Ambulatory colectomy for cancer: Results from a prospective bicentric study of 177 patients.

Autor: Seux H; Department of Digestive Surgery, Hôpital Européen, Marseille, France., Gignoux B; Department of Digestive Surgery, Clinique de La Sauvegarde, Lyon, France., Blanchet MC; Department of Digestive Surgery, Clinique de La Sauvegarde, Lyon, France., Frering V; Department of Digestive Surgery, Clinique de La Sauvegarde, Lyon, France., Fara R; Department of Digestive Surgery, Hôpital Européen, Marseille, France., Malbec A; Department of Digestive Surgery, Hôpital Européen, Marseille, France., Darnis B; Department of Digestive Surgery, Clinique de La Sauvegarde, Lyon, France., Camerlo A; Department of Digestive Surgery, Hôpital Européen, Marseille, France.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2023 Mar; Vol. 127 (3), pp. 434-440. Date of Electronic Publication: 2022 Oct 26.
DOI: 10.1002/jso.27130
Abstrakt: Background: The implementation of an Enhanced Recovery After Surgery programme after colectomy reduces postoperative morbidity and shortens the length of hospital stay.
Objective: To evaluate the short and midterm outcomes of ambulatory colectomy for cancer.
Methods: This was a two-centre, observational study of a database maintained prospectively between 2013 and 2021. Short-term outcome measures were complications, admissions, unplanned consultations and readmission rates. Midterm outcome measures were the delay between surgery and initiation of adjuvant chemotherapy, length of disease-free survival and 2-year disease-free survival rate.
Results: A total of 177 patients were included. The overall morbidity rate was 15% and the mortality rate was 0%. The admission rate was 13% and 11% patients left hospital within 24 h of surgery. The readmission rate was 9% and all readmissions occurred before postoperative Day 4. Eight patients underwent repeat surgery because of anastomotic fistula (n = 7) or anastomotic ileocolic bleeding (n = 1). These patients had an uneventful recovery. Sixty-one patients required adjuvant chemotherapy with a median delay between surgery and chemotherapy initiation of 35 days.
Conclusions: Ambulatory colectomy for cancer is feasible and safe. Adjuvant chemotherapy could be initiated before 6 weeks postsurgery. The ambulatory approach may be a step forward to further improve morbidity and oncologic prognosis.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE