Albiza SL, Betancour CJR, Camejo RD, Meneses GA, Odales CDA

Language: Spanish
References: 23
Page: 1-15
PDF size: 475.12 Kb.

ABSTRACT

Introduction: Colorectal and anal cancer is a disease of high incidence and mortality, and intestinal occlusion is its most frequent complication.
Objective: To identify the predictors of mortality in mechanical intestinal occlusion due to colorectal and anal cancer.
Methods: An analytical observational study was carried out that included all patients with mechanical intestinal occlusion due to colorectal and anal cancer consecutively admitted to the "Camilo Cienfuegos" Hospital in Sancti Spíritus, Cuba, from January 1, 2016 to January 31, December 2018. A total of 126 patients with this diagnosis were registered. Demographic variables and associated risk factors were included. Glycemia, creatinine and arterial blood gas were determined. Surgical time, time from admission to surgery, hospital stay, and American Society of Anesthesia classification were also evaluated. For statistical analysis, a binary logistic regression and a classification tree were performed.
Results: The mortality of the series studied was 27%. Age greater than or equal to 75 years, the American Society of Anesthesia classification greater than or equal to III, reoperations and complications increased the risk of dying using descriptive and inferential statistics.
Conclusions: The results obtained suggest evaluating complications, advanced age, anesthetic risk and reoperations as predictors of mortality in these patients. The probability of death is low in uncomplicated patients under the age of 75 years.

REFERENCES

1. Cancer Survival. Francia: International Agency for Research on Cancer. Septiembre 2018 [acceso 04/05/2019]. Diponible en: https://gco.iarc.fr/survival/survmark/visualizations/viz2/?cancer_site=%22Colon%22&country=%22Australia%22&agegroup=%22All%22&gender=%22All%22&interval=%221%22&survival_year=%221%22&measures=%5B%22Mortality+%28ASR%29%22%5D

2. Hasanpour-Heidari S, Fazel A, Semnani S, Khandoozi SR, Amiriani T, Sedaghat S, et al. Temporal and geographical variations in colorectal cancer incidence in Northern Iran 2004–2013. Cancer epidemiology. 2019;59:143-7. DOI: http://dx.doi.org/10.1016/j.canep.2019.02.003

3. Cancer Tomorrow. Francia: International Agency for Research on Cancer. 2018 [acceso 03/05/2019]. Disponible en: https://gco.iarc.fr/tomorrow/graphic-isotype?type=0&population=900&mode=population&sex=0&cancer=39&age_group=value&apc_male=0&apc_female=0

4. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F, et al. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683-91. DOI: http://dx.doi.org/10.1136/gutjnl-2015-310912

5. Cancer Today. Francia: International Agency for Research on Cancer. 2019 [acceso 09/09/2019]. Disponible en: https://gco.iarc.fr/today/data/factsheets/populations/192-cuba-fact-sheets.pdf

6. Ministerio de Salud Pública. Dirección Nacional de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2018. La Habana: MINSAP. 2019 [acceso 01/06/2019]. Disponible en http://files.sld.cu/bvscuba/files/2019/04/Anuario-Electr%C3%B3nico-Espa%C3%B1ol-2018-ed-2019-compressed.pdf

7. Najjia N, Mahmoud Joshua IS, Bleier Cary B, Aarons E, Robert D. Colon y recto. Tratado de cirugía. Fundamentos biológicos de la práctica quirúrgica moderna. España: Elsevier; 2018. p. 1312-93.

8. Frago R, Ramirez E, Millan M, Kreisler E, del Valle E, Biondo S, et al. Current management of acute malignant large bowel obstruction: a systematic review. The American Journal of Surgery. 2014;207(1):127-38.

9. Detsky AS, Baker J, Johnston N, Whittaker S, Mendelson R, Jeejeebhoy K, et al. What is subjective global assessment of nutritional status? Journal of parenteral and enteral nutrition. 1987;11(1):8-13.

10. Reyes SO, Martínez FA, Díaz GL, González Díaz ME, Villalonga JAG, Santana Porbén S, et al. Valor predictivo de la encuesta subjetiva global en la conducta quirúrgica y la evolución posoperatoria del cáncer colorrectal. Revista Mexicana de Coloproctología Enfermedades del Ano, Recto y Colon. 2005 [acceso 08/04/2019];11(3):[aprox. 7p]. Disponible en: https://www.medigraphic.com/pdfs/proctologia/c-2005/c053d.pdf

11. Irlbeck T, Zwissler B, Bauer A. ASA-Klassifikation. Der Anaesthesist. 2017;66(1):5-10.

12. Cantín M. Asociación Médica Mundial. Declaración de Helsinki: Principios éticos para las investigaciones médicas en seres humanos. Revisando su última versión. Int J Med Surg Sci. 2014 [acceso 28/04/2019];1(4):339-46. Disponible en: http://www.ijmss.org/wp-content/uploads/2015/05/art_8_14.pdf

13. Domínguez González EJ, Piña Prieto LR, Cisneros Domínguez CM, Romero García LI. Escala predictiva de mortalidad en la oclusión intestinal mecánica. Revista Cubana de Cirugía. 2015 [acceso 02/10/2019];54(2). Disponible en: https://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDREVISTA=245&IDARTICULO=61037&IDPUBLICACION=6054

14. Islami F, Goding Sauer A, Miller KD, Siegel RL, Fedewa SA, Jacobs EJ, et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA: a cancer journal for clinicians. 2018;68(1):31-54. Disponible en: http://dx.doi.org/10.3322/caac.21440

15. Portugal Torres JD. Factores asociados a mortalidad post operatoria en cirugía de emergencia por obstrucción intestinal en el Hospital Nacional Guillermo Almenara Irigoyen durante el periodo 2016-2018. Universidad Nacional de San Agustín Perú, Facultad de Medicina. 2019. Disponible en: http://repositorio.unsa.edu.pe/handle/UNSA/8199

16. Valle Albinagorta AE. Tratamiento de la obstrucción aguda de colon por cáncer. Universidad de Cantabria Santander, Facultad de medicina, Departamento de ciencias médicas y quirúrgicas. 2019. Disponible en: https://repositorio.unican.es/xmlui/handle/10902/16574

17. Lv X, Yu H, Gao P, Song Y, Sun J, Chen X, et al. A nomogram for predicting bowel obstruction in preoperative colorectal cancer patients with clinical characteristics. World journal of surgical oncology. 2019;17(1):21-33.

18. Amelung F, Borstlap W, Consten E, Veld J, van Halsema E, Bemelman W, et al. Propensity score‐matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left‐sided colonic obstruction. British Journal of Surgery. 2019;106(8):1075-86.

19. Domínguez-González EJ. Factores predictivos de mortalidad en la oclusión intestinal por bridas. Repertorio de Medicina y Cirugía. 2016;25(3):163-7.

20. Arezzo A, Passera R, Secco GL, Verra M, Bonino MA, Targarona E, et al. Stent as bridge to surgery for left-sided malignant colonic obstruction reduces adverse events and stoma rate compared with emergency surgery: results of a systematic review and meta-analysis of randomized controlled trials. Gastrointestinal endoscopy. 2017;86(3):416-26.

21. Kim MK, Kye BH, Lee IK, Oh ST, Ahn CH, Lee YS, et al. Outcome of bridge to surgery stenting for obstructive left colon cancer. ANZ journal of surgery. 2017;87(12):245-50.

22. Atukorale YN, Church JL, Hoggan BL, Lambert RS, Gurgacz SL, Goodall S, et al. Self-expanding metallic stents for the management of emergency malignant large bowel obstruction: a systematic review. Journal of Gastrointestinal Surgery. 2016;20(2):455-62.

23. Flor-Lorente B, Báguena G, Frasson M, García-Granero A, Cervantes A, Sanchiz V, et al. Stents metálicos autoexpandibles como puente a la cirugía en el tratamiento del cáncer de colon izquierdo en oclusión. Análisis coste-beneficio y resultados oncológicos. Cirugía Española. 2017;95(3):143-51.