- Email: [email protected]
Mo1628 One-Stage Colectomy With Intraoperative Colonic Irrigation for Acute Left-Sided Malignant Colonic Obstruction
higher VFI and SMI than female patients (both p<0.01). Male patients had reduced concentrations of vitamins B1 and B2 in association with reduced SMI (both p<0.05), increased concentrations of vitamin B2, lycopene, a-carotene in association with increased BMI (all p<0.05), increased concentrations of vitamin B2 and zinc in association with increased TFI (both p<0.05), increased concentrations of β-carotene in association with increased VFI (p= 0.043) and increased concentrations of zinc in association with increased SFI (p=0.021). Female patients had reduced concentrations of retinol, vitamins B2 and D in association with reduced SMI and sarcopenia (all p<0.05), increased concentrations of vitamin B2 in association with increased BMI (p=0.026) and increased vitamin C concentrations in association with TFI (p=0.024). Conclusions: Of the micronutrients examined, only vitamin B2 was consistently directly associated with body composition, independent of sex. These results would suggest that other factors may confound the expected association between body composition and blood micronutrient concentrations. It was of interest that vitamin B2 concentrations were measured in red cells rather than plasma. Table 1: The relationship between sex and components of body composition
Table. Comparison of demographics and postoperative outcomes between patients who were readmitted or not
Mann Whitney Mo1627 Predictive Factors and Outcomes of Unplanned Readmissions in a HighVolume Colorectal Unit Cigdem Benlice, Emre Gorgun, Dilara Seyidova-Khoshknabi, Luca Stocchi, Feza H. Remzi
Mo1628
Background: Thirty-day readmission following colorectal surgery occurs frequently and causes a significant financial burden on the healthcare system. The purpose of this study is to analyze demographics and operative outcomes of patients focusing on the readmission status, and identify procedure specific risk factors. Methods: All patients who underwent colon and rectal surgery at the department of colorectal surgery between 01/2011 and 12/ 2013 were identified from our prospectively maintained institutional database. Patients with lost to follow-up or death within 30-day after surgery, and perianal operations were excluded. Demographics and outcomes were compared based on their readmission status. Additionally, readmitted patients were further analyzed for specific readmission related outcomes including; diagnosis, time to readmission and length of readmission stay. Results: A total of 6637 patients met study inclusion criteria with a mean age of 51.2 (±17.1) years [3420 (51.5%) female]. 775 (11.7%) patients were readmitted at least once within 30 days. Most common index procedures related to readmissions were stoma closure (16.3%) and total colectomy (13.5%). Readmitted patients had longer LOS (p<0.001) and operative time (p<0.001), higher intraoperative (p=0.04) and postoperative complication rates (p<0.001) (Table). 89.4 % of readmitted patients had at least one postoperative complication compared to 36 % complication rate of non-readmitted patients (p<0.001). Main readmission diagnoses were gastrointestinal-related causes (31.7%), small bowel obstruction (15.7%), wound complications (10.8%), and dehydration (8.6%). 83% of patients were readmitted to our own department whereas 11% to other services and 6% to an outside hospital. Median readmission LOS was 4 (1-71) days. 54% (N=407) of readmissions occurred within 7 days of discharge. Those readmitted within 7 days had longer length of readmission stay (p=0.008) and higher complication rates related to the index procedure (p=0.03). Conclusion: Implementing best practice cultures to decrease postoperative complication rates may play the most important role in reducing hospital readmissions and improve patient care and overall quality.
Background: One-stage colectomy with intraoperative colonic irrigation (OCICI) may be useful in early resolution of acute left-sided malignant colonic obstruction (ALMCO). However, the clinical benefit of this technique has not yet been investigated. Methods: Between January 2007 and July 2014, 451 patients underwent primary tumor resection for left-sided colon cancer, of whom 25 underwent OCICI for ALMCO. The medical records of the patients who underwent OCICI for ALMCO were compared to 174 medical records of a control population (without ALMCO) who were matched for tumor characteristics. Results: There were no statistically significant differences between the two groups in regard to age, sex, American Society of Anesthesiologists Physical Status (ASA-PS), location of tumor, preoperative CEA levels, and previous abdominal surgeries. The OCICI for ALMCO group was associated with a longer operation time (153±33 versus 111±47 min, p<0.001). However, no significant differences were found in patient morbidity, the duration of the postoperative hospital stay, or the tumor pathology between the two groups. Univariate and multivariate analyses indicated that OCICI for ALMCO did not increase the risk of postoperative morbidity in patients with left-sided colon cancer. Conclusions: OCICI for ALMCO did not increase the rate of morbidity or prolong the hospital stay duration compared to treatment of a control population. Mo1629 Abdominal Adhesions and Pain Six Months After Elective Abdominal Surgery; A Prospective Analysis Chema Strik, Martijn W. Stommel, Richard P. ten Broek, Harry van Goor Background The incidence of chronic postoperative abdominal pain (CPAP) after surgery is estimated at 11%. Intra-abdominal adhesions are the cause of CPAP in 57% of the patients. Diagnosing adhesions as the cause of CPAP is usually done per exclusionem. Due to the mixed results of laparoscopic adhesiolysis as treatment for CPAP their causative relationship has been debated. Studies assessing CPAP after abdominal surgery showed an increased risk for female gender, age, and preoperative anxiety and depression. However, these studies lack data on preoperative health and pain status, or are limited by small patient samples. Additionally, the impact of the presence and severity of adhesions at abdominal surgery on CPAP has never been investigated. Aim To assess the impact of adhesions and to elucidate risk factors for the prevalence of chronic postoperative abdominal pain. Methods Design Prospective cohort study, before surgery and 6 months after discharge patients were asked to complete a pain questionnaire. CPAP was defined as pain impacting social functioning or worse. Univariable and multivariable analyses were used to assess risk factors for CPAP. Settings A single institution Participants Patients participating in the LAPAD study, undergoing elective abdominal surgery Results 518 (78%) out of 662 patients completed pre- and postoperative questionnaires. 330 (64%) patients showed to have adhesions at the time of surgery. 127 (39%) patients with adhesions had intra-abdominal pain before undergoing surgery compared to 51 (27%) patients without adhesions (p = 0.01). 6 months after discharge, 120 (36%) patients with adhesions had abdominal pain versus 64 (34%) patients
S-1155
SSAT Abstracts
SSAT Abstracts
One-Stage Colectomy With Intraoperative Colonic Irrigation for Acute LeftSided Malignant Colonic Obstruction Shimpei Otsuka, Yuji Kaneoka, Atsuyuki Maeda, Yuichi Takayama
Table. Comparison of demographics and postoperative outcomes between patients who were readmitted or not
Mann Whitney Mo1627 Predictive Factors and Outcomes of Unplanned Readmissions in a HighVolume Colorectal Unit Cigdem Benlice, Emre Gorgun, Dilara Seyidova-Khoshknabi, Luca Stocchi, Feza H. Remzi
Mo1628
Background: Thirty-day readmission following colorectal surgery occurs frequently and causes a significant financial burden on the healthcare system. The purpose of this study is to analyze demographics and operative outcomes of patients focusing on the readmission status, and identify procedure specific risk factors. Methods: All patients who underwent colon and rectal surgery at the department of colorectal surgery between 01/2011 and 12/ 2013 were identified from our prospectively maintained institutional database. Patients with lost to follow-up or death within 30-day after surgery, and perianal operations were excluded. Demographics and outcomes were compared based on their readmission status. Additionally, readmitted patients were further analyzed for specific readmission related outcomes including; diagnosis, time to readmission and length of readmission stay. Results: A total of 6637 patients met study inclusion criteria with a mean age of 51.2 (±17.1) years [3420 (51.5%) female]. 775 (11.7%) patients were readmitted at least once within 30 days. Most common index procedures related to readmissions were stoma closure (16.3%) and total colectomy (13.5%). Readmitted patients had longer LOS (p<0.001) and operative time (p<0.001), higher intraoperative (p=0.04) and postoperative complication rates (p<0.001) (Table). 89.4 % of readmitted patients had at least one postoperative complication compared to 36 % complication rate of non-readmitted patients (p<0.001). Main readmission diagnoses were gastrointestinal-related causes (31.7%), small bowel obstruction (15.7%), wound complications (10.8%), and dehydration (8.6%). 83% of patients were readmitted to our own department whereas 11% to other services and 6% to an outside hospital. Median readmission LOS was 4 (1-71) days. 54% (N=407) of readmissions occurred within 7 days of discharge. Those readmitted within 7 days had longer length of readmission stay (p=0.008) and higher complication rates related to the index procedure (p=0.03). Conclusion: Implementing best practice cultures to decrease postoperative complication rates may play the most important role in reducing hospital readmissions and improve patient care and overall quality.
Background: One-stage colectomy with intraoperative colonic irrigation (OCICI) may be useful in early resolution of acute left-sided malignant colonic obstruction (ALMCO). However, the clinical benefit of this technique has not yet been investigated. Methods: Between January 2007 and July 2014, 451 patients underwent primary tumor resection for left-sided colon cancer, of whom 25 underwent OCICI for ALMCO. The medical records of the patients who underwent OCICI for ALMCO were compared to 174 medical records of a control population (without ALMCO) who were matched for tumor characteristics. Results: There were no statistically significant differences between the two groups in regard to age, sex, American Society of Anesthesiologists Physical Status (ASA-PS), location of tumor, preoperative CEA levels, and previous abdominal surgeries. The OCICI for ALMCO group was associated with a longer operation time (153±33 versus 111±47 min, p<0.001). However, no significant differences were found in patient morbidity, the duration of the postoperative hospital stay, or the tumor pathology between the two groups. Univariate and multivariate analyses indicated that OCICI for ALMCO did not increase the risk of postoperative morbidity in patients with left-sided colon cancer. Conclusions: OCICI for ALMCO did not increase the rate of morbidity or prolong the hospital stay duration compared to treatment of a control population. Mo1629 Abdominal Adhesions and Pain Six Months After Elective Abdominal Surgery; A Prospective Analysis Chema Strik, Martijn W. Stommel, Richard P. ten Broek, Harry van Goor Background The incidence of chronic postoperative abdominal pain (CPAP) after surgery is estimated at 11%. Intra-abdominal adhesions are the cause of CPAP in 57% of the patients. Diagnosing adhesions as the cause of CPAP is usually done per exclusionem. Due to the mixed results of laparoscopic adhesiolysis as treatment for CPAP their causative relationship has been debated. Studies assessing CPAP after abdominal surgery showed an increased risk for female gender, age, and preoperative anxiety and depression. However, these studies lack data on preoperative health and pain status, or are limited by small patient samples. Additionally, the impact of the presence and severity of adhesions at abdominal surgery on CPAP has never been investigated. Aim To assess the impact of adhesions and to elucidate risk factors for the prevalence of chronic postoperative abdominal pain. Methods Design Prospective cohort study, before surgery and 6 months after discharge patients were asked to complete a pain questionnaire. CPAP was defined as pain impacting social functioning or worse. Univariable and multivariable analyses were used to assess risk factors for CPAP. Settings A single institution Participants Patients participating in the LAPAD study, undergoing elective abdominal surgery Results 518 (78%) out of 662 patients completed pre- and postoperative questionnaires. 330 (64%) patients showed to have adhesions at the time of surgery. 127 (39%) patients with adhesions had intra-abdominal pain before undergoing surgery compared to 51 (27%) patients without adhesions (p = 0.01). 6 months after discharge, 120 (36%) patients with adhesions had abdominal pain versus 64 (34%) patients
S-1155
SSAT Abstracts
SSAT Abstracts
One-Stage Colectomy With Intraoperative Colonic Irrigation for Acute LeftSided Malignant Colonic Obstruction Shimpei Otsuka, Yuji Kaneoka, Atsuyuki Maeda, Yuichi Takayama