Impact of Postoperative Complications on Survival and Recurrence After Resection of Colorectal Liver Metastases

OBJECTIVE To study the effect of postoperative complications (POC) on overall survival (OS) and disease-free survival (DFS) after surgical resection of colorectal liver metastases (CRLM). SUMMARY BACKGROUND DATA Morbidity rates after liver resection can reach 45%. The negative impact of POC on oncologic outcomes has been reported in various types of cancer, especially colorectal. However, data on the consequences of POC after CRLM resection on long-term survival are scarce. METHODS Eligible studies examining the association between POC after CRLM resection and OS/DFS were sought using the PubMed and Web of Science databases. A random-effects model was used to calculate pooled effect estimat…

Additional file 1 of The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study

Additional file 1: Table 1. Patient and surgery related characteristics. Table 2. Intraoperative venitlatory setting by group.

Intraoperative positive end-expiratory pressure and postoperative pulmonary complications: a patient-level meta-analysis of three randomised clinical trials

BACKGROUND: High intraoperative PEEP with recruitment manoeuvres may improve perioperative outcomes. We re-examined this question by conducting a patient-level meta-analysis of three clinical trials in adult patients at increased risk for postoperative pulmonary complications who underwent non-cardiothoracic and non-neurological surgery. METHODS: The three trials enrolled patients at 128 hospitals in 24 countries from February 2011 to February 2018. All patients received volume-controlled ventilation with low tidal volume. Analyses were performed using one-stage, two-level, mixed modelling (site as a random effect; trial as a fixed effect). The primary outcome was a composite of postoperati…

Physical and Quality of Life Changes in Elderly Patients after Laparoscopic Surgery for Colorectal Cancer—A Prospective Cohort Study

Background—The incidence of colorectal cancer is increasing among elderly people, where postoperative complications are frequent. Methods—We evaluated postoperative physical and quality of life changes in elderly patients undergoing laparoscopic surgery for colorectal cancer. A prospective cohort study was performed in 31 colorectal cancer patients ≥60 years who were scheduled for laparoscopic surgery due to colorectal cancer. Outcomes were measured one month preoperative (T1), three days postoperative (T2) and one month postoperative (T3). Results—The largest early postoperative (from T1 to T2) declines were observed for isometric knee extension strength (33.1%), 30 s …

El Fenómeno de Facilitación y sus implicaciones en al monitorización neuromuscular durante anestesia general

INTRODUCCIÓN: No siempre los anestesiólogos, como el resto de individuos a pesar de la preparación profesional que tengan, son capaces de tomar decisiones basadas en un análisis racional (están sometidos a sesgos cognitivos) sobre todo cuando están sometidos a presiones exteriores como una situación de urgencia o un escenario clínico complejo que se tiene que resolver en poco tiempo. A esto se añade una cierta dificultad intrínseca en la interpretación de datos probabilísticos. Partiendo de datos exclusivamente poblacionales sobre la acción de un fármaco no nos es posible a priori saber cuánto durará la acción del fármaco en un paciente concreto sin ninguna medida suplementaria una vez efec…

Bloqueo neuromuscular residual en la sala de recuperación postanestésica. Análisis secundario del estudio ReCuSS. Estudio observacional transversal de una cohorte multicéntrica

Individualised perioperative open-lung approach versus standard protective ventilation in abdominal surgery (iPROVE): a randomised controlled trial

Background The effects of individualised perioperative lung-protective ventilation (based on the open-lung approach [OLA]) on postoperative complications is unknown. We aimed to investigate the effects of intraoperative and postoperative ventilatory management in patients scheduled for abdominal surgery, compared with standard protective ventilation. Methods We did this prospective, multicentre, randomised controlled trial in 21 teaching hospitals in Spain. We enrolled patients who were aged 18 years or older, were scheduled to have abdominal surgery with an expected time of longer than 2 h, had intermediate-to-high-risk of developing postoperative pulmonary complications, and who had a bod…

A noninvasive postoperative clinical score to identify patients at risk for postoperative pulmonary complications: The air-test score

BACKGROUND: Postoperative pulmonary complications (PPCs) negatively affect morbidity, healthcare costs and postsurgical survival. Preoperative and intraoperative peripheral oxyhemoglobin saturation (SpO2) levels are independent risk factors for postoperative pulmonary complications (PPCs). The air-test assesses the value of SpO2 while breathing room-air. We aimed at building a clinical score that includes the air-test for predicting the risk for PPCs. METHODS: This is a development and validation study in patients -randomly divided into two cohorts- from a large randomized clinical trial (iPROVE) that enrolled 964 intermediate-to-high risk patients scheduled for abdominal surgery. Arterial …

Additional file 2 of The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study

Additional file 2: Table S1. Definition of postoperative pulmonary complications. Table S2. Definition of intraoperative complications. Table S3. Number of data available at each time point. Table S4. Patients demographics and surgery–related characteristics in the matched cohort for type of surgery. Table S5. Intraoperative and postoperative outcomes in matched cohort for type of surgery. Table S6. Mixed multivariable logistic regression in matched cohort for postoperative pulmonary complications. Figure S1. Time weighted average and coefficient of variation calculation. Figure S2. Summary plot of covariate balance for time-weighted ΔP before (red line) and after (blue line) conditioning f…

Bayesian hierarchical nonlinear modelling of intra-abdominal volume during pneumoperitoneum for laparoscopic surgery

Laparoscopy is an operation carried out in the abdomen or pelvis through small incisions with external visual control by a camera. This technique needs the abdomen to be insufflated with carbon dioxide to obtain a working space for surgical instruments' manipulation. Identifying the critical point at which insufflation should be limited is crucial to maximizing surgical working space and minimizing injurious effects. Bayesian nonlinear growth mixed-effects models are applied to data coming from a repeated measures design. This study allows to assess the relationship between the insufflation pressure and the intra--abdominal volume.