Analyzing postoperative complications in colorectal cancer surgery: a systematic review enhanced by artificial intelligence.

IF 1.6 4区医学 Q2 SURGERY Frontiers in Surgery Pub Date : 2024-10-31 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1452223

Dan Andras, Angela Madalina Lazar, Dragoş Crețoiu, Florian Berghea, Dragos Eugen Georgescu, Valentin Grigorean, Simona Raluca Iacoban, Bogdan Mastalier

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Abstract

Introduction: Colorectal cancer stands as a predominant cause of cancer-related mortality worldwide. Despite progressive strides in surgical methodologies, the specter of postoperative complications is very large, significantly impacting both morbidity and mortality rates. This review aims to meticulously examine existing scholarly works to gauge the prevalence, severity, and therapeutic approaches to postoperative complications arising from colorectal cancer surgeries.

Methods: Employing a systematic approach, this study reviewed 135 peer-reviewed publications from the period of 2000-2023. The corpus was organized into categories reflective of the postoperative complications discussed: anastomotic leakage, port-site metastases, small bowel adhesions and obstructions, thrombosis, ileus, postoperative infections, urinary dysfunctions, and cardiovascular dysfunctions. Advanced artificial intelligence tools were leveraged for in-depth literature searches and semantic analyses to pinpoint research lacunae.

Results: The analysis revealed that anastomotic leakage and postoperative infections garnered the majority of academic focus, representing 35% and 25% of the studies, respectively. Conversely, port-site metastases and cardiovascular dysfunctions were less frequently examined, accounting for merely 5% and 3% of the literature. The reviewed studies indicate a disparity in the reported prevalence rates of each complication, oscillating between 3% and 20%. Furthermore, the review identified a dearth of evidence-based management protocols, underscored by a pronounced heterogeneity in treatment guidelines.

Conclusions: The literature is replete with analyses on anastomotic leakage and postoperative infections; however, there exists a glaring scarcity of exhaustive research on other postoperative complications. This review emphasizes the pressing need for uniform treatment guidelines and spotlights areas in dire need of further research, aiming at the comprehensive enhancement of patient outcomes following colorectal cancer surgery.

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分析结直肠癌手术的术后并发症：人工智能增强型系统综述。

导言：结直肠癌是全球癌症相关死亡的主要原因。尽管手术方法在不断进步，但术后并发症的阴影仍然很大，对发病率和死亡率都有很大影响。本综述旨在仔细研究现有的学术著作，以衡量结直肠癌手术术后并发症的发生率、严重程度和治疗方法：本研究采用系统方法，对 2000-2023 年间 135 篇同行评审出版物进行了审查。这些文献按术后并发症的类别进行了分类：吻合口漏、端口部位转移、小肠粘连和梗阻、血栓形成、回肠梗阻、术后感染、排尿功能障碍和心血管功能障碍。利用先进的人工智能工具进行了深入的文献检索和语义分析，以找出研究空白点：分析结果显示，吻合口漏和术后感染是学术界关注的焦点，分别占研究的 35% 和 25%。相反，对端口转移和心血管功能障碍的研究较少，仅占文献的 5%和 3%。综述研究表明，每种并发症的报告发病率都不尽相同，介于 3% 和 20% 之间。此外，综述还发现缺乏循证管理方案，治疗指南的明显异质性也凸显了这一点：结论：关于吻合口漏和术后感染的分析文献比比皆是，但关于其他术后并发症的详尽研究却明显不足。这篇综述强调了制定统一治疗指南的迫切性，并指出了急需进一步研究的领域，旨在全面提高结直肠癌术后患者的治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.