Prospective multicentre study of a new bowel obstruction treatment in colorectal surgery: Reduced morbidity and mortality

Fahim, Milad; Dijksman, Lea M.; Derksen, Wouter J.M.; Bloemen, Johanne G.; Biesma, Douwe H.; Smits, Anke B.

doi:10.1016/j.ejso.2021.05.010

Cited by 9 publications

(12 citation statements)

References 26 publications

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Section: Benefits Of Physical Activity On Mortalitymentioning

confidence: 99%

“…Patients with a small bowel obstruction in various chronic diseases, including CD, also seemed to benefit from physical activity. Fahim et al [12] reported no 30-day mortality in a Dutch cohort of 89 patients after a conservative obstruction treatment of 3 weeks, combining 30-min aerobic exercise two times a day, nutritional management, delayed surgery, laxatives, smoking cessation and reduction of alcohol consumption. The authors considered this result lower than the national average in the Netherlands for the same pathology.…”

Section: Potential Benefits Of Physical Activity In Inflammatory Bowe...mentioning

confidence: 99%

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Physical activity in inflammatory bowel disease: benefits, challenges and perspectives

Mareschal

Douissard

Genton

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewPhysical activity is gaining significative interest in the field of inflammatory bowel disease (IBD). In the light of the most recent publications, the present review aims to describe the level of physical activity in adult patients with IBD; describe the current body of evidence on the benefits of physical activity and discuss the challenges and perspectives related to physical activity in this population. Recent findingsRecent studies showed that IBD patients tend to be less active than healthy people. There is growing evidence of a positive impact of physical activity on mortality, quality of life, fatigue, body composition, strength and physical performance. The direct benefits of physical activity on clinical remission and disease activity have recently been observed only in Crohn's disease. Limitations to physical activity related to the disease, such as gastrointestinal and psychological symptoms, need to be considered in this population. Finally, no guidelines are available and there is no evidence regarding the effects of combined physical activity and nutritional support.

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Section: Benefits Of Physical Activity On Mortalitymentioning

confidence: 99%

Section: Potential Benefits Of Physical Activity In Inflammatory Bowe...mentioning

confidence: 99%

Physical activity in inflammatory bowel disease: benefits, challenges and perspectives

Mareschal

Douissard

Genton

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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“…The nutritional status of CRC patients, especially those complicated with obstruction, has received increased attention in the first-line clinical practice, and nutritional therapy plays a key role in comprehensive treatment [ 30 , 31 ]. The nutritional status of patients is generally worse due to the presence of digestive tract obstruction symptoms, and their surgical tolerance, postoperative or post-treatment complication risk, recovery ability, and anti-infection ability are lower than those of patients without obstruction [ 9 , 32 ]. Therefore, we could better assess the status and prognosis of OCRC patients and make more appropriate therapeutic interventions by focusing on pre-treatment nutritional status.…”

Section: Discussionmentioning

confidence: 99%

Modified Naples prognostic score for evaluating the prognosis of patients with obstructive colorectal cancer

Gu,

Deng,

Jiang

et al. 2023

BMC Cancer

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Background Inflammatory, immune, and nutritional status are key factors in obstructive colorectal cancer (OCRC). This study aims to investigate the value of modified Naples prognostic score (M-NPS) in evaluating OCRC prognosis. Methods A total of 196 OCRC patients were retrospectively analyzed to construct M-NPS based on serum albumin (ALB), total cholesterol (CHOL), neutrophil:lymphocyte ratio (NLR), and lymphocyte:monocyte ratio (LMR), and then they were divided into three groups. The Kaplan–Meier (KM) method and Cox proportional hazard regression analysis were performed for overall survival (OS) and disease-free survival (DFS) of OCRC patients. Results Patients with high M-NPS had worse OS and DFS (P = 0.0001, P = 0.0011). Multivariate COX analysis showed that M-NPS was an independent prognostic factor for OCRC patients. Patients in the M-NPS 2 group had significantly worse OS (hazard ratio [HR] = 4.930 (95% confidence interval [95% CI], 2.217–10.964), P < 0.001) and DFS (HR = 3.508 (95% CI, 1.691–7.277), P < 0.001) than those in the 0 group. Conclusion M-NPS was an independent prognostic factor for OCRC patients; it might provide a potential reference for immunonutritional intervention in patients with obstruction.

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“…However, postponing emergency surgery without using stent or stoma may have been more frequently applied in the present study compared to Amelung et al, who included patients that were treated between 2009 and 2013. Postponing surgery without decompressing stoma or the use of stents has recently been described by Fahim et al [ 39 ]. This study showed that obstruction treatment prevented emergency surgery, seeming to be a safe and efficient alternative to emergency surgery.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment and overall survival in patients with right-sided obstructing colon cancer—a nationwide retrospective cohort study

Boeding,

Elferink,

Tanis

et al. 2023

Int J Colorectal Dis

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Purpose The aim of this study was to compare baseline characteristics, 90-day mortality and overall survival (OS) between patients with obstructing and non-obstructing right-sided colon cancer at a national level. Methods All patients who underwent resection for right-sided colon cancer between January 2015 and December 2016 were selected from the Netherlands Cancer Registry and stratified for obstruction. Primary outcome was 5-year OS after excluding 90-day mortality as assessed by the Kaplan-Meier and multivariable Cox regression analysis. Results A total of 525 patients (7%) with obstructing and 6891 patients (93%) with non-obstructing right-sided colon cancer were included. Patients with right-sided obstructing colon cancer (OCC) were older and had more often transverse tumour location, and the pathological T and N stage was more advanced than in those without obstruction (p < 0.001). The 90-day mortality in patients with right-sided OCC was higher compared to that in patients with non-obstructing colon cancer: 10% versus 3%, respectively (p < 0.001). The 5-year OS of those surviving 90 days postoperatively was 42% in patients with OCC versus 73% in patients with non-obstructing colon cancer, respectively (p < 0.001). Worse 5-year OS was found in patients with right-sided OCC for all stages. Obstruction was an independent risk factor for decreased OS in right-sided colon cancer (HR 1.79, 95% CI 1.57–2.03). Conclusion In addition to increased risk of postoperative mortality, a stage-independent worse 5-year OS after excluding 90-day mortality was found in patients with right-sided OCC compared to patients without obstruction.

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Prospective multicentre study of a new bowel obstruction treatment in colorectal surgery: Reduced morbidity and mortality

Cited by 9 publications

References 26 publications

Physical activity in inflammatory bowel disease: benefits, challenges and perspectives

Physical activity in inflammatory bowel disease: benefits, challenges and perspectives

Modified Naples prognostic score for evaluating the prognosis of patients with obstructive colorectal cancer

Surgical treatment and overall survival in patients with right-sided obstructing colon cancer—a nationwide retrospective cohort study

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