Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Short-term outcomes after complete mesocolic excision compared with 'conventional' colonic cancer surgery

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Differential recurrence after laparoscopic incisional hernia repair: importance of a nationwide registry-based mesh surveillance

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Response to: Meticulous surgical technique cannot be replaced by cholangiography

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Fluorescence or X-ray cholangiography in elective laparoscopic cholecystectomy: a randomized clinical trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Closure of the fascial defect during laparoscopic umbilical hernia repair: a randomized clinical trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Associations between blood cultures after surgery for colorectal cancer and long-term oncological outcomes

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Associations between blood cultures after surgery for colorectal cancer and long-term oncological outcomes

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Sår og benigne abdominalkirurgiske hudlidelser

    Publikation: Bidrag til bog/antologi/rapportBidrag til bog/antologiUndervisningpeer review

  3. The clinical implication of the association between hypoxaemia and postoperative troponin I: a reply

    Publikation: Bidrag til tidsskriftKommentar/debatForskningpeer review

  4. The incomplete story of complete mesocolic excision - Authors' reply

    Publikation: Bidrag til tidsskriftLetterForskning

Vis graf over relationer

BACKGROUND: Complete mesocolic excision (CME) seems to be associated with improved oncological outcomes compared with 'conventional' surgery, but there is a potential for higher morbidity.

METHODS: Data for patients after elective resection at the four centres in the Capital Region of Denmark (June 2008 to December 2013) were retrieved from the Danish Colorectal Cancer Group database and medical charts. Approval from a Danish ethics committee was not required (retrospective study).

RESULTS: Some 529 patients who underwent CME surgery at one centre were compared with 1701 patients undergoing 'conventional' resection at the other three hospitals. Laparoscopic CME was performed in 258 (48·8 per cent) and laparoscopic 'conventional' resection in 1172 (68·9 per cent). More extended right colectomy procedures were done in the CME group (17·4 versus 3·6 per cent). The 90-day mortality rate in the CME group was 6·2 per cent versus 4·9 per cent in the 'conventional' group (P = 0·219), with a propensity score-adjusted logistic regression odds ratio (OR) of 1·22 (95 per cent c.i. 0·79 to 1·87). Laparoscopic surgery was associated with a lower risk of mortality at 90 days (OR 0·63, 0·42 to 0·95). Intraoperative injury to other organs was more common in CME operations (9·1 per cent versus 3·6 per cent for 'conventional' resection; P < 0·001), including more splenic (3·2 versus 1·2 per cent; P = 0·004) and superior mesenteric vein (1·7 versus 0·2 per cent; P < 0·001) injuries. Rates of sepsis with vasopressor requirement (6·6 versus 3·2 per cent; P = 0·001) and postoperative respiratory failure (8·1 versus 3·4 per cent; P < 0·001) were higher in the CME group.

CONCLUSION: CME is associated with more intraoperative organ injuries and severe non-surgical complications than 'conventional' resection for colonic cancer.

OriginalsprogEngelsk
TidsskriftThe British journal of surgery
Vol/bind103
Udgave nummer5
Sider (fra-til)581-589
ISSN0007-1323
DOI
StatusUdgivet - apr. 2016

ID: 46016582