Factors pronòstics en la dehiscència anastomòtica de la cirurgia del càncer de còlon. Models de predicció actuals i validació externa independent

INTRODUCTION: Anastomotic leak (AL) is the most dreadful and life-threatening complication in colon cancer (CC) surgery. It is associated to an increase of morbimortality, longer hospital stay, increased healthcare costs and a diminished overall survival rate and a disease free survival rate. The in...

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Detalhes bibliográficos
Autor: Pigem Rodeja, Anna
Formato: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2023
País:España
Recursos:CBUC, CESCA
Repositorio:TDR. Tesis Doctorales en Red
OAI Identifier:oai:www.tdx.cat:10803/688371
Acesso em linha:http://hdl.handle.net/10803/688371
Access Level:acceso abierto
Palavra-chave:Càncer de còlon
Cáncer de colon
Colon cancer
Cirurgia
Cirugía
Surgery
Dehiscència anastomòtica
Dehiscencia anastomótica
Anastomotic leak
Factors pronòstics
Factores pronósticos
Pronostic factors
Models de predicció
Modelos de predicción
Prediction models
Factors de risc
Factores de riesgo
Risk factors
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Descrição
Resumo:INTRODUCTION: Anastomotic leak (AL) is the most dreadful and life-threatening complication in colon cancer (CC) surgery. It is associated to an increase of morbimortality, longer hospital stay, increased healthcare costs and a diminished overall survival rate and a disease free survival rate. The incidence of AL ranges from 3 to 30% depending on the paper, and its mortality ranges from 10 to 15%. Multiple risk factors for AL, related to the patient, the tumor and the treatment, have been described in literature. In addition, different predictive models for AL have been published, but most of them are too complex to be used in daily medical practice. Continuous research on risk factors for AL is crucial and a comfortable and easy to use predicting model for AL is needed, in order to have a better detection of patients at risk and to prevent or minimize risk factors before surgery. OBJECTIVE: The objectives in our study were: (1) to identify risk factors for AL in elective CC surgery at Dr. Josep Trueta de Girona University Hospital (DJTGUH), (2) to perform an external independent validation of current and most important predictive models published in literature and (3) to develop a predicting model for our population. In addition, incidence of AL, clinical impact and survival in our cohort of patients (with and without AL) was studied, and differences between right CC and left CC were sought