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
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
[91]  
Werawatganon T., Charuluxanun S., Patient controlled intravenous opioid analgesia versus continuous epidural analgesia for pain after intra-abdominal surgery, Cochrane Database Syst Rev, (2005)
[92]  
Popping D.M., Zahn P.K., Van Aken H.K., Dasch B., Boche R., Pogatzki-Zahn E.M., Effectiveness and safety of postoperative pain management: a survey of 18 925 consecutive patients between 1998 and 2006 (2nd revision): a database analysis of prospectively raised data, Br J Anaesth, 101, pp. 832-840, (2008)
[93]  
Popping D.M., Elia N., Marret E., Remy C., Tramer M.R., Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta-analysis, Arch Surg, 143, pp. 990-999, (2008)
[94]  
Bauer J.J., Gelernt I.M., Salky B.A., Kreel I., Is routine postoperative nasogastric decompression really necessary?, Ann Surg, 201, pp. 233-236, (1985)
[95]  
Lewis S.J., Egger M., Sylvester P.A., Thomas S., Early enteral feeding versus "nil by mouth" after gastrointestinal surgery: systematic review and meta-analysis of controlled trials, BMJ, 323, pp. 773-776, (2001)
[96]  
Andersen H.K., Lewis S.J., Thomas S., Early enteral nutrition within 24 h of colorectal surgery versus later commencement of feeding for postoperative complications, Cochrane Database Syst Rev, (2006)
[97]  
Lewis S.J., Andersen H.K., Thomas S., Early Enteral Nutrition Within 24 h of Intestinal Surgery Versus Later Commencement of Feeding: A Systematic review and Meta-analysis, J Gastrointest Surg, 13, 3, pp. 569-575, (2009)
[98]  
Kehlet H., Multimodal approach to control postoperative pathophysiology and rehabilitation, Br J Anaesth, 78, pp. 606-617, (1997)
[99]  
Kehlet H., Wilmore D.W., Evidence-based surgical care and the evolution of fast-track surgery, Ann Surg, 248, pp. 189-198, (2008)
[100]  
Kehlet H., Wilmore D.W., Fast-track surgery, Br J Surg, 92, pp. 3-4, (2005)