Resection of the Primary Tumor in Stage IV Colorectal Cancer: When Is It Necessary?

Management of metastatic colorectal cancer requires accurate staging and multidisciplinary evaluation, leading to a consensus treatment plan with the ultimate goal of increasing survival and improving the quality of life, while taking into consideration the patient's performance status, disease burden, and goals of care. Since the introduction of multidrug chemotherapeutic regimens, survival of patients with metastatic colorectal cancer has improved. Many patients with unresectable disease are undergoing surgery for asymptomatic primary tumors despite evidence that it is usually a futile intervention.

Incremental cost of complications in colectomy: a warranty guided approach to surgical quality improvement.

Background: We assessed the warranty cost for colectomy at a single institution, as defined by the additional cost of treating complications distributed across all patients treated.

Methods: All segmental colectomies from July 8 to June 12 were reviewed for 0, 1, 2, and ≥3 complications. Warranty cost is defined as follows: ([mean additional cost of the case with complication(s) - mean base case cost] × number of episodes)/total population.

Anastomotic leaks: technique and timing of detection.

Background: Despite the proven benefits of laparoscopic colorectal surgery, the rate of anastomotic leaks has not changed. This study looks at the time of presentation of anastomotic leaks between laparoscopic and open colectomies.

Methods: Retrospective chart review was performed between July 2008 and 2012.

Colonic stents: the modern treatment of colonic obstruction.

Colonic stents traditionally have been used for the management of colorectal cancer, either as a palliative treatment or as a bridge to surgery. More recently, colonic stents have also been advocated as part of the therapy of benign strictures. A number of colonic stents are available worldwide, four of which are made in the USA.