Complications in colorectal surgery: Risk factors and preventive strategies

被引：294
作者：
Kirchhoff P. [1 ]
Clavien P.-A. [1 ]
Hahnloser D. [1 ]
机构：
[1] Department of Visceral and Transplantation Surgery, University Hospital of Zürich
来源：
Patient Safety in Surgery | / 4卷 / 1期
关键词：
Anastomotic Leakage; Enteral Nutrition; Postoperative Ileus; Splenic Injury; Prophylactic Drainage;
D O I：
10.1186/1754-9493-4-5
中图分类号：
学科分类号：
摘要：
Backround: Open or laparoscopic colorectal surgery comprises of many different types of procedures for various diseases. Depending upon the operation and modifiable and non-modifiable risk factors the intra- and postoperative morbidity and mortality rate vary. In general, surgical complications can be divided into intraoperative and postoperative complications and usually occur while the patient is still in the hospital.Methods: A literature search (1980-2009) was carried out, using MEDLINE, PubMed and the Cochrane library.Results: This review provides an overview how to identify and minimize intra- and postoperative complications. The improvement of different treatment strategies and technical inventions in the recent decade has been enormous. This is mainly attributable to the increase in the laparoscopic approach, which is now well accepted for many procedures. Training of the surgeon, hospital volume and learning curves are becoming increasingly more important to maximize patient safety, surgeon expertise and cost effectiveness. In addition, standardization of perioperative care is essential to minimize postoperative complications.Conclusion: This review summarizes the main perioperative complications of colorectal surgery and influencable and non-influencable risk factors which are important to the general surgeon and the relevant specialist as well. In order to minimize or even avoid complications it is crucial to know these risk factors and strategies to prevent, treat or reduce intra- and postoperative complications. © 2010 Kirchhoff et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 130 条
[1]  
Clavien P.A., Barkun J., de Oliveira M.L., Vauthey J.N., Dindo D., Schulick R.D., de S.E., Pekolj J., Slankamenac K., Bassi C., Graf R., Vonlanthen R., Padbury R., Cameron J.L., Makuuchi M., The Clavien-Dindo classification of surgical complications: five-year experience, Ann Surg, 250, pp. 187-196, (2009)
[2]  
Dindo D., Demartines N., Clavien P.A., Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey, Ann Surg, 240, pp. 205-213, (2004)
[3]  
Artinyan A., Nunoo-Mensah J.W., Balasubramaniam S., Gauderman J., Essani R., Gonzalez-Ruiz C., Kaiser A.M., Beart R.W., Prolonged postoperative ileus-definition, risk factors, and predictors after surgery, World J Surg, 32, pp. 1495-1500, (2008)
[4]  
Klotz H.P., Candinas D., Platz A., Horvath A., Dindo D., Schlumpf R., Largiader F., Preoperative risk assessment in elective general surgery, Br J Surg, 83, pp. 1788-1791, (1996)
[5]  
Kirchhoff P., Dincler S., Buchmann P., A multivariate analysis of potential risk factors for intra- and postoperative complications in 1316 elective laparoscopic colorectal procedures, Ann Surg, 248, pp. 259-265, (2008)
[6]  
Longo W.E., Virgo K.S., Johnson F.E., Oprian C.A., Vernava A.M., Wade T.P., Phelan M.A., Henderson W.G., Daley J., Khuri S.F., Risk factors for morbidity and mortality after colectomy for colon cancer, Dis Colon Rectum, 43, pp. 83-91, (2000)
[7]  
McGillicuddy E.A., Schuster K.M., Davis K.A., Longo W.E., Factors predicting morbidity and mortality in emergency colorectal procedures in elderly patients, Arch Surg, 144, pp. 1157-1162, (2009)
[8]  
Yoo P.S., Mulkeen A.L., Frattini J.C., Longo W.E., Cha C.H., Assessing risk factors for adverse outcomes in emergent colorectal surgery, Surg Oncol, 15, pp. 85-89, (2006)
[9]  
Margenthaler J.A., Longo W.E., Virgo K.S., Johnson F.E., Grossmann E.M., Schifftner T.L., Henderson W.G., Khuri S.F., Risk factors for adverse outcomes following surgery for small bowel obstruction, Ann Surg, 243, pp. 456-464, (2006)
[10]  
Leung J.M., Dzankic S., Relative importance of preoperative health status versus intraoperative factors in predicting postoperative adverse outcomes in geriatric surgical patients, J Am Geriatr Soc, 49, pp. 1080-1085, (2001)
12345678910