Higher one-year mortality rates were observed in elderly patients undergoing surgery for clinical T4 and locally recurrent rectal cancer. Factors associated with increased mortality included preoperative anemia, total pelvic exenteration, pulmonary complications, and higher grade complications. The main causes of death were failure to recover and disease recurrence. Tailoring treatment for these patients should consider […]
Category: Intestine and Lower Gastrointestinal Tract
Self-Expanding Metallic Stenting Emerges as Safe Alternative for Left-Sided Colonic Obstruction
Emergency colonic resection has long been the standard treatment for left-sided malignant colonic obstruction, but self-expanding metallic stenting and decompressing stomas are emerging as viable alternatives. A systematic review and network meta-analysis of randomized controlled trials and propensity score matching studies found that stenting and stomas both significantly reduced permanent stoma rates, with stenting also […]
Middle Eastern Study Highlights Non-Operative Management of Epiploic Appendagitis
Epiploic appendagitis (EPA) is a rare, self-limiting acute abdominal disorder that is mostly treated non-operatively. A retrospective analysis of 156 cases in a Middle Eastern country showed that EPA primarily affects males with a mean age of 33 years. Computerized tomographic scans were the main diagnostic tool, with surgery required in only a few cases. […]
Salvage Surgery Vital for Primary Ileal Pouch Leaks
Primary ileal pouch leaks after IPAA procedures are infrequent but challenging complications. Despite attempts at nonoperative management, success rates are limited. Salvage surgery has a high pouch retention rate, emphasizing its importance in leak management. A retrospective study at Cleveland Clinic over 27 years found that patients diagnosed with leaks after IPAA procedures had an […]
Religion rarely addressed in preoperative stoma counseling
Healthcare providers at a high-volume academic institution lack training on addressing religious beliefs impacting patients undergoing stoma surgery, with only 35% reporting training on how stomas interact with faith practices. Religious services are rarely present during counseling sessions, and interviewees note difficulties in discussing religious beliefs during preoperative sessions. Lack of support and awareness about […]
Centralization of Cytoreductive Surgery Alone Improves Perioperative Outcomes for Colorectal Peritoneal Metastases
Centralization of cytoreductive surgery alone for colorectal peritoneal metastases improved 90-day postoperative mortality and failure-to-rescue rates. High-volume centers showed lower mortality rates compared to low-volume and no-hipec centers. After the Prodige 7 trial, there was a drastic decrease in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy rates in cancer centers, while patients treated with cytoreductive surgery […]
Higher social vulnerability linked to reduced surgery access and increased mortality in localized colon cancer patients.
The study aimed to investigate the impact of social vulnerability on treatment and survival outcomes in localized colon cancer patients. They found that higher social vulnerability was associated with reduced odds of receiving surgery and increased mortality. Patients under the age of 65 were particularly sensitive to variations in social vulnerability. These results underscore the […]
Key Factors Impacting Timely Receipt of Appropriate Surgery for Stage 3 Colon Cancer
Research found that patients who are non-Hispanic white, younger, have fewer comorbidities, lower household income, and receive surgery at a community cancer program within 50 miles of their primary residence are more likely to undergo timely surgery for stage 3 colon cancer. These factors play an important role in reducing the time to surgery and […]
Same-Day Ileostomy Closure Discharge Reduces Costs without Compromising Outcomes
Same-day discharge diverting loop ileostomy closure (SDD) demonstrated a significant reduction in median index episode hospitalization and 30-day post-operative costs compared to standard inpatient enhanced recovery protocol, saving $4,827 per patient. Complication rates, readmission, and reoperation rates were similar between groups. Implementing SDD for ileostomy closure offers substantial cost savings and potentially improves healthcare resource […]
Association of National Accreditation Program for Rectal Cancer Accreditation with Lower Morbidity and Mortality Rates after Surgery
NAPRC-accredited hospitals have lower risk-adjusted in-hospital, 30-day, and 1-year mortality rates, as well as lower 30-day complication rates, compared to non-accredited hospitals among Medicare beneficiaries undergoing proctectomy for rectal cancer. Patients at accredited hospitals were more likely to receive minimally invasive procedures and had higher rates of sphincter preservation, pointing to higher quality surgical care […]