Standard and multivisceral colectomy in locally advanced colon cancer
| Autor: | Andranik Aleksanyan, Hovhannes Batikyan, Hmayak Petrosyan, Mushegh А. Sahakyan, Artur M. Sahakyan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Blood transfusion Colorectal cancer medicine.medical_treatment Locally advanced R895-920 morbidity multivisceral 03 medical and health sciences Medical physics. Medical radiology. Nuclear medicine 0302 clinical medicine locally advanced medicine Humans Radiology Nuclear Medicine and imaging Neoplasm Invasiveness Stage (cooking) Colectomy Neoplasm Staging Retrospective Studies business.industry Mortality rate Perioperative Middle Aged medicine.disease colectomy Surgery Oncology colon cancer 030220 oncology & carcinogenesis Colonic Neoplasms 030211 gastroenterology & hepatology Female business Visceral peritoneum Research Article |
| Zdroj: | Radiology and Oncology, Vol 54, Iss 3, Pp 341-346 (2020) Radiology and Oncology |
| ISSN: | 1581-3207 |
| Popis: | Background Management of locally advanced colon cancer (LACC) is challenging. Surgery is the mainstay of the treatment, yet its outcomes remain unclear, especially in the setting of multivisceral resections. The aim of the study was to examine the outcomes of standard and multivisceral colectomy in patients with LACC. Patients and methods Patients demographics, clinical and perioperative data of patients operated within study period 2004–2018 were collected. LACC was defined as stage T4 colon cancer including tumor invasion either through the visceral peritoneum or to the adjacent organs/structures. Accordingly, either standard or multivisceral colectomy (SC and MVC) was performed. Results Two hundred and three patients underwent colectomy for LACC. Of those, 112 had SC (55.2%) and 91 (44.8%) had MVC. Severe morbidity and mortality rates were 5.9% and 2.5%, respectively. MVC was associated with an increased blood loss (200 ml vs. 100 ml, p = 0.01), blood transfusion (22% vs. 8.9%, p = 0.01), longer operative time (180 minutes vs. 140 minutes, p < 0.01) and postoperative hospital stay (11 days vs. 10 days, p < 0.01) compared with SC. The complication-associated parameters were similar. Male gender, presence of ≥ 3 comorbidities, tumor location in the left colon and perioperative blood transfusion were associated with complications in the univariable analysis. In the multivariable model, the presence of ≥ 3 comorbidities was the only independent predictor of complications. Conclusions Colectomy with or without multivisceral resection is a safe procedure in LACC. In experienced hands, the postoperative outcomes are similar for SC and MVC. Given the complexity of the latter, these procedures should be reserved to qualified expert centers. |
| Databáze: | OpenAIRE |
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