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Avellaneda N, Rodrigues Coy CS, Sarubbi Fillmann H, Saad-Hossne R, Muñoz JP, García-Duperly R, Bellolio F, Rotholtz N, Rossi G, Marquez V JR, Cillo M, Lacerda-Filho A, Carrie A, Yuki Maruyama B, Sarubbi Fillmann L, Silvino Craveiro MM, Ferro E, Londoño-Schimmer E, Iglesias A, Bras Harriott C, Campana JP, Londoño Estrada D, Balachandran R, Kotze PG. Risk factors for major complications after surgical treatment of primary ileocecal Crohn's disease. A multicentric Latin American experience. Cir Esp 2023; 101:824-832. [PMID: 37244420 DOI: 10.1016/j.cireng.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Complications after ileocecal resection for Crohn's disease (CD) are frequent. The aim of this study was to analyze risk factors for postoperative complications after these procedures. MATERIALS AND METHODS We conducted a retrospective analysis of patients treated surgically for Crohn's disease limited to the ileocecal region during an 8-year period at 10 medical centers specialized in inflammatory bowel disease (IBD) in Latin America. Patients were allocated into 2 groups: those who presented major postoperative complications (Clavien-Dindo > II), the "postoperative complication" (POC) group; and those who did not, the "no postoperative complication" (NPOC) group. Preoperative characteristics and intraoperative variables were analyzed to identify possible factors for POC. RESULTS In total, 337 patients were included, with 51 (15.13%) in the POC cohort. Smoking was more prevalent among the POC patients (31.37 vs. 17.83; P = .026), who presented more preoperative anemia (33.33 vs. 17.48%; P = .009), required more urgent care (37.25 vs. 22.38; P = .023), and had lower albumin levels. Complicated disease was associated with higher postoperative morbidity. POC patients had a longer operative time (188.77 vs. 143.86 min; P = .005), more intraoperative complications (17.65 vs. 4.55%; P < .001), and lower rates of primary anastomosis. In the multivariate analysis, both smoking and intraoperative complications were independently associated with the occurrence of major postoperative complications. CONCLUSION This study shows that risk factors for complications after primary ileocecal resections for Crohn's disease in Latin America are similar to those reported elsewhere. Future efforts in the region should be aimed at improving these outcomes by controlling some of the identified factors.
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Affiliation(s)
- Nicolás Avellaneda
- General Surgery Department, Hospital Universitario CEMIC, Argentina; Colorectal Surgery Department, Aarhus University Hospital, Denmark.
| | | | | | | | | | | | - Felipe Bellolio
- Coloproctology Unit, Digestive Surgery Department, Pontíficia Universidad Católica de Chile, Chile
| | - Nicolás Rotholtz
- Colorectal Surgery Service, General Surgery Department, Hospital Aleman de Buenos Aires, Argentina
| | - Gustavo Rossi
- Section of Colorectal Surgery, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Mariano Cillo
- Colorectal Surgery Department, Hospital Británico de Buenos Aires, Argentina
| | | | - Augusto Carrie
- General Surgery Department, Hospital Universitario CEMIC, Argentina
| | - Beatriz Yuki Maruyama
- Colorectal Surgery Unit, Pontificia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
| | | | | | - Ezequiel Ferro
- Colorectal Surgery Department, Nueva Proctología, Argentina
| | | | - Andrés Iglesias
- Coloproctology Unit, Digestive Surgery Department, Pontíficia Universidad Católica de Chile, Chile
| | - Camila Bras Harriott
- Colorectal Surgery Service, General Surgery Department, Hospital Aleman de Buenos Aires, Argentina
| | - Juan Pablo Campana
- Section of Colorectal Surgery, Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Paulo Gustavo Kotze
- Colorectal Surgery Unit, Pontificia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
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Arias-Amézquita F, Londoño-Schimmer E, Otero-Bernal JM, Cétares C, Mora M, Burbano A, Gómez-Mayorga JL, Cortés-Murgueitio N. 4-stage management of Peritoneal Malignant Mesothelioma, management of 7 cases at a Clinical Care Center for Peritoneal Neoplasms. Eur J Surg Oncol 2021. [DOI: 10.1016/j.ejso.2020.11.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Arias-Amézquita F, Londoño-Schimmer E, Otero-Bernal JM, Cétares C, Mora M, González L, Gómez-Mayorga JL, Cortés-Murgueitio N. Sclerosing Encapsulating Peritonitis after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Description of 4 Cases. Eur J Surg Oncol 2021. [DOI: 10.1016/j.ejso.2020.11.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Oliveira L, Hagerman G, Torres ML, Lumi CM, Siachoque JAC, Reyes JC, Perez-Aguirre J, Sanchez-Robles JC, Guerrero-Guerrero VH, Regadas SM, Filho VG, Rosato G, Vieira E, Marzan L, Lima D, Londoño-Schimmer E, Wexner SD. Sacral neuromodulation for fecal incontinence in Latin America: initial results of a multicenter study. Tech Coloproctol 2019; 23:545-550. [DOI: 10.1007/s10151-019-02004-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/13/2019] [Indexed: 12/17/2022]
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Trujillo CG, Domínguez C, Robledo D, Caicedo JI, Bravo-Balado A, Cataño JG, Cortés N, Parra L, Riaño W, Londoño-Schimmer E, Otero J, Herrera G, Arias F, Plata M. Urological approach for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in a clinical care center. Acta Chir Belg 2018; 118:348-353. [PMID: 29475412 DOI: 10.1080/00015458.2018.1436797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is associated with significant manipulation of the urinary tract (UT). We aim to describe the urological events and their management in patients who underwent CRS-HIPEC. METHODS Clinical records of patients who underwent treatment between 2007 and 2015 were reviewed. Urological events and their multidisciplinary management were analyzed. Descriptive statistics were calculated. RESULTS A total of 103 patients were included. Mean age was 51 years (SD ± 11.8). Mean peritoneal cancer index (PCI) was 20.4 (SD ± 10.1). Primary tumors included appendicular (64%), gynecological (16%), colorectal (10%), and peritoneal mesotheliomas (9%). Ninety-three percent of patients had bilateral ureteral catheters inserted prior to surgery, without complications. Intraoperative UT injuries occurred in 7% of patients. In 5% of patients, tumor invasion of the bladder was evident at surgery and partial resection and primary repair of the bladder wall was performed. Urological complications included urinary tract infection (UTI) (21%) acute post-renal failure (4%), urinary fistulae (4%), and acute urinary retention (AUR) (1%). CONCLUSIONS In our study, intraoperative UT events and postoperative complications, although not neglectable, were infrequent. Due to the high complexity of these cases, a multidisciplinary approach is mandatory. However, randomized clinical trials are necessary to clarify current data on the need and efficacy of prophylactic ureteral catheterization in patients undergoing CRS-HIPEC.
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Affiliation(s)
- Carlos Gustavo Trujillo
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Cristina Domínguez
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Daniela Robledo
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Juan Ignacio Caicedo
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Alejandra Bravo-Balado
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Juan Guillermo Cataño
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine, Bogotá, Colombia
| | - Natalia Cortés
- Department of Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Lina Parra
- Department of Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Wilson Riaño
- Department of Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Eduardo Londoño-Schimmer
- Department of Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Clinical Care Center for Peritoneal Neoplasms, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Jorge Otero
- Clinical Care Center for Peritoneal Neoplasms, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Department of Oncology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Gabriel Herrera
- Department of Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Clinical Care Center for Peritoneal Neoplasms, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Fernando Arias
- Department of Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Clinical Care Center for Peritoneal Neoplasms, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Mauricio Plata
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine, Bogotá, Colombia
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Arias F, Londoño-Schimmer E, Otero J, Cétares C, Herrera G, Mora M, Rodriguez P, Mejía M, Guerra J, Ruiz-Patiño A, Cardona Zorrilla A. Long-term outcomes with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in peritoneal carcinomatosis: 10-year experience in a developing country. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rojas-Rojas MM, Mejiah M, Mora M, Otero J, Arias-Amézquita F, Londoño-Schimmer E, Rodríguez-Urrego PA. Retroperitoneal Mucinous Neoplasm Arising from Colonic Duplication Cyst. J Gastrointest Cancer 2018; 50:583-585. [PMID: 29388059 DOI: 10.1007/s12029-018-0061-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- María M Rojas-Rojas
- Department of Pathology, Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 # 7-75, Bogotá, Colombia
| | - Marcela Mejiah
- Department of Pathology, Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 # 7-75, Bogotá, Colombia
| | - Martha Mora
- Nursing Department, Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 # 7-75, Bogotá, Colombia
| | - Jorge Otero
- Department of Clinical Oncology, Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 # 7-75, Bogotá, Colombia
| | - Fernando Arias-Amézquita
- Department of Surgery-Subdivision of Peritoneal Diseases, Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 # 7-75, Bogotá, Colombia
| | - Eduardo Londoño-Schimmer
- Department of Surgery-Subdivision of Peritoneal Diseases, Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 # 7-75, Bogotá, Colombia
| | - Paula A Rodríguez-Urrego
- Department of Pathology, Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 # 7-75, Bogotá, Colombia.
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Baena-del-Valle J, Palau-Lázaro M, Mejía-Arango M, Otero J, Londoño-Schimmer E, Cortes N, Pozo M, Herrera-Almario G, Arias F, Rodriguez-Urrego P. Well differentiated neuroendocrine tumor of the appendix and low-grade appendiceal mucinous neoplasm presenting as a collision tumor. Rev Esp Enferm Dig 2015; 107:396-398. [PMID: 26031879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Arias F, Herrera-Almario G, Pozo ME, Londoño-Schimmer E, Otero JM, Cardona A, Cortes N, Mora M. Safety and Quality Outcomes in Peritoneal Surface Malignancy Patients: Developing a National Center for Excellence in Colombia. Ann Surg Oncol 2014; 22:1733-8. [DOI: 10.1245/s10434-014-4064-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Indexed: 12/26/2022]
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