Open AccessImproving the outcomes in oncological colorectal surgery
Author(s) -
Jeroen L.A. van Vugt,
Kostan W. Reisinger,
Joep P. M. Derikx,
Djamila Boerma,
Jan H. M. B. Stoot
Publication year - 2014
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v20.i35.12445
Subject(s) - medicine , colorectal cancer , laparoscopy , perioperative , colorectal surgery , fast track , surgery , anastomosis , sarcopenia , general surgery , laparoscopic surgery , cancer , abdominal surgery
During the last several decades, colorectal cancer surgery has experienced some major perioperative improvements. Preoperative risk-assessment of nutrition, frailty, and sarcopenia followed by interventions for patient optimization or an adapted surgical strategy, contributed to improved postoperative outcomes. Enhanced recovery programs or fast-track surgery also resulted in reduced length of hospital stay and overall complications without affecting patient safety. After an initially indecisive start due to uncertainty about oncological safety, the most significant improvement in intraoperative care was the introduction of laparoscopy. Laparoscopic surgery for colon and rectal cancer is associated with better short-term outcomes, whereas long-term outcomes regarding survival and recurrence rates are comparable. Nevertheless, long-term results in rectal surgery remain to be seen. Early recognition of anastomotic leakage remains a challenge, though multiple improvements have allowed better management of this complication.