A Comprehensive Analysis of Outcome of Colectomy in Colorectal Cancer Patients: An Insight from Private Center from the North of Brazil

Charles Cruz e Silva, Weany Jeniffer Costa da Conceição, Paulo Victor Ataliba Morais, Suellen Emilliany Feitosa Machado, Raissa Norat Vanetta
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Abstract

Aims: to analyze results of partial or total colectomies conducted in colorectal cancer (CRC) patients at a private hospital in Belém, Pará, Brazil. Study Design: The study was cross-sectional, retrospective and descriptive. Place and duration of the study: the study analyzed medical records of CRC patients subjected to either partial or total colectomy at a hospital in Belém between 2018 and 2022. Methods: The research abided by ethical norms including the Norms for Research Involving Humans of the Health National Center. The target population was composed of CRC patients of both sexes. The definitive International Classification Diseases (ICD) C18 and C19 and the following keywords “colorectal cancer”, “colon cancer”, “partial colectomy” and “total colectomy” were used to search the medical records. The analyzed variables were: epidemiologic factors, pre-operative variables, peri-operative and post-operative variables, bleeding, oncological factors, presence of compromised lymph nodes, and early and late complications. Results: After searching the hospital records, it was found that 414 patients were hospitalized with CRC between 2018 and 2022. Of these, 288 were not considered for the study due to the exclusion criteria and, therefore, 122 patients were included in the research. Fistulas were the most common early complication and recurrence the most common late complication with significant association to the presence of positive lymph nodes to pathological staging (p=0.025). Early deaths were most recurrent in stage IV (p=0.003). No statistical relevance was found between the type of colectomy and the presence of early (p=0.906) and late (p=0.237) complications. As for surgeries, conventional surgeries were related to higher rates of complications and prolonged admission. Conclusion: Negative outcomes for CRC patients are related to pathological staging and patients with positive lymph nodes presented the worst results. In addition, robotic surgery and laparoscopy were related to faster recovery and lessened early complications.
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结直肠癌患者结肠切除术结果的综合分析:来自巴西北部私立中心的启示
目的:分析巴西帕拉州贝伦一家私立医院对结直肠癌(CRC)患者进行部分或全部结肠切除术的结果。研究设计:研究为横断面、回顾性和描述性。研究地点和持续时间:研究分析了2018年至2022年期间在贝伦一家医院接受部分或全部结肠切除术的CRC患者的医疗记录。研究方法:研究遵守伦理规范,包括《国家卫生中心人类研究规范》。目标人群由男性和女性 CRC 患者组成。研究人员使用明确的国际疾病分类(ICD)C18 和 C19 以及以下关键词 "结肠直肠癌"、"结肠癌"、"部分结肠切除术 "和 "全结肠切除术 "搜索病历。分析的变量包括:流行病学因素、术前变量、围手术期和术后变量、出血、肿瘤学因素、是否存在受损淋巴结以及早期和晚期并发症。研究结果经过检索医院病历,发现在2018年至2022年期间,有414名患者因CRC住院治疗。其中,288 名患者因排除标准未被考虑纳入研究,因此,122 名患者被纳入研究。瘘管是最常见的早期并发症,复发是最常见的晚期并发症,淋巴结阳性的出现与病理分期有显著关联(P=0.025)。早期死亡以 IV 期复发率最高(P=0.003)。结肠切除术的类型与早期并发症(p=0.906)和晚期并发症(p=0.237)之间没有统计学相关性。至于手术,传统手术的并发症发生率更高,住院时间更长。结论CRC患者的不良预后与病理分期有关,淋巴结阳性的患者预后最差。此外,机器人手术和腹腔镜手术恢复更快,早期并发症更少。
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