Impact of Surgical and Anesthetic Procedures after Colorectal Cancer Surgery: A Propensity Score-Matched Cohort Study (The PROCOL Study)
These videos have been matched automatically. Contact us if they are not relevant.
These videos have been matched automatically. Contact us if they are not relevant.
View abstract on PubMed
Summary
This summary is machine-generated.Minimally invasive colorectal surgery reduces complications and hospital stay but doesn't improve survival. However, local anesthetics like epidural analgesia and lidocaine infusion may enhance patient outcomes and reduce recurrence.
Area Of Science
- Oncology
- Surgical Oncology
- Immunology
Background
- Surgical inflammatory pain can suppress anti-tumor immune responses and promote circulating tumor cells.
- Minimally invasive surgeries (MIS) like laparoscopic and robotic procedures may mitigate these effects compared to open laparotomy.
Purpose Of The Study
- To compare oncological outcomes after colorectal resection between MIS and laparotomy.
- To evaluate the impact of surgical approach on postoperative complications, survival, and recurrence.
Main Methods
- Single-center propensity score-matched study of patients undergoing colectomy and rectum resection (July 2017 - December 2019).
- Comparison of 74 laparotomies versus 211 minimally invasive procedures.
- Analysis of overall survival (OS) and recurrence-free survival (RFS) using Cox regression.
Main Results
- MIS group showed significantly less blood loss, shorter hospital stay, and fewer complications at 3 months.
- No significant difference in OS or RFS at 3 years between MIS and laparotomy groups.
- Multivariate analysis identified age and epidural analgesia as predictors for OS, and lidocaine infusion as a predictor for RFS.
Conclusions
- Minimally invasive colorectal surgery improves short-term outcomes (fewer complications, shorter stay) but not long-term prognosis compared to laparotomy.
- Neuraxial anesthesia and intravenous lidocaine infusion may positively influence survival and reduce cancer recurrence.
These videos have been matched automatically. Contact us if they are not relevant.
These videos have been matched automatically. Contact us if they are not relevant.
Related Concept Videos
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
Ascending Colon: Rises upward on the right side of the abdomen.
Transverse Colon: Stretches from the ascending colon across the body to the left side.
Descending Colon: Travels...
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Strictureplasty
Proctocolectomy or total colectomy with ileostomy
Restorative proctocolectomy with Ileal pouch-anal anastomosis
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Vagotomy: This procedure aims to reduce gastric acid secretion by cutting a portion of the vagus nerve. While effective, its frequency has declined due to the availability of effective acid-suppressing medications. It may be performed with or...