Breaking News
May 3, 2019 - Vaping and Smoking May Signal Greater Motivation to Quit
May 3, 2019 - Dementia looks different in brains of Hispanics
May 3, 2019 - Short-Staffed Nursing Homes See Drop In Medicare Ratings
May 3, 2019 - Study of teens with eating disorders explores how substance users differ from non-substance users
May 3, 2019 - Scientists develop new video game that may help in the study of Alzheimer’s
May 3, 2019 - Arc Bio introduces Galileo Pathogen Solution product line at ASM Clinical Virology Symposium
May 3, 2019 - Cornell University study uncovers relationship between starch digestion gene and gut bacteria
May 3, 2019 - How to Safely Use Glucose Meters and Test Strips for Diabetes
May 3, 2019 - Anti-inflammatory drugs ineffective for prevention of Alzheimer’s disease
May 3, 2019 - Study tracks Pennsylvania’s oil and gas waste-disposal practices
May 3, 2019 - Creating a better radiation diagnostic test for astronauts
May 3, 2019 - Vegans are often deficient in these four nutrients
May 3, 2019 - PPDC announces seed grants to develop medical devices for children
May 3, 2019 - Study maps out the frequency and impact of water polo head injuries
May 3, 2019 - Research on Reddit identifies risks associated with unproven treatments for opioid addiction
May 3, 2019 - Good smells may help ease tobacco cravings
May 3, 2019 - Medical financial hardship found to be very common among people in the United States
May 3, 2019 - Researchers develop multimodal system for personalized post-stroke rehabilitation
May 3, 2019 - Study shows significant mortality benefit with CABG over percutaneous coronary intervention
May 3, 2019 - Will gene-editing of human embryos ever be justifiable?
May 3, 2019 - FDA Approves Dengvaxia (dengue vaccine) for the Prevention of Dengue Disease in Endemic Regions
May 3, 2019 - Why Tonsillitis Keeps Coming Back
May 3, 2019 - Fighting the opioid epidemic with data
May 3, 2019 - Maggot sausages may soon be a reality
May 3, 2019 - Deletion of ATDC gene prevents development of pancreatic cancer in mice
May 2, 2019 - Targeted Therapy Promising for Rare Hematologic Cancer
May 2, 2019 - Alzheimer’s disease is a ‘double-prion disorder,’ study shows
May 2, 2019 - Reservoir bugs: How one bacterial menace makes its home in the human stomach
May 2, 2019 - Clinical, Admin Staff From Cardiology Get Sneak Peek at Epic
May 2, 2019 - Depression increases hospital use and mortality in children
May 2, 2019 - Vicon and NOC support CURE International to create first gait lab in Ethiopia
May 2, 2019 - Researchers use 3D printer to make paper organs
May 2, 2019 - Viral infection in utero associated with behavioral abnormalities in offspring
May 2, 2019 - U.S. Teen Opioid Deaths Soaring
May 2, 2019 - Opioid distribution data should be public
May 2, 2019 - In the Spotlight: “I’m learning every single day”
May 2, 2019 - 2019 Schaefer Scholars Announced
May 2, 2019 - Podcast: KHN’s ‘What The Health?’ Bye-Bye, ACA, And Hello ‘Medicare-For-All’?
May 2, 2019 - Study describes new viral molecular evasion mechanism used by cytomegalovirus
May 2, 2019 - SLU study suggests a more equitable way for Medicare reimbursement
May 2, 2019 - Scientists discover first gene involved in lower urinary tract obstruction
May 2, 2019 - Researchers identify 34 genes associated with increased risk of ovarian cancer
May 2, 2019 - Many low-income infants receive formula in the first few days of life, finds study
May 2, 2019 - Global study finds high success rate for hip and knee replacements
May 2, 2019 - Taking depression seriously: What is it?
May 2, 2019 - With Head Injuries Mounting, Will Cities Put Their Feet Down On E-Scooters?
May 2, 2019 - Scientists develop small fluorophores for tracking metabolites in living cells
May 2, 2019 - Study casts new light into how mothers’ and babies’ genes influence birth weight
May 2, 2019 - Researchers uncover new brain mechanisms regulating body weight
May 2, 2019 - Organ-on-chip systems offered to Asia-Pacific regions by Sydney’s AXT
May 2, 2019 - Adoption of new rules drops readmission penalties against safety net hospitals
May 2, 2019 - Kids and teens who consume zero-calorie sweetened beverages do not save calories
May 2, 2019 - Improved procedure for cancer-related erectile dysfunction
May 2, 2019 - Hormone may improve social behavior in autism
May 2, 2019 - Alzheimer’s disease may be caused by infectious proteins called prions
May 2, 2019 - Even Doctors Can’t Navigate Our ‘Broken Health Care System’
May 2, 2019 - Study looks at the impact on criminal persistence of head injuries
May 2, 2019 - Honey ‘as high in sugars as table sugar’
May 2, 2019 - Innovations to U.S. food system could help consumers in choosing healthy foods
May 2, 2019 - FDA Approves Mavyret (glecaprevir and pibrentasvir) as First Treatment for All Genotypes of Hepatitis C in Pediatric Patients
May 2, 2019 - Women underreport prevalence and intensity of their own snoring
May 2, 2019 - Concussion summit focuses on science behind brain injury
May 2, 2019 - Booker’s Argument For Environmental Justice Stays Within The Lines
May 2, 2019 - Cornell research explains increased metastatic cancer risk in diabetics
May 2, 2019 - Mount Sinai study provides fresh insights into cellular pathways that cause cancer
May 2, 2019 - Researchers to study link between prenatal pesticide exposures and childhood ADHD
May 2, 2019 - CoGEN Congress 2019: Speakers’ overviews
May 2, 2019 - A new strategy for managing diabetic macular edema in people with good vision
May 2, 2019 - Sagent Pharmaceuticals Issues Voluntary Nationwide Recall of Ketorolac Tromethamine Injection, USP, 60mg/2mL (30mg per mL) Due to Lack of Sterility Assurance
May 2, 2019 - Screen time associated with behavioral problems in preschoolers
May 2, 2019 - Hormone reduces social impairment in kids with autism | News Center
May 2, 2019 - Researchers synthesize peroxidase-mimicking nanozyme with low cost and superior catalytic activity
May 2, 2019 - Study results of a potential drug to treat Type 2 diabetes in children announced
May 2, 2019 - Multigene test helps doctors to make effective treatment decisions for breast cancer patients
May 2, 2019 - UNC School of Medicine initiative providing unique care to dementia patients
May 2, 2019 - Nestlé Health Science and VHP join forces to launch innovative COPES program for cancer patients
May 2, 2019 - Study examines how our brain generates consciousness and loses it during anesthesia
May 2, 2019 - Transition Support Program May Aid Young Adults With Type 1 Diabetes
May 2, 2019 - Study shows how neutrophils exacerbate atherosclerosis by inducing smooth muscle-cell death
May 2, 2019 - Research reveals complexity of how we make decisions
International audit of colorectal surgeries provides highly realistic reflection of current practices

International audit of colorectal surgeries provides highly realistic reflection of current practices

European Society for Coloproctology will undertake further cohort studies on robotic colorectal surgery, the management of acute severe Ulcerative Colitis and parastomal hernia repair in 2019

The European Society of Coloproctology (ESCP) has undertaken a major international audit of colorectal operations to understand which are most widely used techniques across the world, which appear to be associated with the best outcomes and where further research needs to be undertaken.

Participation in 2017 audit

The cohort data is the result of a multinational collaboration of 1,448 clinicians at 335 sites in 49 countries covering 5,640 colorectal surgeries, making it one of the largest studies of its kind ever undertaken. The data were collected prospectively over just 8 weeks using a ‘snapshot’ methodology, giving an up to date and highly realistic reflection of current colorectal practice on a global scale.

The findings reveal variation in practice of left colon, sigmoid colon and rectal resections (removal of all or part of an organ) with a variety of operation approaches used:

  • Laproscopic (‘keyhole’) surgeries were used in 56.6% of cases
  • Robotic surgeries were used in just 4% of cases
  • Open surgery was used in 39.5% of cases
  • Operations using a transanal approach for part of the resection (a new technique) were seen in 14.3% of cases

Across all techniques, the average post-operative anastomotic leak rate (breaking down of the join between two pieces of bowel) was 8.6%.  Patients stayed in hospital for an average of seven days and 6.6% needed to be re-admitted due to complications within 30 days of leaving hospital. If a patient suffered an anastomotic leak, the average length of stay more than doubled to 15 days, and the death rate rose 7-fold, from 0.5% to 3.5%, showing the major impact of this surgical complication.

Five pre-planned analyses of the study data were published simultaneously on 27th September 2018 in the journal Colorectal Disease, which is the official journal of ESCP and other coloproctology societies around the world. These papers explored the following five research questions:

  1. Are oral antibiotics combined with mechanical bowel preparation associated with a reduced risk of anastomotic leak?
  2. How is the surgical approach chosen for patients undergoing surgery for rectal cancer?
  3. Is there a difference in postoperative complication rates between patients undergoing end stoma or anastomosis following emergency colorectal surgery?
  4. What is the ‘complete response’ rate following neoadjuvant (pre-operative) chemoradiotherapy for rectal cancer?
  5. What is the safety profile of laparoscopic conversion in colonic surgery?

The results were announced at the recent ESCP Annual & General Scientific Meeting in Nice from 26 to 29 September, gaining significant interest online and on social media.

On the back of the success of this 2017 study and the expanding and active international research network created, ESCP will undertake three new prospective  international  studies  in 2019. These focus on outcomes after robotic surgery, the medical and surgical management of acute severe Ulcerative Colitis, and patient-reported outcomes after repair of a parastomal hernia.

Tom Pinkney, chair of cohort studies for ESCP said:

We were very excited with the overwhelming response to the study which has allowed us to collect data from so many different sites and countries. This level of participation and volume of data is unprecedented and gives us a full picture of where colorectal surgery is, and where it is heading.”

Alaa Al-Hussana the 2017 cohort study lead said:

Using a cohort study model rather than a randomised a controlled trial (RCT) removes many hurdles and gives us data that is both up-to-date and ‘real-world’ to work with at a fraction of the cost and time investment for the benefit of our patients.”

This study was the third in ESCP’s series of studies on bowel anastomoses.  Its first cohort study on right hemicolectomy was completed in 2015 across 284 centres, including 3200 patients. The second study, in 2016, focussed on stoma closures across 305 centres, including 2441 patients. The results from these three cohorts are already paving the way for progress on treatments and training to improve patient care internationally.

Source:

https://www.escp.eu.com/news/1755-international-colorectal-cohort-study-advances-research-into-surgical-techniques-and-post-operative-outcomes-for-patients

Tagged with:

About author

Related Articles