1
|
Avellaneda N, Rodrigues Coy CS, Sarubbi Fillmann H, Saad-Hossne R, Muñoz JP, García-Duperly R, Bellolio F, Rotholtz N, Rossi G, Marquez V JR, Cillo M, Lacerda-Filho A, Carrie A, Yuki Maruyama B, Sarubbi Fillmann L, Silvino Craveiro MM, Ferro E, Londoño-Schimmer E, Iglesias A, Bras Harriott C, Campana JP, Londoño Estrada D, Balachandran R, Kotze PG. Risk factors for major complications after surgical treatment of primary ileocecal Crohn's disease. A multicentric Latin American experience. Cir Esp 2023; 101:824-832. [PMID: 37244420 DOI: 10.1016/j.cireng.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Complications after ileocecal resection for Crohn's disease (CD) are frequent. The aim of this study was to analyze risk factors for postoperative complications after these procedures. MATERIALS AND METHODS We conducted a retrospective analysis of patients treated surgically for Crohn's disease limited to the ileocecal region during an 8-year period at 10 medical centers specialized in inflammatory bowel disease (IBD) in Latin America. Patients were allocated into 2 groups: those who presented major postoperative complications (Clavien-Dindo > II), the "postoperative complication" (POC) group; and those who did not, the "no postoperative complication" (NPOC) group. Preoperative characteristics and intraoperative variables were analyzed to identify possible factors for POC. RESULTS In total, 337 patients were included, with 51 (15.13%) in the POC cohort. Smoking was more prevalent among the POC patients (31.37 vs. 17.83; P = .026), who presented more preoperative anemia (33.33 vs. 17.48%; P = .009), required more urgent care (37.25 vs. 22.38; P = .023), and had lower albumin levels. Complicated disease was associated with higher postoperative morbidity. POC patients had a longer operative time (188.77 vs. 143.86 min; P = .005), more intraoperative complications (17.65 vs. 4.55%; P < .001), and lower rates of primary anastomosis. In the multivariate analysis, both smoking and intraoperative complications were independently associated with the occurrence of major postoperative complications. CONCLUSION This study shows that risk factors for complications after primary ileocecal resections for Crohn's disease in Latin America are similar to those reported elsewhere. Future efforts in the region should be aimed at improving these outcomes by controlling some of the identified factors.
Collapse
Affiliation(s)
- Nicolás Avellaneda
- General Surgery Department, Hospital Universitario CEMIC, Argentina; Colorectal Surgery Department, Aarhus University Hospital, Denmark.
| | | | | | | | | | | | - Felipe Bellolio
- Coloproctology Unit, Digestive Surgery Department, Pontíficia Universidad Católica de Chile, Chile
| | - Nicolás Rotholtz
- Colorectal Surgery Service, General Surgery Department, Hospital Aleman de Buenos Aires, Argentina
| | - Gustavo Rossi
- Section of Colorectal Surgery, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Mariano Cillo
- Colorectal Surgery Department, Hospital Británico de Buenos Aires, Argentina
| | | | - Augusto Carrie
- General Surgery Department, Hospital Universitario CEMIC, Argentina
| | - Beatriz Yuki Maruyama
- Colorectal Surgery Unit, Pontificia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
| | | | | | - Ezequiel Ferro
- Colorectal Surgery Department, Nueva Proctología, Argentina
| | | | - Andrés Iglesias
- Coloproctology Unit, Digestive Surgery Department, Pontíficia Universidad Católica de Chile, Chile
| | - Camila Bras Harriott
- Colorectal Surgery Service, General Surgery Department, Hospital Aleman de Buenos Aires, Argentina
| | - Juan Pablo Campana
- Section of Colorectal Surgery, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Paulo Gustavo Kotze
- Colorectal Surgery Unit, Pontificia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
| |
Collapse
|
2
|
Moura RM, Hartmann RM, Licks F, Schemitt EG, Colares JR, do Couto Soares M, Fillmann LS, Fillmann HS, Marroni NP. Antioxidant effect of mesalazine in the experimental colitis model induced by acetic acid. Journal of Coloproctology 2021. [DOI: 10.1016/j.jcol.2016.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Abstract
Introduction Inflammatory bowel disease (IBD) is characterized by a chronic inflammation of the gastrointestinal tract, without specific cause or pathogen.
Objective The effect of mesalazine in a colitis model induced by acetic acid (AA) was evaluated.
Methods We used 40 Wistar rats, ±350 g, divided into 4 groups: control (CO); control + mesalazine (CO + M); colitis (CL) and colitis + M (CL + M) at 24 and 48 h of treatment. The animals received the substances by an intracolonic enema of AA 4% and treatment with mesalazine PO 20 mg/kg after colitis induction.
Results Mesalazine reduced tissue damage in the gut, normalized sphincter anal pressure levels and decreased lipid peroxidation, metabolites of nitric oxide and iNOS and NF-kB expression in the treated groups in both treatment time points (24 and 48 h), as well as the activity of antioxidant enzymes.
Conclusion Mesalazine was effective in reducing tissue damage and oxidative and inflammatory damage, restored antioxidant capacity and increased anal sphincter pressure levels, possibly due to its antioxidant effect.
Collapse
Affiliation(s)
- Rosa Maria Moura
- Universidade Luterana do Brasil (ULBRA), Laboratório de Estresse Oxidativo e Antioxidantes, Canoas, RS, Brazil
| | - Renata Minuzzo Hartmann
- Universidade Federal do Rio Grande do Sul (UFRGS), Pós-graduação em Ciências Médicas, Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Laboratório Experimental de Hepatologia e Gastroenterologia, Porto Alegre, RS, Brazil
| | - Francielli Licks
- Universidade Luterana do Brasil (ULBRA), Laboratório de Estresse Oxidativo e Antioxidantes, Canoas, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Laboratório Experimental de Hepatologia e Gastroenterologia, Porto Alegre, RS, Brazil
| | - Elizângela Gonçalves Schemitt
- Universidade Luterana do Brasil (ULBRA), Laboratório de Estresse Oxidativo e Antioxidantes, Canoas, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Pós-graduação em Ciências Médicas, Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Laboratório Experimental de Hepatologia e Gastroenterologia, Porto Alegre, RS, Brazil
| | - Josieli Raskopf Colares
- Universidade Luterana do Brasil (ULBRA), Laboratório de Estresse Oxidativo e Antioxidantes, Canoas, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Laboratório Experimental de Hepatologia e Gastroenterologia, Porto Alegre, RS, Brazil
| | - Mariana do Couto Soares
- Universidade Luterana do Brasil (ULBRA), Laboratório de Estresse Oxidativo e Antioxidantes, Canoas, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Laboratório Experimental de Hepatologia e Gastroenterologia, Porto Alegre, RS, Brazil
| | | | - Henrique Sarubbi Fillmann
- Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Laboratório Experimental de Hepatologia e Gastroenterologia, Porto Alegre, RS, Brazil
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Norma Possa Marroni
- Universidade Luterana do Brasil (ULBRA), Laboratório de Estresse Oxidativo e Antioxidantes, Canoas, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Pós-graduação em Ciências Médicas, Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Laboratório Experimental de Hepatologia e Gastroenterologia, Porto Alegre, RS, Brazil
| |
Collapse
|
3
|
Freitas BAD, Loth CAT, Swarowsky GL, LourenÇo GM, Fillmann LS, Fillmann HS, Santos ML, Padoin AV. ARE OBESITY AND ADENOMA DEVELOPMENT ASSOCIATED AS COLORECTAL CANCER PRECURSORS? ACTA ACUST UNITED AC 2020; 33:e1500. [PMID: 32667530 PMCID: PMC7357550 DOI: 10.1590/0102-672020190001e1500] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/10/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND One of the most important concerns on health is the increased rates of obesity in population and the speed in which this number is increasing. This number translates a serious public health problem, since it also increases the risk of several other diseases associated with obesity resulting in significant morbidity and mortality. Among them, it seems to be connected to several neoplasms, such as colorectal carcinoma. AIM To evaluate the impact of obesity as a risk factor for colorectal carcinoma through the detection of adenoma, and to discuss the mechanisms that could establish a link between obesity and neoplasm. METHODS Patients who underwent colonoscopy were included. Personal and anthropometric data, clinical history, and results of the tests were analyzed in order to verify the correlation of BMI and the presence of adenomatous polyps. RESULTS A total of 142 patients were studied, which a mean age of 62 years. Of the patients, 74 (52.1%) were men and 68 (47.9%) were. Obesity was identified in 16.2% of the patients. Polyps were found in 61 (42.9%), mostly smaller than 1 cm. Obese individuals were 1.56 times more likely to present colorectal adenoma than patients with normal weight. CONCLUSION This study, although showing the greater presence of colorectal adenomas in obese individuals, did not show a significant difference in the occurrence of pre-malignant lesions.
Collapse
Affiliation(s)
| | | | | | | | - Lucio Sarubbi Fillmann
- Pontifical University do Rio Grande do Sul, School of Medicine, Porto Alegre, RS, Brazil
| | | | - Maria Luiza Santos
- Pontifical University do Rio Grande do Sul, School of Medicine, Porto Alegre, RS, Brazil
| | | |
Collapse
|
4
|
Ghezzi TL, Brum IS, Biolchi V, Garicochea B, Fillmann LS, Corleta OC. Is there any association between TACSTD2, KIAA1253, Ku70 and mutant KRAS gene expression and clinical-pathological features of colorectal cancer? Exp Oncol 2011; 33:28-32. [PMID: 21423092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM To determine the quantitative gene expression of KRAS codon 12 mutant, TACSTD2, Ku70 and SERIN1 in samples of tumor tissue and to relate them with clinical-pathological characteristics of colorectal cancer. METHODS Samples of tumor and normal tissue of patients surgically treated for colorectal cancer between July 2005 and July 2009 were stored in a tissue bank. These samples were studied with the technique of real-time polymerase chain reaction in respect to expression of the following genes: KRAS codon 12 mutation, TACSTD2, Ku70, and SERIN1. RESULTS Tumor samples of 37 patients were studied. The mean age was 65.5 years. Twenty one patients (56.8%) were male. Nine patients (24.3%) were classified as TNM stage I, 11 patients (29.8%) as TNM stage II, eight patients (21.6%) as TNM stage III and nine patients (24.3%) as TNM stage IV. The Ku70 expression in poorly-differentiated tumors is significantly higher than in well and moderately-differentiated tumors (2.76 vs. 1.13; p < 0.05). SERIN1, TACSTD2 and KRAS codon 12 mutation are not associated with clinical-pathological characteristics of colorectal cancer. CONCLUSION Ku70 expression in poorly-differentiated tumors is significantly higher than in well and moderately-differentiated colorectal tumors.
Collapse
Affiliation(s)
- T L Ghezzi
- Postgraduate Program in Medicine: Surgical Sciences, Federal University of Rio Grande do Sul, Ramiro Barcelos Street 2400 , Porto Alegre, RS, 90035-003, Brazil.
| | | | | | | | | | | |
Collapse
|