Association Between Intraoperative Blood Glucose and Anastomotic Leakage in Colorectal Surgery

Lieverse, Aloysius G.; Bleeker, Wim; Bootsma, Boukje T; Daams, Freek; Feo, Carlo V.; Hoogstraten, M. J. van; Huisman, Daitlin E.; Jongen, Audrey C. H. M.; Komen, Niels; Kroon, Hidde M.; Lagae, E. A. A. G. L.; Reudink, Muriël; Rooijen, Stefanus J. van; Roumen, R. M. H.; Sammour, Tarik; Slooter, Gerrit D.; Sonneveld, D J A; Stassen, Laurents P. S.; Talsma, A Koen; Targa, Simone; Veltkamp, Sanne C.; Verdaasdonk, Emiel G. G.; Reilingh, T. S. de Vries; Wely, B. van; Reilingh, J. A. Wegdam

doi:10.1007/s11605-021-04933-2

Cited by 9 publications

(10 citation statements)

References 36 publications

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“…e greatest risks for patients with calcaneal fractures are nonhealing wounds, nonunion of the fracture and infection, so it is crucial to fully understand the condition of the diabetic patient and the medication used before surgery [19]. Diabetic patients with poor blood circulation in the heel require additional attention to blood circulation in the distal limb.…”

Section: Discussionmentioning

confidence: 99%

“…Psychological care improves patient compliance, and early functional exercise enhances patients' self-care ability, thereby promoting disease recovery and improving their quality of life. The greatest risks for patients with calcaneal fractures are nonhealing wounds, nonunion of the fracture and infection, so it is crucial to fully understand the condition of the diabetic patient and the medication used before surgery [ 19 ]. Diabetic patients with poor blood circulation in the heel require additional attention to blood circulation in the distal limb.…”

Section: Discussionmentioning

confidence: 99%

“…Diabetes mellitus is associated with a slow recovery. A previous study indicated that patients with intraoperative hyperglycemia had higher anastomotic leakage rates than patients with a normal blood glucose level (12% versus 5%, P < 0.001) [ 19 ]. Therefore, a proper diet was necessitated to ensure enough nutrients for patients and enable better healing and faster recovery.…”

Section: Discussionmentioning

confidence: 99%

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The Efficacy of Targeted Perioperative Management for Diabetic Patients with Traumatic Calcaneal Fractures

Hao

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To assess the efficacy of targeted perioperative management for diabetic patients with traumatic calcaneal fractures. Methods. Between April 2020 and December 2020, 100 diabetic patients with traumatic calcaneal fractures treated in our institution satisfying the inclusion criteria were enrolled and assigned to receive either conventional treatment with surgery or plaster fixation (observation group) or targeted treatment with surgery or plaster fixation (experimental group) via the random number table method, with 50 patients in each group. All eligible patients were followed up for 1 year postoperatively. Outcome measures included length of hospital stay, recovery time, fracture healing, duration of postoperative wound drainage, complication rate, blood glucose, and treatment satisfaction. The Maryland score was used for the assessment of foot function. Results. The duration of postoperative wound drainage, length of hospital stay, and recovery time in the experimental group (3.63 ± 1.04 d, 12.13 ± 3.77 d, and 111.22 ± 16.24 d) were significantly shorter than those in the observation group (5.71 ± 2.34 d, 15.28 ± 4.42 d, 123.10 ± 22.82 d) ( P < 0.01 ). The experimental group obtained a markedly higher complete healing rate versus the observation group ( P < 0.001 ). A significantly lower complication rate was observed in the experimental group than in the observation group ( P < 0.05 ). The Maryland scores results were dichotomized into good (≥75 points) and poor (<75 points). The experimental group showed significantly higher Maryland scores good rate and treatment satisfaction versus the observation group ( P < 0.01 ). The experimental group patients were associated with better postoperative fasting glucose and 2 h postprandial glucose versus those in the observation group ( P < 0.05 ). Conclusion. Targeted treatment in the perioperative management of diabetic patients with traumatic calcaneal fractures significantly promotes the recovery of patients, reduces the incidence of complications, increases treatment satisfaction, and ameliorates the doctor-patient relationship.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Efficacy of Targeted Perioperative Management for Diabetic Patients with Traumatic Calcaneal Fractures

Hao

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Although we found a lower incidence of intraoperative hyperglycemia than in these abovementioned studies, the increased incidence of surgical site infection was observed. Similarly, previous studies showed a high incidence of surgical site infection [4] and anastomotic leakage in colorectal surgery after intraoperative hyperglycemia [5]. Furthermore, Kotagal et al reported that hyperglycemic non-diabetic patients have higher odds of adverse events occurring than those with hyperglycemic diabetes [3].…”

Section: Discussionmentioning

confidence: 76%

“…Intraoperative hyperglycemia is associated with multiple postoperative complications such as myocardial infarction, stroke, and postoperative infection [1][2][3][4][5][6]. However, the impact of intraoperative hyperglycemia has been mainly focused upon in diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study

et al. 2022

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Background Intraoperative hyperglycemia has been associated with multiple postoperative complications such as surgical site infection, myocardial infarction, stroke, and death. These complications are not confined to only diabetic patients. However, the incidence of intraoperative hyperglycemia in non-diabetic patients has not been fully elucidated. Additionally, these patients’ risk factors were not well established in previous studies. Methods Four hundred forty non-diabetic patients who underwent intermediate- to high-risk surgery were included in the study. We prospectively measured the capillary blood glucose level in all patients during surgery. The incidence of intraoperative hyperglycemia was defined as at least one episode of blood glucose level of more than 180 mg/dL. Risk factors for hyperglycemia were assessed using multivariable logistic regression analysis. Results Sixty-five (14.7%) patients developed hyperglycemia during surgery. The independent risk factors for intraoperative hyperglycemia were an American Society of Anesthesiologists status ≥ 3 (odds ratio [OR] 6.09, 95% confidence interval [CI]: 2.67–13.89, p < 0.001), preoperative impaired fasting blood sugar (OR 2.28, 95%CI:1.13–4.61, p = 0.021), duration of anesthesia ≥ 3 h (OR 4.06, 95%CI: 1.23–13.45, p = 0.021), intraoperative hypotension (OR 5.37, 95%CI: 2.35–12.29, p < 0.001), intraoperative blood transfusion (OR 4.35, 95%CI: 2.15–8.79, p < 0.001), and steroid use (OR 2.39, 95%CI: 1.20–4.76, p = 0.013). Surgical site infection was higher in patients with intraoperative hyperglycemia compared with patients without intraoperative hyperglycemia (4 [6.1%] vs. 6 [1.6%], respectively, p = 0.035). Conclusion The incidence of intraoperative hyperglycemia was significant in non-diabetic patients during intermediate- to high-risk surgery. Risk factors should be identified to prevent intraoperative hyperglycemia. Trial registration The study was prospectively registered at https://www.thaiclinicaltrials.org (TCTR20191114001).

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Comprehensive testing of colorectal anastomosis: results of prospective observational cohort study

et al. 2022

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Association Between Intraoperative Blood Glucose and Anastomotic Leakage in Colorectal Surgery

Cited by 9 publications

References 36 publications

The Efficacy of Targeted Perioperative Management for Diabetic Patients with Traumatic Calcaneal Fractures

The Efficacy of Targeted Perioperative Management for Diabetic Patients with Traumatic Calcaneal Fractures

Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study

Comprehensive testing of colorectal anastomosis: results of prospective observational cohort study

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