Epidural analgesia and mortality after colorectal cancer surgery: A retrospective cohort study
Autor: | Peter Matthiessen, Gary A. Bass, Shahin Mohseni, Wiebke Falk, Hans Hjelmqvist, Maximilian Peter Forssten, Anil Gupta |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Anestesi och intensivvård Colorectal cancer Epidural analgesia Open surgery 03 medical and health sciences symbols.namesake 0302 clinical medicine Minimally invasive surgery Internal medicine Colorectal cancer surgery medicine Poisson regression Mortality Cohort Study Anesthesiology and Intensive Care business.industry Retrospective cohort study General Medicine Perioperative medicine.disease 030220 oncology & carcinogenesis Cohort symbols 030211 gastroenterology & hepatology Surgery business Abdominal surgery |
Zdroj: | Annals of Medicine and Surgery |
ISSN: | 2049-0801 |
Popis: | Background: Epidural analgesia (EA) has been the standard of care after major abdominal surgery for many years. This study aimed to correlate EA with postoperative complications, short- and long-term mortality in patients with and without EA after open surgery (OS) and minimally invasive surgery (MIS) for colorectal cancer. Methods: Patient, clinical and outcome data were obtained from the Swedish Colorectal Cancer Registry and the Swedish Perioperative Registry. All adult patients diagnosed with colorectal cancer without metastases who underwent elective curative MIS or OS for colorectal cancer between January 2016 and December 2018 and who had data recorded in both registries, were included in the study. Data were analyzed for OS and MIS procedures separately. A Poisson regression model was used to investigate the association between EA and the outcomes of interest. Results: Five thousand seven hundred sixty-two patients were included in the study, 2712 in the MIS and 3050 patients in the OS group. After adjusting for patient specific and clinically relevant variables in the regression model, no statistically significant difference in risk for complications; 30-day, 90-day, and up to 3-year mortality following either MIS or OS could be detected between the EA+ and EA-cohorts. Conclusions: In this large study cohort, EA as part of the comprehensive care provided was not associated with a reduction in postoperative complications risk or improved 30-day, 90-day, or 3-year survival after MIS or OS for colorectal cancer. Funding Agency:ALF funding Region Örebro County OLL-880951 Epidural Analgesia for Colorectal Cancer Surgery: Experimental and Clinical studies |
Databáze: | OpenAIRE |
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