Rectal cancer: Aspects of post-operative complications

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Sverrisson, IngvarUppsala universitet,Centrum för klinisk forskning, Västerås (författare)

Rectal cancer : Aspects of post-operative complications

BokEngelska2018

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Uppsala :Acta Universitatis Upsaliensis,2018
59 s.
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:uu-362704
ISBN:9789151304694
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-362704URI

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Språk:engelska
Sammanfattning på:engelska

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Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine,1651-6206 ;1505

Anmärkningar

Aim: The overall aim of this thesis was to study post-operative complications in patients with rectal cancer.Methods: Post-operative complications in patients operated for rectal cancer was retrospectively analyzed in three prospective registers; the local rectal cancer registry in the Västmanland County, Sweden, the Swedish Colorectal Cancer Registry (SCRCR) and the National Prostate Cancer Registry (NPCR). In Papers I and II, the focus was on the complication pattern after Hartmann’s procedure (HP). In Paper III, the incidence of parastomal hernia was assessed during a period when no prophylactic mesh was used (1996-2006) compared with a period when a prophylactic mesh was routinely used (2007-2012). In Paper IV, the anastomotic leakage (AL) rate after anterior resection (AR) for rectal cancer patients who had previously received RT for prostate cancer was assessed with combined data from the SCRCR and the NPCR.Results: In Paper I, patients operated with a HP were significantly older, had a higher ASA-score, a poorer WHO performance score and lower serum albumin levels. Few developed pelvic complications. In Paper II, the intra-abdominal infection rate was 8% and the re-laparotomy rate was 10%. Multi-variable logistic regression analysis identified pre-operative radiotherapy as a risk factor for intra-abdominal infections. In Paper III, we found no difference in the rate of parastomal hernia between patients with and without a prophylactic stoma mesh. In Paper IV, we identified 59 out of 188 patients who had undergone previous radiation therapy for prostate cancer who had been operated with AR. Twelve (20%) developed an AL, of whom only one underwent re-laparotomy and there was no 90-day mortality.Conclusion: The rate of serious post-operative complications was low after HP and it seems to be a safe and appropriate alternative in old and frail patients. Pre-operative radiotherapy was a risk factor for intra-abdominal infections in rectal cancer patients operated with a HP. A prophylactic stoma mesh did not reduce the rate of parastomal hernias. In patients that had previously been irradiated for prostate cancer, a minority underwent an AR. These patients were healthy with early cancer stages and, in this selected group of patients, the AL rate was much lower than previously reported.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Rectal cancer
Complications
Anastomotic leakage
Abscess
Parastomal hernia
Prostate cancer
Radiation therapy
Surgery
Kirurgi

Biuppslag (personer, institutioner, konferenser, titlar ...)

Smedh, KennetUppsala universitet,Centrum för klinisk forskning, Västerås,Kolorektalkirurgi(Swepub:uu)kensm722 (preses)
Nikberg, Maziar,1975-Uppsala universitet,Centrum för klinisk forskning, Västerås,Kolorektalkirurgi(Swepub:uu)mazho292 (preses)
Chabok, Abbas,1964-Uppsala universitet,Kolorektalkirurgi,Centrum för klinisk forskning, Västerås(Swepub:uu)abbch956 (preses)
Martling, Anna,ProfessorKarolinska Institutet (opponent)
Uppsala universitetCentrum för klinisk forskning, Västerås (creator_code:org_t)

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Av författaren/redakt...: Sverrisson, Ingv ...; Smedh, Kennet; Nikberg, Maziar, ...; Chabok, Abbas, 1 ...; Martling, Anna, ...

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