Impact of perioperative hypoglycaemia in subjects with diabetes undergoing colorectal surgery.

Int J Colorectal Dis

Department of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore.

Published: February 2017

Introduction: This study explores the association between perioperative hypoglycaemia and surgical outcomes in subjects with diabetes, undergoing colorectal surgery.

Methods: A retrospective review of 149 subjects with Type 2 Diabetes Mellitus (DM) who underwent colorectal surgery between 2010 and 2015 was performed. Perioperative glucose levels, glycated haemoglobin (HbA1c) measurements within 3 months of surgery and surgical complications based on Clavien-Dindo classification were analysed.

Results: The mean age was 67 years (67 ± 11.2). Perioperative hypoglycaemia was found in 7.4% of subjects. The mean HbA1c of subjects with Clavien 2 and above surgical complications were higher than patients with Clavien 1 or no complications, Hba1c 7.6% (7.6 ± 2.5%) and 7.0% (7.0 ± 1.1%, p = 0.008), respectively. Similar findings in subjects with Clavien 3 and above complications, HbA1c of 8.2% (8.2 ± 3.9%) as compared to those with Clavien 2 and below complications, 7.2% (7.2 ± 1.5%, p = 0.001). Adjusted multivariate analysis showed that hypoglycaemia was significantly associated with Clavien 2 and above surgical complications, OR of 19.0 (CI 2.23-162, p = 0.007). Preoperative hypoglycaemia was associated with Clavien 2 and above surgical complications, OR 10.7 (CI 1.22-94.1, p = 0.032). Suboptimal glycaemic control (Hba1c >8.0%) was significantly associated with Clavien 2 and above complications, OR 2.48 (CI 1.04-5.91, p = 0.04), but not with Clavien 3 and above complications, OR 1.50 (CI 0.450-4.98, p = 0.511).

Conclusion: Perioperative hypoglycaemia is associated with adverse surgical outcomes in diabetic patients undergoing colorectal surgery. Prevention of hypoglycaemia may improve surgical outcomes. HbA1c is an independent predictor for adverse surgical outcomes.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00384-016-2680-9DOI Listing

Publication Analysis

Top Keywords

clavien complications
20
perioperative hypoglycaemia
16
surgical outcomes
16
surgical complications
16
undergoing colorectal
12
colorectal surgery
12
clavien surgical
12
hypoglycaemia associated
12
associated clavien
12
complications
9

Similar Publications

Robot-assisted kidney transplantation (RAKT) may reduce surgical complications compared to open kidney transplantation (OKT), but no randomised trials have explored this to date. The aim of the present study is to explore the feasibility of introducing RAKT at our institution, making it available in deceased donor transplantation and evaluate early surgical outcomes prior to performing a randomised trial comparing RAKT to OKT. RAKT was performed at Department of Urology, Copenhagen University Hospital, Rigshospitalet, Denmark.

View Article and Find Full Text PDF

[Adrenal tumors in pediatric patients treated with minimally invasive surgery].

Andes Pediatr

October 2024

Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Unlabelled: Adrenal tumors in children are frequently neoplastic and malignant, and surgical resection is the first management option. Minimally invasive surgery (MIS) has proven to be a safe management alternative and is suggested as a preferred alternative approach.

Objective: To report the surgical outcomes of patients with adrenal tumors treated by MIS.

View Article and Find Full Text PDF

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has become standard treatment for peritoneal cancers and metastases, significantly enhancing survival rates. This study evaluated the relationship between tumor burden, hemodynamic management, and postoperative outcomes after CRS-HIPEC. This study included 203 patients undergoing CRS-HIPEC.

View Article and Find Full Text PDF

In right-sided colon cancer surgery, lymph node dissection around the superior mesenteric artery is necessary but technically challenging. Here we introduce the concept of "outermost layer-oriented robotic surgery" to improve the safety, efficacy, and reproducibility of superior mesenteric artery nodal dissection. In this procedure, the thin, loose connective tissue layer between the autonomic nerve sheath of the superior mesenteric artery and adipose tissue bearing lymph nodes, termed "the outermost layer of the autonomic nerve," is dissected.

View Article and Find Full Text PDF

Background: The advantages of robot-assisted minimally invasive esophagectomy (RA-MIE) over conventional minimally invasive esophagectomy (C-MIE) are unknown. This nationwide large-scale study aimed to compare surgical outcomes between RA-MIE and C-MIE using rigorous propensity score methods, including detailed covariates and relevant outcomes.

Methods: This Japanese nationwide retrospective cohort study included RA-MIE or C-MIE for esophageal malignant tumors performed between October 2018 and December 2019 and registered in the Japanese National Clinical Database.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!