Reduction in Cardiac Arrhythmias Within an Enhanced Recovery After Surgery Program in Colorectal Surgery
AbstractBackgroundEnhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to achieve early recovery by preserving preoperative organ function and minimizing the stress response following surgery. Few studies have assessed the association between ERAS and postoperative cardiac complications. The goal of this study is to evaluate the impact of ERAS on postoperative cardiac complications.Materials and MethodsA retrospective review of a prospectively maintained database of colorectal patients who underwent surgery at a tertiary colorectal cancer referral center was carried out. Preoperative, intraoperative, and postoperative factors including demographics, comorbidities, medications, and fluid administration were recorded. The primary outcome was postoperative cardiac arrhythmia, and secondary outcomes included other postoperative complications.ResultsA total of 800 patients who underwent elective colorectal surgery were identified. Four hundred seventeen patients (52%) were in the control group and 383 patients (48%) were in the ERAS group. Patients in both groups were similar with regard to demographics and clinical characteristics. There were significantly higher rates of cardiac arrhythmia in the control group (5.3%) compared with the ERAS group (1.8%),p = 0.009. Multivariable analysis revealed that ERAS was an independent predictor of decreased postoperative cardiac arrhythmia (OR 0.30, 95%CI 0.17–0.55,p
Gastric cancer remains one of the most common causes of cancer deaths worldwide. The best current option for reducing gastric cancer deaths is Helicobacter pylori eradication combined with risk assessment and surveillance programs for those deemed to be at high risk for gastric cancer so as to identify lesions at a stage amenable to curative therapy. In this issue, Nam et al1 report a retrospective study of Helicobacter pylori eradication on gastric cancer incidence among 10,328 Korean adults undergoing health checkups including an H pylori test-and-treat program.
We read with great interest the comment by Dr Li and colleagues1 referring to our study on endoscopic full-thickness resection (EFTR) for early colorectal cancer.2 We would like to thank the editors for the opportunity to reply.
Gastric cancer remains one of the most common cancers worldwide and is the third leading cause of cancer-related mortality, trailing only lung and colon cancer.1 Given its historically low survival rates, early detection and resection is the most effective strategy to improve prognosis. Endoscopic submucosal dissection (ESD), a technique developed in Japan, enables en bloc resection of early gastric cancer (EGC) and can be curative for selected lesions, depending on the histologic features, size, and tumor depth.
We read with interest the article by Kuellmer et al1 evaluating endoscopic full-thickness resection (EFTR) for early colorectal cancer. The authors found that EFTR for early colorectal cancer was feasible and safe. Because their findings are important to current practice, several questions deserve attention.
We have read with great interest the study by Januszewicz et al1 describing the concept of endoscopist biopsy rate (EBR) as a potential quality indicator for routine diagnostic outpatient EGD. The authors found a significant variability in EBR among 26 endoscopists and an association between higher EBR, a higher detection of gastric precancerous conditions, and a lower risk of missed gastric cancers.1
AbstractPurposeFatigue is a common and distressing symptom in cancer patients which negatively affects patients ’ daily functioning and health-related quality of life. The aim of this study was to assess multidimensional fatigue in patients with brain metastases (BM) before, and after Gamma Knife radiosurgery (GKRS).MethodsPatients with BM, an expected survival > 3 months, and a Karnofsky Performance Status ≥ 70 and 104 Dutch non-cancer controls were recruited. The Multidimensional Fatigue Inventory (MFI), measuring general fatigue, physical fatigue, mental fatigue, reduced ac...
ConclusionsOur results suggest a role of decreased MPC1 copy number segments in reducing overall survival in glioblastoma. MPC1 deletion is associated with poor response to TMZ chemotherapy in GBM.
Conclusion This paper summarizes the current findings regarding the anti-colitis activity of plant-derived alkaloids and shows how these alkaloids exhibit significant and beneficial effects in alleviating colonic inflammation. These natural alkaloids are not only promising agents for IBD treatment but are also components for developing new wonder drugs. However, the underlying molecular mechanisms or toxicological evaluation of most plant-derived alkaloids still require much scientific research, and their actual efficacies for IBD patients have not been verified well in field research. Thus, further clinical trials to elu...
Conclusion: Mesenchymal stem cell transplantation could be use as a potential treatment for PHLF. Introduction Partial hepatectomy is an important treatment for benign and malignant liver diseases. Although the liver can be completely regenerated after partial excision or injury, at least 1/3 of the liver should be retained in most of the patients, and 40–50% should be retained in patients with parenchymal liver disease (Adams et al., 2013; Cieslak et al., 2014). Postoperative complications, such as acute post-hepatectomy liver failure (PHLF) or small liver syndrome, may occur when the scope of excision is to...