Crohn’s versus Cancer: Comparison of Functional and Surgical Outcomes after Right-Sided Resections

Autor: Alain M. Schoepfer, Nicolas Demartines, Fabian Grass, Martin Hübner, Dieter Hahnloser, Christophe Brunel, Emilie Zhu
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Adenocarcinoma/physiopathology
Adenocarcinoma/surgery
Aged
Colectomy
Colonic Neoplasms/physiopathology
Colonic Neoplasms/surgery
Crohn Disease/physiopathology
Crohn Disease/surgery
Enhanced Recovery After Surgery
Female
Humans
Length of Stay
Middle Aged
Patient Compliance
Postoperative Complications/etiology
Retrospective Studies
Treatment Outcome
Crohn’s disease
Outcome
Right colectomy
Adenocarcinoma
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Crohn Disease
medicine
Pathological
Lymph node
Crohn's disease
business.industry
Weight change
Gastroenterology
Cancer
General Medicine
medicine.disease
Surgery
medicine.anatomical_structure
030220 oncology & carcinogenesis
Colonic Neoplasms
Right Colectomy
030211 gastroenterology & hepatology
business
Cohort study
Zdroj: Digestive diseases, vol. 39, no. 2, pp. 106-112
ISSN: 1421-9875
0257-2753
DOI: 10.1159/000509748
Popis: Background: The objective of this study was to compare functional and surgical outcomes of patients undergoing ileocecal resection for Crohn’s disease (CD) to patients undergoing oncological right colectomy. Methods: Retrospective single-center cohort study including consecutive patients undergoing right colectomy for adenocarcinoma (oncological resection) or CD (mesentery-sparing resection) between July 2011 and November 2017. Outcome measures were pathological details (lymph node yield), postoperative recovery (pain levels, return to flatus and stool, intake of fluids, weight change, and mobilization), and early (30-day) outcomes (surgical/medical complications, hospital stay, readmissions). Results: A total of 195 patients (153 [78%] with cancer and 42 [22%] with CD) were included. Overall compliance with the institutional enhanced recovery protocol was comparable between the 2 groups (compliance ≥70%: 60% in CD patients vs. 62% in cancer, p = 0.458). The adenocarcinoma group had a larger lymph node yield than the CD group (26 ± 13 vs. 2.4 ± 5, respectively, p < 0.001). While the CD group experienced significantly more pain (3.7 ± 1.9/10 vs. 2.8 ± 2.5/10, p = 0.007, patients requiring opioids: 65 vs. 28%, p = 0.001), return of flatus (2.3 ± 1.2 days vs. 2.4 ± 2.8 days, p = 0.642) and stool (4.1 ± 6.0 vs. 3.0 ± 1.8 days, p = 0.292) was no different in both groups. No difference was observed regarding postoperative complications, length of stay, and readmission rate. Conclusion: This study revealed no differences in both functional and surgical outcomes in CD and cancer patients undergoing mesentery-sparing or formal oncological right colectomy, respectively.
Databáze: OpenAIRE
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