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Sökning: onr:"swepub:oai:DiVA.org:oru-74248" > β-Blockade in Recta...

β-Blockade in Rectal Cancer Surgery : A Simple Measure of Improving Outcomes

Ahl, Rebecka, 1987- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden
Matthiessen, Peter, (författare)
School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Surgery, Örebro University Hospital, Örebro, Sweden
Fang, Xin, (författare)
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Cao, Yang, Associate Professor, 1972- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Region Örebro län, Clinical Epidemiology and Biostatistics
Sjölin, Gabriel, 1979- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Department of Surgery, Örebro University Hospital, Örebro, Sweden
Lindgren, Rickard, (författare)
Department of Surgery, Örebro University Hospital, Örebro, Sweden
Ljungqvist, Olle, 1954- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Mohseni, Shahin, 1978- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Region Örebro län, Department of Surgery
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2020
Engelska.
Ingår i: Annals of Surgery. - Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 271:1, s. 140-146
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • <p><strong>OBJECTIVE:</strong> To ascertain whether regular β-blocker exposure can improve short- and long-term outcomes after rectal cancer surgery.</p><p><strong>BACKGROUND:</strong> Surgery for rectal cancer is associated with substantial morbidity and mortality. There is increasing evidence to suggest that there is a survival benefit in patients exposed to β-blockers undergoing non-cardiac surgery. Studies investigating the effects on outcomes in patients subjected to surgery for rectal cancer are lacking.</p><p><strong>METHODS:</strong> All adult patients undergoing elective abdominal resection for rectal cancer over a 10-year period were recruited from the prospectively collected Swedish Colorectal Cancer Registry. Patients were subdivided according to preoperative β-blocker exposure status. Outcomes of interest were 30-day complications, 30-day cause-specific mortality, and 1-year all-cause mortality. The association between β-blocker use and outcomes were analyzed using Poisson regression model with robust standard errors for 30-day complications and cause-specific mortality. One-year survival was assessed using Cox proportional hazards regression model.</p><p><strong>RESULTS:</strong> A total of 11,966 patients were included in the current study, of whom 3513 (29.36%) were exposed to regular preoperative β-blockers. A significant decrease in 30-day mortality was detected (incidence rate ratio = 0.06, 95% confidence interval: 0.03-0.13, P &lt; 0.001). Deaths of cardiovascular nature, respiratory origin, sepsis, and multiorgan failure were significantly lower in β-blocker users, as were the incidences in postoperative infection and anastomotic failure. The β-blocker positive group had significantly better survival up to 1 year postoperatively with a risk reduction of 57% (hazard ratio = 0.43, 95% confidence interval: 0.37-0.52, P &lt; 0.001).</p><p><strong>CONCLUSIONS:</strong> Preoperative β-blocker use is strongly associated with improved survival and morbidity after abdominal resection for rectal cancer.</p>

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

beta-blocker
mortality
rectal cancer
surgery

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