Digestive System Diseases

All Conditions

Neoplasms

Behaviors and Mental Disorders

Liver Diseases

Liver Neoplasms

Gastrointestinal Diseases

Gastrointestinal Neoplasms

Digestive System Neoplasms

Quality of Life

Hematinics

All Drugs and Chemicals

Liver Extracts

eg. hepatocellular carcinoma, colorectal liver metastases

eg. liver cysts, traumatic liver injuries, adenoma etc

Vanessa Banz, MD

Patients with malignant diseases are increasingly receiving more extensive hepatic resections, with im-proved preoperative and postoperative care leading to a reduced postoperative morbidity and mortality. In this setting, postoperative quality of life may become as important as overall patient survival. In this study we will be investigating the effect of the initial disease for which hepatic resection was carried out on short- and long-term quality of life.

Background: Due to advances in operative methods and perioperative care, mortality and morbidity following major hepatic resection have decreased substantially, making long-term quality of life (QoL) an increasingly prominent issue.

Objectives: We plan on evaluating whether postoperative diagnosis is associated with long-term QoL and health in patients who require hepatic surgery for benign or malignant diseases and how QoL evolves with time.

Method: QoL will be evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and the liver-specific QLQ-LMC21 module. All patients requiring hepatic surgery aged \>18 years will be included in the study. QoL evaluation is carried out preoperatively and at set intervals postoperatively.

Quality of Life After Liver Resection

Long-term Evaluation of the Quality of Life After Major Hepatic Resection for Malignant and Benign Diseases.

University of Bern

Nutritional and Metabolic Diseases

Malnutrition

Nutrition Disorders

Patient that well nourished and without undernutrition

Wei Chen, M.D

Hua Jiang, M.D

Chongmei Lu, M.D

Undernutrition is a state marked by energy and/or protein intake deficiency or mal-absorption, and is often described as protein energy malnutrition (PEM). Malnutrition is common in hospitalized patients worldwide. The prevalence of malnutrition in hospitalized patients range from 20% - 50%, depends on the varieties of diseases, health system, population and assessment tools. It is well documented in Western countries that malnutrition affects clinical outcomes negatively. Compared with well-nourished patients, patients with malnutrition stay longer in hospitals and related cost is significantly higher.

There is increasing evidence which indicates that appropriate nutrition support (e.g., standardized nutrition screening procedures, delivering nutrients with appropriate path, etc) may improve clinical outcome on malnutrition, along with cost saving.

To date, there is no study to document specifically the impact of malnutrition and related nutrition support on the health economics in China. Considering China now is on its way to establish public health security system and a diagnosis-related grouping system, the understanding of the cost effectiveness of nutrition support under the current clinical conditions is crucial.

This study aims to investigate the prevalence of perioperational malnutrition in gastroenterological cancer patient, the nutrition support status and related health economic effects.

The Impact of Perioperational Malnutrition on the Cost on Gastroenterological Cancer Patients

Malnutrition and Its Impact on the Perioperational Hospitalization Cost: A Prospective, Cohort Study on Gastroenterological Cancer Patients

Peking Union Medical College Hospital

Wei Chen,M.D, Vice Professor, Assisstant Director of Department of Parenteral and Enteral Nutrition

Symptoms and General Pathology

Heart and Blood Diseases

Colorectal Neoplasms

Hemorrhage

Postoperative Complications

Neoplasm Metastasis

Intestinal Neoplasms

Thromboembolism

Venous Thromboembolism

Carcinoma

Peritoneal Neoplasms

Colonic Diseases

Intestinal Diseases

Rectal Diseases

Neoplastic Processes

Thrombosis

Embolism

Embolism and Thrombosis

Vascular Diseases

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Abdominal Neoplasms

Peritoneal Diseases

48 patients with peritoneal metastases from colorectal cancer undergoing cytoreductive surgery with HIPEC (cytoreductive surgery with HIPEC patients)

48 rectal cancer patients undergoing minimally invasive rectal cancer resection

Anne-Mette Hvas, MD, PhD

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) has prolonged the survival substantially for selected patients with peritoneal metastases from colorectal cancer.Bleeding and thromboembolic disease have been reported as postoperative complications related to this advanced open surgical treatment. However, perioperative changes in coagulation and fibrinolysis are only sparsely reported in the literature.The mainstay of treatment with curative intend of none-advanced colorectal cancer is minimally invasive laparoscopic surgery followed by adjuvant chemotherapy. The approach is considered associated with a lower risk of thromboembolic disease than open surgery. Despite differences in extent of surgery and thromboembolic risk the same extended thromboprophylaxis regimen for 28 days is currently prescribed to patients undergoing cytoreductive surgery with HIPEC as well as minimally invasive rectal cancer resection. This study aims to investigate all parts of the coagulation system and fibrinolysis, and thereby thromboembolic risk and potential bleeding in two groups of patients with different extent of surgical trauma: 1) Colorectal cancer patients undergoing cytoreductive surgery with HIPEC and 2) rectal cancer patients undergoing minimal invasive rectal cancer resection. Our hypothesis is that patients undergoing cytoreductive surgery with HIPEC are exposed to more aggravated alterations of coagulation and fibrinolysis than patients undergoing minimally invasive rectal cancer resection.

Changes in Coagulation in Colorectal Cancer Patients Undergoing Surgical Treatment

The difference will be measured in blood samples from before surgery to the end of surgery in cytoreductive surgery with HIPEC patients and patients undergoing minimally invasive rectal cancer resection.

The difference will be measured in blood samples from before surgery to the end of surgery in cytoreductive surgery with HIPEC patients and patients undergoing minimally invasive rectal cancer resection.

Thrombin generation will be measured by:

Lagtime (min), time to peak (min), peak thrombin (nM) and endogenous thrombin potential (nM\*min).

The difference between changes of fibrin clot structure from before surgery to the end of surgery in cytoreductive surgery with HIPEC patients and patients undergoing minimally invasive rectal cancer resection.

Fibrin clot structure will be measured by clot maximum, absorbance (arbitrary units), network density, lysis time (seconds), lysis area (balance between clot formation and lysis).

The difference will be measured in blood samples from before surgery to the end of surgery (both groups).

ROTEM will include EXTEM, INTEM, FIBTEM, and APTEM by clotting time (seconds), clot formation time (seconds), alpha-angle (degrees), amplitude 10 min after clotting time (mm), maximum clot firmness (mm), lysis index 30 min after clotting time (mm), maximum lysis (mm).

The difference will be measured in blood samples from before surgery to the end of surgery in cytoreductive surgery.

The difference will be measured in blood samples from the end of cytoreductive surgery (before HIPEC) to the end HIPEC.

The difference will be measured in blood samples from the end of cytoreductive surgery (before HIPEC) to the end of HIPEC.

The difference will be measured in blood samples from the end of cytoreductive surgery (before HIPEC) to the end of HIPEC. Thrombin generation will be measured by: Lagtime (min), time to peak (min), peak thrombin (nM) and endogenous thrombin potential (nM\*min).

The difference will be measured in blood samples from the end of cytoreductive surgery (before HIPEC) to the end of HIPEC. Fibrin clot structure will be measured by clot maximum, absorbance (arbitrary units), network density, lysis time (seconds), lysis area (balance between clot formation and lysis).

The difference will be measured in blood samples from the end of cytoreductive surgery to the end HIPEC.

ROTEM will include EXTEM, INTEM, FIBTEM, and APTEM by clotting time (seconds), clot formation time (seconds), alpha-angle (degrees), amplitude 10 min after clotting time (mm), maximum clot firmness (mm), lysis index 30 min after clotting time (mm), maximum lysis (mm).

Bilateral doppler ultrasonography of the veins in the lower extremities.The scan will be performed within the postoperative period from day 3 to day 7.

University of Aarhus

Gland and Hormone Related Diseases

Rare Diseases

Pancreatic Neoplasms

Stomach Neoplasms

Stomach Diseases

Pancreatic Cancer

Stomach Cancer

Central Nervous System Depressants

Adjuvants, Anesthesia

Analgesics

Platelet Aggregation Inhibitors

Anticonvulsants

Anesthetics

Fentanyl

Nitrous Oxide

Sevoflurane

Thiopental

Vecuronium Bromide

Group air was mechanically ventilated using 35% oxygen in 65% air during the whole surgical procedure.

Thiopental sodium was used for induction of anesthesia, muscle relaxation was maintained with vecuronium. General anesthesia with sevoflurane was maintained during the surgical procedure. Intraoperative analgesia was achieved with fentanyl boluses.

Group N2O was mechanically ventilated using 35 % oxygen and 65 % of nitrous oxyde during the surgical procedure.

Nitrous oxyde may increase cuff pressure during the general endotracheal anesthesia and result in the respiratory symptoms like sore throat, hoarseness and postoperative cough.

Thiopental sodium was used for induction of anesthesia, muscle relaxation was maintained with vecuronium. General anesthesia with sevoflurane was maintained during the surgical procedure. Intraoperative analgesia was achieved with fentanyl boluses.

Nitrous oxyde and sevoflurane anesthesia may alter mucus transport in the early postoperative period. In colonized patients it may result in more respiratory complications.

Tracheal aspirates and nasal smears were taken in all the patients. Laparotomies were performed in all patients.

Slavica Kvolik, MD, PhD

The goals of this study were to investigate whether two anesthesia regimens, with and without N2O, and bacterial colonization influence respiratory complications after major abdominal surgery for cancer.

A study was approved by institutional ethics committee. All patients were informed on the study protocol by attending anesthesiologist on the day of the surgery and written informed consent was obtained. Patients with clinically or radiologically confirmed acute respiratory infections or those using antibiotics due to the respiratory infections a week prior to the surgery were not included in the study. Following risk factors were recorded in all patients: age, sex, weight loss in the last 6 months, comorbidities and operative time. Comorbidities were rated using ASA status and Charlson comorbidity index by 3 independent observers. Charlson comorbidity index was calculated after pathological examination. An advanced malignant disease was considered if tumor had infiltrated other organs or surrounding tissues, or when positive lymph nodes or metastases were confirmed.

A group of 120 colorectal, gastric, or pancreatic cancer patients scheduled for surgery in the single centre were included in the prospective randomized study regardless of their ASA physical status. Nasopharyngeal smears were obtained in the preoperative area and tracheal aspirates were obtained in the operating room at the end of the surgery with a sterile suction catheter in a closed system.

Postoperative Hgb; CRP and lung auscultation were done in all patients on the second and fourth postoperative day.

Outcome measures registered were:

* Postoperative pneumonia
* Productive and difficult cough
* Dysphonia
* Congestive heart failure
* postoperative complications, including hypertensive crisis, thromboembolic and infective complications were summarized one year after surgical treatment was finished \& one year survival

To investigate whether productive cough, dyspnea and hoarseness were different between two groups of patients. Group Air received sevoflurane anesthesia with 35% O2 in air, and Group N2O received sevoflurane anesthesia with 35% O2 in N2O

Postoperative outcomes were registered by doctor who did not know type of anesthesia delivered

Tracheal Colonization and Outcome After Major Abdominal Cancer Surgery

Upon the request all blinded individual participant data (IPD) may be available to other researchers

Number of patients who reported the presence of cough, dyspnea and/or abnormal findings on lung examination, and two of following: fever, leukocytosis or high CRP, and positive chest radiograms.

patients without auscultatory findings who self reported that they have productive sputum and painful expectoration without laboratory and RTG findings suggestive for pneumonia

The patients who self-reported hoarseness and changed voice

All the other postoperative complications, including in-hospital hypertensive crisis, thromboembolic and infective complications were summarized one year after surgical treatment was finished.

Josip Juraj Strossmayer University of Osijek

Osijek University Hospital

Musculoskeletal Diseases

Skin and Connective Tissue Diseases

Bone Neoplasms

Osteoma

Osteoma, Osteoid

Neoplasms, Bone Tissue

Neoplasms, Connective Tissue

Neoplasms, Connective and Soft Tissue

patients with osteoid osteoma at any location

surgery for osteoid osteoma: this may include curettage or en-bloc resection of the lesion

surgical removal of osteoid osteoma

Purpose of the study:

To retrospectively determine the clinical results in an unselected group of consecutive patients with osteoid osteoma treated by surgery.

Materials and Methods:

In 150 consecutive patients with clinical and/or radiological evidence for osteoid osteoma at any location, the clinical symptoms and imaging findings (radiographs and computed tomography (CT)) were assessed before and after surgery. There were no exclusion criteria for this study. A good response was defined as disappearance of symptoms that were manifested at presentation and were attributed to osteoid osteoma. Clinical assessment after the procedure was performed prior to discharge; within 2 weeks after the procedure; and at 3, 6, and 12 months follow-up. After 24 months, a postal questionnaire was used for assessment. Radiographic evaluation (radiographs and thin-slice CT) was performed routinely pre-operatively and one year after surgery.

In case of persisting or recurring symptoms the follow-up protocol was again performed according to the initial protocol.

All patients gave their informed consent both for the surgical intervention as for the use of their patient data in this retrospective study.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Quality of Life After Liver Resection	NCT00681499	Liver Diseases Liver Neoplasms		18 Years -	University of Bern
The Impact of Perioperational Malnutrition on the Cost on Gastroenterological Cancer Patients	NCT00987883	Malnutrition Gastroenterolog... Surgical Proced...		18 Years - 80 Years	Peking Union Medical College Hospital
Changes in Coagulation in Colorectal Cancer Patients Undergoing Surgical Treatment	NCT04744688	Peritoneal Meta... Peritoneal Carc... Colorectal Neop... Intestinal Neop... Cytoreductive S... Venous Thromboe... Bleeding Laparoscopic Su... Coagulation Surgical Proced... Postoperative C... Laparoscopy Minimally Invas... Surgical Oncolo...		18 Years -	University of Aarhus
The Impact of Perioperational Malnutrition on the Cost on Gastroenterological Cancer Patients	NCT00987883	Malnutrition Gastroenterolog... Surgical Proced...		18 Years - 80 Years	Peking Union Medical College Hospital
Tracheal Colonization and Outcome After Major Abdominal Cancer Surgery	NCT04002128	Colorectal Neop... Surgical Proced... Stomach Neoplas... Pancreatic Canc...	Tracheal aspira...	18 Years - 90 Years	Osijek University Hospital
Treatment Outcome After Surgical Treatment of Osteoid Osteoma	NCT01466010	Osteoid Osteoma	surgical remova...	2 Years - 70 Years	Universitaire Ziekenhuizen KU Leuven
Tracheal Colonization and Outcome After Major Abdominal Cancer Surgery	NCT04002128	Colorectal Neop... Surgical Proced... Stomach Neoplas... Pancreatic Canc...	Tracheal aspira...	18 Years - 90 Years	Osijek University Hospital

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