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Fundamentals of Rectal Cancer SurgeryFundamentals of Rectal Cancer Surgery

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Impact of Postoperative Complications On Oncologic Outcomes

Impact of Postoperative Complications On Oncologic Outcomes is a topic covered in the Fundamentals of Rectal Cancer Surgery.

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Postoperative complications carry implications for short-term quality of life and negatively affect the cost of care. In addition, there is evidence that postoperative complications are associated with worse long-term, oncologic outcomes.[1] While the exact mechanism of the impact on long-term survival is unclear, one factor is that postoperative complications result in delays in receiving and, in some cases, result in complete omission of chemotherapy after surgery. Hendren and colleagues used the SEER-Medicare database from 1993-2005 and examined risk for chemotherapy omission.[2] They found that patients who suffered postoperative complications were more likely to have chemotherapy omitted or delayed.[2] Tevis and colleagues looked at this question in patients undergoing surgery for rectal cancer.[1] They found that patients with postoperative complications had worse long-term survival than did those patients with no complications. Using a multivariable analysis, postoperative complications correlated with decreased overall survival in patients who received chemotherapy. These results suggest that in addition to omission of chemotherapy, complications may have other negative effects leading to decreased long-term survival.[1] Theories include immunosuppression caused by the prolonged recovery and debility after surgery with complications, as well as a changed microenvironment for tumor recurrence where there is a leak or infection.

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Postoperative complications carry implications for short-term quality of life and negatively affect the cost of care. In addition, there is evidence that postoperative complications are associated with worse long-term, oncologic outcomes.[1] While the exact mechanism of the impact on long-term survival is unclear, one factor is that postoperative complications result in delays in receiving and, in some cases, result in complete omission of chemotherapy after surgery. Hendren and colleagues used the SEER-Medicare database from 1993-2005 and examined risk for chemotherapy omission.[2] They found that patients who suffered postoperative complications were more likely to have chemotherapy omitted or delayed.[2] Tevis and colleagues looked at this question in patients undergoing surgery for rectal cancer.[1] They found that patients with postoperative complications had worse long-term survival than did those patients with no complications. Using a multivariable analysis, postoperative complications correlated with decreased overall survival in patients who received chemotherapy. These results suggest that in addition to omission of chemotherapy, complications may have other negative effects leading to decreased long-term survival.[1] Theories include immunosuppression caused by the prolonged recovery and debility after surgery with complications, as well as a changed microenvironment for tumor recurrence where there is a leak or infection.

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Last updated: September 21, 2021

Citation

"Impact of Postoperative Complications On Oncologic Outcomes." Fundamentals of Rectal Cancer Surgery, 2021. ASCRS U, www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831033/all/Impact of Postoperative Complications On Oncologic Outcomes.
Impact of Postoperative Complications On Oncologic Outcomes. Fundamentals of Rectal Cancer Surgery. 2021. https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831033/all/Impact of Postoperative Complications On Oncologic Outcomes. Accessed March 21, 2023.
Impact of Postoperative Complications On Oncologic Outcomes. (2021). In Fundamentals of Rectal Cancer Surgery https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831033/all/Impact of Postoperative Complications On Oncologic Outcomes
Impact of Postoperative Complications On Oncologic Outcomes [Internet]. In: Fundamentals of Rectal Cancer Surgery. ; 2021. [cited 2023 March 21]. Available from: https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831033/all/Impact of Postoperative Complications On Oncologic Outcomes.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Impact of Postoperative Complications On Oncologic Outcomes ID - 2831033 Y1 - 2021/09/21/ BT - Fundamentals of Rectal Cancer Surgery UR - https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831033/all/Impact of Postoperative Complications On Oncologic Outcomes DB - ASCRS U DP - Unbound Medicine ER -
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Grapherence® [↑2]
    • Fundamentals of Rectal Cancer Surgery
    • Background
    • Rectal Anatomy
    • Rectal Cancer Biology and Hereditary Cancer Syndromes
    • Rationale for Multi-Modality Therapy
    • Preoperative Issues
    • Preoperative Staging
    • Role of Tumor Board
    • Indications for Preoperative Neoadjuvant Therapy
    • Local Excision
    • Indications for LAR Versus Intersphincteric Resection Versus APR
    • Indications for Extended Resection
    • Preoperative Preparation
    • Interoperative
    • Patient Positioning and Equipment for Rectal Cancer Surgery
    • Inferior Mesenteric Artery
    • Inferior Mesenteric Vein (IMV)
    • Splenic Flexure Mobilization
    • Surgical Techniques for Length
    • Technique of Total Mesorectal Excision (TME)
    • Tailored Mesorectal Excision (TME)
    • Bowel Transection and Anastomosis
    • Indications for Fecal Diversion
    • Abdominoperineal Resection
    • Standardized Operative Report
    • Management of Intraoperative Vascular and Urinary Complications
    • Postoperative Issues
    • Rectal Cancer Pathology Assessment
    • Adjuvant Therapy for Rectal Adenocarcinoma
    • Surveillance After Rectal Cancer Treatment
    • Management of Local Recurrences
    • Short-Term Complications - Anastomotic
    • Short-Term Complications - Urinary
    • Ostomy Complications and Management
    • Long-Term Complications – Bowel Dysfunction
    • Long-Term Complications - Sexual Dysfunction and Its Management
    • Parastomal and Perineal Hernias
    • Impact of Postoperative Complications On Oncologic Outcomes
    • Course Complete
    • Final Assessment
Grapherence® [↑2]
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