Equivalent Operative Outcomes for Emergency Colon Cancer Resections Among Acute Care Surgeons and Specialists in Colorectal Surgery.
Equivalent Operative Outcomes for Emergency Colon Cancer Resections Among Acute Care Surgeons and Specialists in Colorectal Surgery.
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DOI：
10.1177/00031348211050820
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发表时间：
2022-05
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
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改进的筛查减少了但没有消除结肠癌（CC）紧急手术的需要，其中许多是由急性护理手术（ACS）外科医生进行的。本回顾性综述比较了ACS服务与外科肿瘤学和结直肠服务（SO/CRS）中CC切除术的结局。对2014年至2019年的CC手术进行了回顾性审查。收集切缘状态、癌症分期、淋巴结清扫数量、肿瘤内科随访时间和开始化疗时间的数据。排除了选择舒适护理、接受替代服务或非CC适应症的根治性切除患者以及失访患者。36例ACS患者和269例SO/CRS患者接受了CC切除术。与SO/CC组相比，大多数ACS患者表现为急诊（83.3% vs 1%，P <0.05），并且肿瘤分期更晚期。在转移性疾病的存在、获得的淋巴结数量或术后护理时间（天）和化疗开始时间（天）方面没有统计学显著差异。由于ACS组中存在穿孔的肿瘤，EGS组3例（8%）患者具有阳性切缘，而CRS/SO组6例（2%）患者具有阳性切缘（p <0.05）。尽管急性冠脉综合征患者有急诊表现，但30天或1年死亡率无统计学显著差异。这些研究结果表明，尽管紧急的表现和先进的疾病负担，ACS外科医生提供优质的护理CC患者，无论是在手术室和护理协调。
Improved screening has decreased but not eliminated the need for emergent surgery for colon cancer (CC), many of which are performed by acute care surgery (ACS) surgeons. This retrospective review compares outcomes for CC resections on the ACS service to the surgical oncology and colorectal services (SO/CRS). Retrospective review was performed for CC operations between 2014 and 2019. Data for margin status, cancer stage, number of lymph nodes dissected, time to medical oncology follow-up, and time to initiation of chemotherapy were collected. Patients with curative resection, who chose comfort care, presented on alternative services or with non-CC indications as well as those were lost to follow-up were excluded. 36 ACS patients and 269 SO/CRS patients underwent CC resections. Most ACS patients presented emergently compared to the SO/CC group (83.3% vs 1%, P < .05) as well as with more advanced tumor stage. There were no statistically significant differences for presence of metastatic disease, number of lymph nodes obtained, or time to post-surgical care (in days) and chemotherapy initiation (in days). 3 (8%) EGS patients had positive margins compared to 6 (2%) CRS/SO patients due to the presence of perforated tumors in the ACS group (p < .05). There were no statistically significant differences in 30- day or 1-year mortality despite the emergent presentation of the ACS patients. These findings suggest that despite emergent presentation and advanced disease burden, ACS surgeons provide quality care to CC patients, both in the operating room and in coordination of care.
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影响因子：
3.3
作者：
Miliaras, S E;Trygonis, K;Kiskinis, D
通讯作者：
Kiskinis, D
DOI：
10.1186/1749-7922-9-19
发表时间：
2014-03-21
期刊：
World journal of emergency surgery : WJES
影响因子：
--
作者：
Anantha RV;Brackstone M;Parry N;Leslie K
通讯作者：
Leslie K
影响因子：
9
作者：
Karanicolas, Paul J.;Dubois, Luc;Guyatt, Gordon H.
通讯作者：
Guyatt, Gordon H.
影响因子：
3.4
作者：
Frago, R.;Biondo, S.;Jaurrieta, E.
通讯作者：
Jaurrieta, E.
DOI：
10.1097/ta.0b013e31821e43d2
发表时间：
2011-07-01
影响因子：
--
作者：
Schuster, Kevin M.;McGillicuddy, Edward A.;Davis, Kimberly A.
通讯作者：
Davis, Kimberly A.