Laparoscopic right colectomy: changes in surgical technique and perioperative management allow better postoperative results in a comparative series of 361 patients

Grieco, Michele; Marcellinaro, Rosa; Spoletini, Domenico; Menditto, Rosa; Lisi, Giorgio; Russo, Giulia; Napoleone, Vincenzo; Carlini, Massimo

doi:10.1007/s13304-022-01287-5

Cited by 8 publications

(3 citation statements)

References 28 publications

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“…Unfortunately, only 27.6% of the hospitals were reported to have such minimal volume of procedures in 2015, and more than 10.000 patients were operated on in low volume hospitals, that paradoxically deal more frequently with this type of patients for reasons of proximity, especially for those serving vast rural territories, as already mentioned [ 15 ]. The shift of colon and rectal cancer patients to high-volume surgeons or high-volume urban hospitals has been suggested [ 11 , 12 , 27 ], since high volume hospital are undoubtedly prepared to deal with postoperative complications such as anastomotic leak, that remains the main concern for the surgeon, and sepsis [ 39 , 40 ]. However, in a such widespread oncological disease over the country, the shift of colon and rectal cancer patients to urban high-volume hospitals might have disadvantages for the patients’ safety and comfort in population residing in rural areas and will have an unjustifiable negative impact on health economics.…”

Section: Discussionmentioning

confidence: 99%

Exploring 6 years of colorectal cancer surgery in rural Italy: insights from 648 consecutive patients unveiling successes and challenges

Santoro,

Goglia,

Brighi

et al. 2024

Updates Surg

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The multidisciplinary management of patients suffering from colorectal cancer (CRC) has significantly increased survival over the decades and surgery remains the only potentially curative option for it. However, despite the implementation of minimally invasive surgery and ERAS pathway, the overall morbidity and mortality remain quite high, especially in rural populations because of urban − rural disparities. The aim of the study is to analyze the characteristics and the surgical outcomes of a series of unselected CRC patients residing in two similar rural areas in Italy. A total of 648 consecutive patients of a median age of 73 years (IQR 64–81) was enrolled between 2017 and 2022 in a prospective database. Emergency admission (EA) was recorded in 221 patients (34.1%), and emergency surgery (ES) was required in 11.4% of the patients. Tumor resection and laparoscopic resection rates were 95.0% and 63.2%, respectively. The median length of stay was 8 days. The overall morbidity and mortality rates were 23.5% and 3.2%, respectively. EA was associated with increased median age (77.5 vs. 71 ys, p < 0.001), increased mean ASA Score (2.84 vs. 2.59; p = 0.002) and increased IV stage disease rate (25.3% vs. 11.5%, p < 0.001). EA was also associated with lower tumor resection rate (87.3% vs. 99.1%, p < 0.001), restorative resection rate (71.5 vs. 89.7%, p < 0.001), and laparoscopic resection rate (36.2 vs. 72.6%, p < 0.001). Increased mortality rates were associated with EA (7.2% vs. 1.2%, p < 0.001), ES (11.1% vs. 2.0%, p < 0.001) and age more than 80 years (5.8% vs. 1.9%, p < 0.001). In rural areas, high quality oncologic care can be delivered in CRC patients. However, the surgical outcomes are adversely affected by a still too high proportion of emergency presentation of elderly and frail patients that need additional intensive care supports beyond the surgical skill and alternative strategies for earlier detection of the disease.

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Section: Discussionmentioning

confidence: 99%

Exploring 6 years of colorectal cancer surgery in rural Italy: insights from 648 consecutive patients unveiling successes and challenges

Santoro,

Goglia,

Brighi

et al. 2024

Updates Surg

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“…In addition to the surgical approaches that have radically changed colorectal surgery and perioperative outcomes in patients affected by the early stages of CRC [91][92][93][94][95], the combination of cytoreductive surgery, chemotherapy, and hyperthermic intraperitoneal chemotherapy (HIPEC) in cases of peritoneal metastases achieved a 5-year survival rate of up to 30% [96].…”

Section: Chemotherapy Regimenmentioning

confidence: 99%

Artificial Intelligence to Early Predict Liver Metastases in Patients with Colorectal Cancer: Current Status and Future Prospectives

Avella,

Cappuccio,

Cappuccio

et al. 2023

Life

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Background: Artificial Intelligence (AI)-based analysis represents an evolving medical field. In the last few decades, several studies have reported the diagnostic efficiency of AI applied to Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) to early detect liver metastases (LM), mainly from colorectal cancer. Despite the increase in information and the development of different procedures in several radiological fields, an accurate method of predicting LM has not yet been found. This review aims to compare the diagnostic efficiency of different AI methods in the literature according to accuracy, sensibility, precision, and recall to identify early LM. Methods: A narrative review of the literature was conducted on PubMed. A total of 336 studies were screened. Results: We selected 17 studies from 2012 to 2022. In total, 14,475 patients were included, and more than 95% were affected by colorectal cancer. The most frequently used imaging tool to early detect LM was found to be CT (58%), while MRI was used in three cases. Four different AI analyses were used: deep learning, radiomics, machine learning, and fuzzy systems in seven (41.18%), five (29.41%), four (23.53%), and one (5.88%) cases, respectively. Four studies achieved an accuracy of more than 90% after MRI and CT scan acquisition, while just two reported a recall rate ≥90% (one method using MRI and CT and one CT). Conclusions: Routinely acquired radiological images could be used for AI-based analysis to early detect LM. Simultaneous use of radiomics and machine learning analysis applied to MRI or CT images should be an effective method considering the better results achieved in the clinical scenario.

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“…The five-year relative survival rate for CRC increased by 15%, from 50% in the mid-1970s to 65% during 2012–2018. This trend reflects earlier detection of CRC through routine clinical examinations and screening, more accurate staging through advances in imaging, improvements in surgical techniques, and advances in chemotherapy and radiation [ 5 , 58 , 59 , 60 , 61 , 62 ]. Stage at diagnosis is the most important predictor of survival, with five-year relative survival ranging from 91% for initial disease to 14% for metastatic one.…”

Section: Survivalmentioning

confidence: 99%

Colorectal Cancer: Current Updates and Future Perspectives

Marcellinaro,

Spoletini,

Grieco

et al. 2023

JCM

Self Cite

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Colorectal cancer is a frequent neoplasm in western countries, mainly due to dietary and behavioral factors. Its incidence is growing in developing countries for the westernization of foods and lifestyles. An increased incidence rate is observed in patients under 45 years of age. In recent years, the mortality for CRC is decreased, but this trend is slowing. The mortality rate is reducing in those countries where prevention and treatments have been implemented. The survival is increased to over 65%. This trend reflects earlier detection of CRC through routine clinical examinations and screening, more accurate staging through advances in imaging, improvements in surgical techniques, and advances in chemotherapy and radiation. The most important predictor of survival is the stage at diagnosis. The screening programs are able to reduce incidence and mortality rates of CRC. The aim of this paper is to provide a comprehensive overview of incidence, mortality, and survival rate for CRC.

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Laparoscopic right colectomy: changes in surgical technique and perioperative management allow better postoperative results in a comparative series of 361 patients

Cited by 8 publications

References 28 publications

Exploring 6 years of colorectal cancer surgery in rural Italy: insights from 648 consecutive patients unveiling successes and challenges

Exploring 6 years of colorectal cancer surgery in rural Italy: insights from 648 consecutive patients unveiling successes and challenges

Artificial Intelligence to Early Predict Liver Metastases in Patients with Colorectal Cancer: Current Status and Future Prospectives

Colorectal Cancer: Current Updates and Future Perspectives

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