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Wang Y, Hu H, Feng C, Liu D, Ding N. Effect of Ultrasound-Guided Quadratus Lumborum Block Preemptive Analgesia on Postoperative Recovery of Patients with Open Radical Colon Cancer Surgery: A Retrospective Study. Cancer Manag Res 2021; 13:6859-6867. [PMID: 34512025 PMCID: PMC8420684 DOI: 10.2147/cmar.s322678] [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: 06/04/2021] [Accepted: 08/21/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the effect of ultrasound-guided quadratus lumborum block (QLB) preemptive analgesia on recovery in colon cancer patients undergoing open radical surgery and provide reference for its clinical application. Methods From July 2019 to June 2020, according to the anesthesia method, 56 patients who received open radical colon surgery were divided into two groups: Group Q (n=27), which received QLB combined general anesthesia, and Group C (n=29), which received general anesthesia only. Both groups were given self-controlled intravenous analgesia pump after surgery. The primary outcome is a series of parameters representing postoperative recovery. The secondary outcome was VAS scores and opioid consumption. Results The first time of getting up, flatus, taking semi-liquid diet and the postoperative hospital stay in Group Q were significantly reduced (P<0.01). The rest and active VAS scores were significantly lower in Group Q (P<0.01). The opioids consumption was significantly decreased in Group Q (P<0.05). Conclusion The application of ultrasound-guided QLB preemptive analgesia in open radical colon cancer surgery can significantly enhance the postoperative analgesia effect, reduce opioid consumption, and accelerate the postoperative recovery of the patients. Clinical Trial Registration Number The Chinese Clinical Trial Registry (ChiCTR-2000034824).
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Affiliation(s)
- Ying Wang
- Department of Operation, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Hongping Hu
- Department of Anesthesiology, The Third People's Hospital of Liaocheng, Liaocheng, People's Republic of China
| | - Chang Feng
- Department of Anesthesiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Dongyi Liu
- Department of Anesthesiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Ning Ding
- Department of Outpatient, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
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Short-Term Outcomes Following Hand-Assisted Laparoscopy for Left-Sided Colon and Rectal Malignancies: Single-Center Experience of 580 Cases. Indian J Surg 2021. [DOI: 10.1007/s12262-021-02868-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Long-term oncologic outcome and risk factors after conversion in laparoscopic surgery for colon cancer. Int J Colorectal Dis 2020; 35:395-402. [PMID: 31872265 DOI: 10.1007/s00384-019-03489-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE The goal of this study was to evaluate the long-term oncologic outcomes after laparoscopic converted surgery for patients with colon cancer. METHODS Retrospective database of consecutive curative-intent laparoscopic-assisted surgery for primary stage I-III colon cancer was reviewed from 2000 to 2013. The patients were divided into non-conversion and conversion groups. The patient characters, operative features, perioperative parameters, pathologic features, and oncologic outcomes were compared. RESULTS A total of 4010 patients were included in the study: 3929 in the non-conversion group and 81 (2%) in the conversion group. The median follow-up period was 63.9 months. There were significant differences in age, preoperative clinical T-stage, and tumor size between the groups. In operative details between the two groups, there were also significant differences in access to surgery, tumor location, cancer obstruction, cancer perforation, and estimated blood loss (P < 0.001). The two most common reasons for conversion were adhesion (n = 37, 46%) and bleeding (n = 21, 26%). Multivariate analysis showed that conversion was an independent predictor of both overall survival (OS) (P < 0.001) and disease-free survival (P = 0.003). The 5-year OS rate of the conversion group was 79.6%, and that of the non-conversion group was 96.2% (P < 0.001). The multivariate predictors of conversion were age, type of surgery, cancer obstruction, cancer perforation, and clinical T-stage. CONCLUSION Conversion to open surgery may affect patient survival and recurrence after laparoscopic-assisted surgery for colon cancer. Our data suggest that conversion is associated with poor outcomes, but we should not hesitate to convert it to patients who have difficulty in laparoscopic surgery.
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Siddiqui J, Young CJ. Thirteen-year experience with hand-assisted laparoscopic surgery in colorectal patients. ANZ J Surg 2019; 90:113-118. [PMID: 31828890 DOI: 10.1111/ans.15578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 10/26/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND We report outcomes on 324 consecutive cases of hand-assisted laparoscopic surgery (HALS) in colorectal patients over 13 years performed by a single surgeon. METHODS A prospectively maintained database was used to identify all patients undergoing HALS colorectal procedures for benign or malignant indications from September 2004 to February 2018, at two major tertiary centres in Sydney, Australia. RESULTS Median age was 64 years, 51% were female and median body mass index was 26. Colorectal cancer (55%), diverticular disease (13%) and polyp related conditions (13%) were common indications. Anterior resection (65%) and right hemicolectomy (18%) were most commonly performed. Median operative time was 244 min (190-300) and 75% of Gelport incisions were Pfannenstiel. Sixty-three percent of colorectal cancer patients had a T3 or T4 cancer. Median tumour size was 35 mm (25-45). Seven percent required conversion to open and 4% a re-operation in the early post-operative period. Thirty-six percent had a post-operative complication, and 11% were major complications. Follow-up extended to 12.8 years and there were 33 late deaths. Being in a high dependency unit or intensive care unit was significant for late mortality (odds ratio 2.8, 95% confidence interval 1.06-7.78, P = 0.037). Three percent developed an incisional hernia and 6% had small bowel obstruction at long-term follow-up. CONCLUSION HALS is an effective technique for both benign and malignant colorectal indications with the added advantage of tactile feedback and a lower rate of conversion to open.
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Affiliation(s)
- Javariah Siddiqui
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Christopher J Young
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
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Dumont F, Muñoz MA, De Franco V, Wernert R, Verriele V, Heyman MF, Kerdraon O, Capitain O, Guerin-Meyer V, Raimbourg J, Senellart H, Hiret S, Raoul JL, Thibaudeau E. Significance of lymph node involvement in local recurrence of colorectal cancer. J Surg Oncol 2019; 120:722-728. [PMID: 31332806 DOI: 10.1002/jso.25631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 06/24/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND There are few data on lymphatic spread concomitant to local recurrence (LR) of colorectal cancer (CRC). The objectives of this study were to determine variables associated with lymphatic spread, to analyze the distribution of LN+, and understand the underlying mechanisms. METHODS A total of 76 patients underwent resection of LR of CRC between January 2007 and December 2018 at Institut cancérologique de l'Ouest and were retrospectively reviewed. RESULTS Twenty-five (32.9%) patients had lymph node (LN) involvement with LR. Lymphatics from the mesocolon-rectum and aorto-iliac compartments were involved in 21%, 20.3% and 18.1%, 20.3% for pelvic and retroperitoneal LRs, respectively. In multivariate analysis, the only predictive factor for LN invasion (LN+) was a primary positive LN status (odds ratio, 5.3; P = .007). Despite a trend toward a worse median overall survival in the LN+ group, the difference was not significant in comparison with the LN- group (46 vs. 57 months; P = 0.31) or with the LN- plus LN not assessed groups (46 months vs not reached; P = .07). CONCLUSIONS LN invasion with LR from CRC is a frequent occurrence without significant impact on survival. The only predictive factor is a primary positive nodal status.
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Affiliation(s)
- Frédéric Dumont
- Department of Surgical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Miguel A Muñoz
- Department of Surgical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Valéria De Franco
- Department of Surgical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Angers, France
| | - Romuald Wernert
- Department of Surgical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Angers, France
| | - Valérie Verriele
- Department of Pathology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Angers, France
| | - Marie-Françoise Heyman
- Department of Pathology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Angers, France
| | - Olivier Kerdraon
- Department of Pathology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Angers, France
| | - Olivier Capitain
- Department of Medical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Angers, France
| | - Véronique Guerin-Meyer
- Department of Medical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Angers, France
| | - Judith Raimbourg
- Department of Medical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Hélène Senellart
- Department of Medical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Sandrine Hiret
- Department of Medical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Jean-Luc Raoul
- Department of Medical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Emilie Thibaudeau
- Department of Surgical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
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