Latest developments in Coloproctology
There are exciting things happening in the world of coloproctology. BDRF will be publishing regular updates about developments in colorectal surgery. You can learn about comparative research of clinical trials, different surgical methods, and much more.
Read below about the advances in colorectal surgery:
The authors aimed to evaluate the impact of IMN combinations of post operative infectious and non-infectious complication, length of stay and mortality in patients undergoing major open GI surgery. RCT’s published between January 1980 and February 2011 comparing isocaloric and isonitrogenous enteral IMN combinations with standard diet were included. The quality of evidence and strength of recommendations were assessed using the GRADE approach. 26 RCT’s enrolling 2496 patients were included. The meta-analysis suggested strong evidence in support of decrease in the incidence of postoperative infectious [risk ratio (RR) (95% confidence interval [CI]): 0.64 (0.55, 0.74)] and length of stay [mean difference (95% CI): −1.88 (−2.91, −0.84 days)] in those receiving IMN. Observed benefit for non-infectious complications [RR (95% CI): 0.82 (0.71, 0.95)] sowed statistical significance but quality of evidence was low and there was no significant benefit on mortality [RR (95% CI): 0.83 (0.49, 1.41)]. IMN is beneficial in reducing postoperative infectious and noninfectious complications and shortening hospital stay in patients undergoing major open gastrointestinal surgery.
Annals of Surgery 2012;255:1060–1068
The authors tested the hypothesis that the amount of blood loss during surgery for colon cancer affected long term survival. All patients undergoing surgery for colon cancer between 1997 and 203 in the health care region of Uppsala/ Örebro were prospectively registered at the regional oncology centre and data on patients who underwent surgery for stage I –III disease were analysed. Patients who died within 6 months were excluded. Hazard rations were calculated with uni and multivariate cox proportional hazard regression and due to co-variation blood loss, blood transfusion and complications were tested in separate analyses. Blood loss >250ml, male gender, complication, >75 years and stage III disease were risk factors doer mortality in both multi and univariate analysis. Peri-operative blood transfusion was shown to be a risk factor in univariate analysis only. The results support the hypothesis that degree of blood loss during surgery for colon cancer is a factor that influences long-term survival.
Annals of Surgery 2012;255:1126–1128
Synopses provided by the schoolofsurgery.org
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