative parenteral glutamine supplementation improves the short-term outcomes in patients undergoing colorectal cancer surgery: A propensity score matching study. Front Nutr 2023; 10:1040893. [PMID: 37006941 PMCID: PMC10060866 DOI: 10.3389/fnut.2023.1040893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/06/2023] [Indexed: 03/17/2023] Open
Abstract
IntroductionThe clinical utility of glutamine in patients undergoing colorectal cancer (CRC) surgery remains unclear. Therefore, we aimed to investigate the impact of postoperative treatment with glutamine on postoperative outcomes in patients undergoing CRC surgery.MethodsWe included patients with CRC undergoing elective surgery between January 2014 and January 2021. Patients were divided into the glutamine and control groups. We retrospectively analyzed postoperative infections complications within 30 days and other outcomes using propensity score matching and performed between-group comparisons.ResultsWe included 1,004 patients who underwent CRC surgeries; among them, 660 received parenteral glutamine supplementation. After matching, there were 342 patients in each group. The overall incidence of postoperative complications was 14.9 and 36.8% in the glutamine and control groups, respectively, indicating that glutamine significantly reduced the incidence of postoperative complications [p < 0.001; risk ratio (RR) 0.41 [95% CI 0.30–0.54]]. Compared with the control group, the glutamine group had a significantly lower postoperative infection complications rate (10.5 vs. 28.9%; p < 0.001; RR 0.36 [95% CI 0.26–0.52]). Although there was no significant between-group difference in the time to first fluid diet (p = 0.052), the time to first defecation (p < 0.001), first exhaust (p < 0.001), and first solid diet (p < 0.001), as well as hospital stay (p < 0.001) were significantly shorter in the glutamine group than in the control group. Furthermore, glutamine supplementation significantly reduced the incidence of postoperative intestinal obstruction (p = 0.046). Moreover, glutamine supplementation alleviated the decrease in albumin (p < 0.001), total protein (p < 0.001), and prealbumin levels (p < 0.001).ConclusionsTaken together, postoperative parenteral glutamine supplementation can effectively reduce the incidence of postoperative complications, promote the recovery of intestinal function, and improve albumin levels in patients undergoing CRC surgery.
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15
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Tang G, Pi F, Wei Z, Li X. Effect of Glutamine on Short-term Surgical Outcomes in Rectal Cancer Patients Receiving Neoadjuvant Therapy: A Propensity Score Matching Study. Nutr Cancer 2023; 75:1254-1262. [PMID: 36920049 DOI: 10.1080/01635581.2023.2189046] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
The effect of glutamine on postoperative complications and postoperative recovery in rectal cancer (RC) patients receiving neoadjuvant therapy (NT) is unclear. This study aimed to investigate the effects of intravenous glutamine supplementation on short-term postoperative outcomes in these patients. This retrospective study included patients with RC who received NT and underwent radical surgery between January 2013 and July 2022 and were either administered glutamine (glutamine group) or not administered glutamine (non-glutamine group). Propensity score matching method was used to analyze and compare postoperative complications and other outcome indicators. A total of 208 patients were reviewed, and 53 were included in each group post matching. While no significant difference in the time to first solid food intake between the two groups was observed, the glutamine group had a significantly reduced incidence of postoperative complications, shorter length of hospital stay, and shorter time to first defecation, first exhaust, and first fluid diet intake than those of the control group. Moreover, glutamine alleviated the reduction in albumin and prealbumin levels. Perioperative parenteral glutamine supplementation effectively reduces the incidence of postoperative complications, promotes postoperative recovery, and improves albumin levels in patients undergoing RC surgery and receiving NT.
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Affiliation(s)
- Gang Tang
- Department of gastrointestinal surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Pi
- Department of gastrointestinal surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhengqiang Wei
- Department of gastrointestinal surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiangshu Li
- Department of gastrointestinal surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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16
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Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications. J Clin Med 2023; 12:jcm12041489. [PMID: 36836024 PMCID: PMC9966470 DOI: 10.3390/jcm12041489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/30/2022] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Rectal cancer (RC) is one of the deadliest malignancies worldwide. Surgery is the most common treatment for RC, performed in 63.2% of patients. The type of surgical approach chosen aims to achieve maximum residual function with the lowest risk of recurrence. The selection is made by a multidisciplinary team that assesses the characteristics of the patient and the tumor. Total mesorectal excision (TME), including both low anterior resection (LAR) and abdominoperineal resection (APR), is still the standard of care for RC. Radical surgery is burdened by a 31% rate of major complications (Clavien-Dindo grade 3-4), such as anastomotic leaks and a risk of a permanent stoma. In recent years, less-invasive techniques, such as local excision, have been tested. These additional procedures could mitigate the morbidity of rectal resection, while providing acceptable oncologic results. The "watch and wait" approach is not a globally accepted model of care but encouraging results on selected groups of patients make it a promising strategy. In this plethora of treatments, the radiologist is called upon to distinguish a physiological from a pathological postoperative finding. The aim of this narrative review is to identify the main post-surgical complications and the most effective imaging techniques.
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Solow M, Perry TE. Multimodal prehabilitation program valuation for thoracic surgical patients. Curr Opin Anaesthesiol 2023; 36:61-67. [PMID: 36550606 DOI: 10.1097/aco.0000000000001212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Modifiable patient-related risk factors, such as physical, emotional, and cognitive frailty, poor nutritional status, sleep hygiene, anemia, alcohol abuse, and smoking reduce a patient's ability to effectively recover from the insult of surgery. Herein, we review the value of implementing a comprehensive prehabilitation program for patients undergoing thoracic surgery. RECENT FINDINGS Although prehabilitation is not a novel concept, recent evidence suggest that 4-6 weeks of prehabilitation prior to surgery is likely to increase a patient's preoperative functional status allowing patients to return to independence earlier after surgery. The value of a prehabilitation program can be determined using cost effectiveness analysis, cost-benefit analysis (CBA), cost-utility analysis (CUA), and cost-consequence analysis (CCA). SUMMARY It stands to reason that well designed prehabilitation programs can add value by improving quality metrics at a lower cost to our healthcare system. Definitive randomized trials are needed to confirm this notion.
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Affiliation(s)
- Maxamillian Solow
- Division of Cardiothoracic Anesthesia, Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota, USA
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18
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Li N, Liu Y, Chen H, Sun Y. Efficacy and Safety of Enhanced Recovery After Surgery Pathway in Minimally Invasive Colorectal Cancer Surgery: A Systemic Review and Meta-Analysis. J Laparoendosc Adv Surg Tech A 2023; 33:177-187. [PMID: 36074099 DOI: 10.1089/lap.2022.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Enhanced recovery after surgery (ERAS) has been proven valuable for colorectal cancer (CRC) patients who received traditional surgery. While for those receiving minimally invasive surgery (MIS), its efficacy and safety remain debatable. Materials and Methods: Databases, including PubMed, EMBASE, Cochrane libraries, and Web of science, were searched for relevant articles from their inception to February 23, 2022. Eligible articles were subjected to quality assessment and data extraction. The comparison between ERAS and traditional care (TC) was performed. Primary outcomes of this study were postoperative length of stay (LOS), postoperative complications, and mortality. Secondary outcomes were 30-day readmission, 30-day reoperation, time to the first anal exhaust, and defecation. Results: Thirteen cohort studies covering 4308 patients were included. Patients in the ERAS group had significantly shorter LOS (weight mean differences [WMD]: -1.89; 95% confidence interval [CI]: -2.33 to -1.45; P < .001), lower incidence of postoperative complications (risk ratios [RR]: 0.73; 95% CI: 0.5-0.88; P < .001), lower 30-day readmission rate (RR: 0.75; 95% CI: 0.61-0.92; P < .05), and shorter time to the first defecation (WMD: -1.93; 95% CI: -3.26 to -0.59; P < .001), but unimproved mortality, reoperation rate, and time to the first anal exhaust (P > .05) compared with those in the TC group. Conclusions: ERAS was effective and safe for CRC patients receiving MIS from a real-world perspective. Hence, the implementation of ERAS should be recommended for minimally invasive CRC surgery. Clinical Trial Registration Number: CRD42022321333.
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Affiliation(s)
- Niu Li
- Department of Gastrointestinal Surgery and The First Hospital, China Medical University, Shenyang, People's Republic of China
| | - Yanbiao Liu
- Department of Breast Surgery, The First Hospital, China Medical University, Shenyang, People's Republic of China
| | - Huijuan Chen
- Department of Gastrointestinal Surgery and The First Hospital, China Medical University, Shenyang, People's Republic of China
| | - Yefei Sun
- Department of Gastrointestinal Surgery and The First Hospital, China Medical University, Shenyang, People's Republic of China
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NCAPG deregulation indicates poor patient survival and contributes to colorectal carcinogenesis. Pathol Res Pract 2023; 241:154238. [PMID: 36442414 DOI: 10.1016/j.prp.2022.154238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/09/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
Colorectal cancer (CRC) is one of the types of cancers with a high incidence and is ranked the 3rd among men and 2nd among women worldwide. The purpose of this study was to investigate the correlation between non-SMC condensin I complex subunit G (NCAPG) and the prognosis of CRC and its function in CRC cells. The expression of NCAPG in colorectal tissues and cells was detected by immunoblotting and immunohistochemistry. Kaplan-Meier analysis was used to analyze the correlation between NCAPG and CRC prognosis. RNAi technology was used to investigate how NCAPG inhibition affected the proliferation and migration of CRC cells. Overexpression of NCAPG was positively correlated with several clinicopathologic characteristics, including T stage (P = 0.0198), M stage (P = 0.0005), and TNM stage (P < 0.0001). Kaplan-Meier analysis showed that the overexpression of NCAPG was also negatively correlated with disease-free survival and overall survival. In the culture of CRC cells, the knockdown of NCAPG inhibited the proliferation, migration, and invasion of the cells. Meanwhile, it was also found that NCAPG knockdown could interfere with G2/M-G1 transition in the cell cycle, resulting in the inhibition of cell proliferation. The overexpression of NCAPG may serve as a candidate biomarker for CRC prognosis. NCAPG is also a potential therapeutic target for CRC.
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Value of different anastomoses in laparoscopic radical right hemicolectomy for right-sided colon cancer: retrospective study and literature review. World J Surg Oncol 2022; 20:318. [PMID: 36171623 PMCID: PMC9520856 DOI: 10.1186/s12957-022-02789-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/21/2022] [Indexed: 01/19/2023] Open
Abstract
Background This study aimed to analyze the safety of circular lateral anastomosis and cross-lateral anastomosis in laparoscopic radical resection of right-sided colon cancer. Methods From January 2018 to March 2021, 147 patients with right-sided colon cancer were admitted to the Department of General Surgery, Cancer Hospital, Zhengzhou University. The experimental group comprised patients with circular lateral anastomosis, whereas the control group comprised patients with cruciform lateral anastomosis. The general clinical data, intraoperative features, and postoperative results of the two groups were compared and analyzed. Results Both groups successfully underwent laparoscopic lateral ileocolic anastomosis, with significant differences in anastomotic leakage (χ2=4.520, P < 0.05). By contrast, body mass index (t = 1.568, P = 0.119), histological typing (χ2 = 2.067, P = 0.559), intraoperative bleeding (t = 0.418, P = 0.677), and intestinal obstruction (χ2 = 2.564, P = 0.109) were not significantly different between the groups (P > 0.05). Conclusions In laparoscopic-assisted radical hemicolectomy for right-sided colon cancer, the incidence of postoperative anastomotic leakage was lower with circular lateral anastomosis than with cross-lateral anastomosis, and circular lateral anastomosis was superior to cross-lateral anastomosis in terms of reducing the length of hospital stay and improving patients' postoperative quality of life.
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Zhang X, Yang Z, Meng C, Gao J, Liu Y, Shi B, Sun L, Wu G, Yao H, Zhang Z. Abdomen anatomic characteristics on CT scans as predictive markers for short-term complications following radical resection of colorectal cancer. Front Surg 2022; 9:899179. [PMID: 35923439 PMCID: PMC9339639 DOI: 10.3389/fsurg.2022.899179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/30/2022] [Indexed: 12/24/2022] Open
Abstract
BackgroundPrediction and management of short-term postoperative complications in patients with colorectal cancer are essential in postoperative rehabilitation. Through CT scan images, we can easily measure some parameters of abdomen anatomic characteristics. This study aimed to assess whether there is a relationship between the abdomen anatomic characteristics and short-term postoperative complications.Materials and methodsWe conducted a retrospective study. Eighty patients in each complication group and non-complication group were recruited with propensity score match. Demographics, perioperative laboratory results and surgical information were collected and compared between groups with univariate analysis. Significant elements were brought into subsequent logistic regression analysis and ROC analysis for further identification.ResultsUnivariate analysis showed that preoperative white blood cells, preoperative neutrophil counts, rectus abdominis thickness (RAT), subcutaneous fat thickness (SFT), and abdomen depth (AD) were significantly different between the complication group and non-complication group. Logistic regression analysis demonstrated that higher RAT (p = 0.002), SFT (p < 0.001) and AD (p < 0.001) independently predicted the incidence of short-term postoperative complications.ConclusionsIn this study on patients undergoing radical resection of colorectal cancer, abdomen anatomic characteristics including higher RAT, SFT and AD are associated with an increased risk of short-term postoperative complications.
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Affiliation(s)
| | | | | | | | | | | | | | - Guocong Wu
- Correspondence: Guocong Wu Hongwei Yao Zhongtao Zhang
| | - Hongwei Yao
- Correspondence: Guocong Wu Hongwei Yao Zhongtao Zhang
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22
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Cheng Z, Jiang S, Tao R, Ge H, Qin J. Activating transcription factor 3-activated long noncoding RNA forkhead box P4-antisense RNA 1 aggravates colorectal cancer progression by regulating microRNA-423-5p/nucleus accumbens associated 1 axis. Bioengineered 2022; 13:2114-2129. [PMID: 35034547 PMCID: PMC8973600 DOI: 10.1080/21655979.2021.2023798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Long noncoding RNAs (lncRNAs) have vital roles in the progression of colorectal cancer (CRC). Forkhead box P4-antisense RNA 1 (FOXP4-AS1) showed a potential unfavorable prognostic factor for CRC, while its underlying mechanism remains elusive. Thus, the goal of this research is to determine mechanism of FOXP4-AS1 in CRC occurrence and development. Herein, a Dual-luciferase reporter assay was performed to assess the regulation of miR-423-5p to nucleus accumbens-associated protein 1 (NACC1) and activating transcription factor 3 (ATF3) to FOXP4-AS1 promoter. Hematoxylin-eosin (H&E) staining was performed to detect the pathological changes of tumor tissues. Flow cytometry, cell counting kit 8, Transwell, and wound healing assays were conducted to assess apoptosis, proliferation, migration, and invasion of CRC cells, respectively. The results showed that FOXP4-AS1 was highly expressed in CRC cell lines and tissues. CRC progression was promoted by the overexpression of FOXP4-AS1 in HTC116 cells and animal models. Furthermore, FOXP4-AS1 served as a molecular sponge for miR-423-5p, and NACC1 is a direct target of miR-423-5p. MiR-423-5p silencing or overexpression of NACC1 increased proliferation, migration, and invasion of HCT116 cells while suppressing apoptosis. We also found that the upregulation of FOXP4-AS1 was activated by ATF3 in CRC cells. Collectively, our results demonstrated that ATF3-activated FOXP4-AS1 aggravates CRC progression by regulating miR-423-5p/NACC1 axis, indicating a new target for CRC treatment.
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Affiliation(s)
- Zhouyang Cheng
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, JS, China
| | - Song Jiang
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, JS, China
| | - Ran Tao
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, JS, China
| | - Haipeng Ge
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, JS, China
| | - Jun Qin
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, JS, China
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Bektaş M, Tuynman JB, Costa Pereira J, Burchell GL, van der Peet DL. Machine Learning Algorithms for Predicting Surgical Outcomes after Colorectal Surgery: A Systematic Review. World J Surg 2022; 46:3100-3110. [PMID: 36109367 PMCID: PMC9636121 DOI: 10.1007/s00268-022-06728-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Machine learning (ML) has been introduced in various fields of healthcare. In colorectal surgery, the role of ML has yet to be reported. In this systematic review, an overview of machine learning models predicting surgical outcomes after colorectal surgery is provided. METHODS Databases PubMed, EMBASE, Cochrane, and Web of Science were searched for studies using machine learning models for patients undergoing colorectal surgery. To be eligible for inclusion, studies needed to apply machine learning models for patients undergoing colorectal surgery. Absence of machine learning or colorectal surgery or studies reporting on reviews, children, study abstracts were excluded. The Probast risk of bias tool was used to evaluate the methodological quality of machine learning models. RESULTS A total of 1821 studies were analysed, resulting in the inclusion of 31 articles. A vast proportion of ML algorithms have been used to predict the course of disease and response to neoadjuvant chemoradiotherapy. Radiomics have been applied most frequently, along with predictive accuracies up to 91%. However, most studies included a retrospective study design without external validation or calibration. CONCLUSIONS Machine learning models have shown promising potential in predicting surgical outcomes after colorectal surgery. However, large-scale data is warranted to bridge the gap between calibration and external validation. Clinical implementation is needed to demonstrate the contribution of ML within daily practice.
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Affiliation(s)
- Mustafa Bektaş
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Jurriaan B. Tuynman
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Jaime Costa Pereira
- Department of Computer Science, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands
| | - George L. Burchell
- Medical Library, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Donald L. van der Peet
- Department of Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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