Colon cancer – evaluation of complications and risks of planned resections
Authors:
M. Škrovina 1,2; M. Straka 1; E. Holášková 1; J. Bartoš 1; M. Migrová 1; P. Anděl 1; L. Adamčík 1; M. Duda 1,4; R. Soumarová 3; I. Selingerová 5
Authors place of work:
Chirurgické oddělení, Nemocnice Nový Jičín, a. s., Komplexní onkologické centrum Nový Jičín
primář: MUDr. M. Škrovina, Ph. D.
1; I. chirurgická klinika, LF UP a FN Olomouc, přednosta: Prof. MUDr. Č. Neoral, CSc.
2; Onkologické oddělení, Nemocnice Nový Jičín, a. s., Komplexní onkologické centrum Nový Jičín
primář: Doc. MUDr. R. Soumarová, Ph. D., MBA
3; II. chirurgická klinika, LF UP a FN Olomouc, přednosta: Prof. MUDr. P. Bachleda, CSc.
4; Ústav matematiky a statistiky, PřF MU Brno, ředitel: Prof. RNDr. J. Rosický, DrSc.
5
Published in the journal:
Rozhl. Chir., 2014, roč. 93, č. 6, s. 311-316.
Category:
Original articles
Summary
Introduction:
Resection procedures for colorectal cancer are burdened with a relatively high number of complications. The aim of this study is to define risk factors associated with the development of postoperative complications based on retrospective data analysis.
Material and methods:
From January 1
st 2007 to December 31st 2012, 1093 patients underwent surgery for colorectal cancer. Retrospectively, we selected a group of 406 patients who underwent planned, elective colon resection for colon cancer. Open surgery was performed in 158 patients (38.9%), laparoscopic resection in 248 patients (61.1%). Based on initial staging of the disease, there were 85 patients (20.9%) in stage I, 137 patients (33.8%) in stage II, 110 patients (27.1%) in stage III and 74 patients (18.2%) in stage IV. Postoperative complications were evaluated according to Clavien – Dindo classification.
Results:
Grade I complications were observed in 34 patients (8.4%), grade II in 25 patients (6.2%), grade III in 43 patients (10.6%), grade IV in 7 patients (1.7%) and grade V in 8 patients (2.0%). The highest incidence of complications was observed in left colon resection procedures (41.1%), open resections (39.8%), procedures lasting longer than 301 minutes (50%), patients older than 81 years (41.6%) and in procedures performed by the youngest, less experienced surgeon (40.6%).
Conclusion:
Our results confirmed that the type and approach of surgical procedure, patient’s age and surgeon’s experience are risk factors associated with a higher incidence of postoperative complications. High-risk surgical patients should be operated on by experienced surgeon who regularly performs a high number of resection procedures.
Key words:
colon cancer – complications
Zdroje
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