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International Journal of Colorectal Disease

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01-02-2016 | Original Article

Impact of intraoperative blood loss on morbidity and survival after radical surgery for colorectal cancer patients aged 80 years or older

Authors: Ryosuke Okamura, Koya Hida, Suguru Hasegawa, Yoshiharu Sakai, Madoka Hamada, Masayoshi Yasui, Takao Hinoi, Masahiko Watanabe, The Japan Society of Laparoscopic Colorectal Surgery

Published in: International Journal of Colorectal Disease | Issue 2/2016

Abstract

Purpose

This study aimed to assess the effect of intraoperative blood loss (IBL) on short- and long-term outcomes of colorectal cancer surgery for very elderly patients.

Methods

We acquired the data of consecutive patients aged 80 years or older who underwent elective radical surgery for stage I to III colorectal cancer between January 2003 and December 2007 in 41 institutions. The patients were divided into high and low IBL groups, and the differences in postoperative morbidity and survival between the two groups were primarily assessed. Eleven factors were treated as potential confounders in multivariate analyses.

Results

A total of 1554 patients were eligible for this study, with an age range of 80–103 years. Median IBL was 71 ml (interquartile range, 25 to 200 ml), and 412 patients had IBL ≥200 ml. Morbidity was 46 % among patients with IBL ≥200 ml, compared with 30 % among those with IBL <200 ml (p < 0.001). Patients with IBL ≥200 ml had worse overall survival rates and recurrence-free survival rates at 1, 3, and 5 years than those with IBL <200 ml. In multivariate analyses, IBL ≥200 ml was identified as an independent risk factor for postoperative adverse events (odds ratio (OR) 1.41, 95 % confidence interval (CI) 1.08 to 1.86), overall survival (hazard ratio (HR) 1.34, 95 % CI 1.04 to 1.72), and recurrence-free survival (HR 1.29, 95 % CI 1.03 to 1.62).

Conclusion

The degree of IBL is significantly associated with postoperative morbidity and survival in very elderly colorectal cancer patients.

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Title: Impact of intraoperative blood loss on morbidity and survival after radical surgery for colorectal cancer patients aged 80 years or older
Authors: Ryosuke Okamura
Koya Hida
Suguru Hasegawa
Yoshiharu Sakai
Madoka Hamada
Masayoshi Yasui
Takao Hinoi
Masahiko Watanabe
The Japan Society of Laparoscopic Colorectal Surgery
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 2/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-015-2405-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of intraoperative blood loss on morbidity and survival after radical surgery for colorectal cancer patients aged 80 years or older

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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