AI Article Synopsis
- The study compared post-operative recovery and complications between obese and non-obese patients after open gynecologic cancer surgery in an enhanced recovery program.
- Although obese patients had longer surgery times and more blood loss, their hospital stay was similar to that of non-obese patients, averaging 3 days.
- Both groups experienced similar rates of serious complications and readmissions, but obese patients had more minor complications and required higher opioid doses.
Article Abstract
Objective: To compare post-operative length of stay and complication rates of matched obese and non-obese patients in an enhanced recovery (ERAS) program after open gynecologic cancer surgery.
Methods: We performed an observational cohort study of patients (n=1225) undergoing open surgery from November 2014 to November 2018 at a tertiary cancer center. Patients undergoing multidisciplinary procedures, non-oncologic surgery, or procedures in addition to abdominal surgery were excluded (n=190). Obese and non-obese patients were matched by date, age, disease status, and surgical complexity. The primary outcome was post-operative length of stay. Secondary outcomes included 30-day peri-operative complications, re-operation, re-admission, opioid use, and program compliance.
Results: After matching, 696 patients (348 obese, 348 non-obese) with median age of 57 years (IQR 48-66) were analyzed. Obese patients had a longer median procedure time (218 min vs 192.5 min, p<0.001) and greater median estimated blood loss (300 mL vs 200 mL, p<0.001). Median (IQR) post-operative length of stay was the same for obese and non-obese patients: 3 days (IQR 2-4). Obese and non-obese patients had similar rates of grade III-IV complications (10.9% and 6.6%, respectively, p=0.06), re-operation (2.3% and 1.4%, respectively, p=0.58), and re-admission (11.8% and 8.0%, respectively, p=0.13). Grade I-II complications were more common among obese patients (62.4% vs 48.3%, p<0.001) because they had more wound complications (17.8% vs 4.9%, p<0.001). Obese patients received more opioids both during surgery (morphine equivalent dose 57.25 mg (IQR 35-72.5) vs 50 mg (IQR 25-622.5), p=0.003) and after surgery (morphine equivalent daily dose 45 mg/day (IQR 10-96.2) vs 29.37 mg/day (IQR 7.5-70), p=0.01). Obese and non-obese patients had similar ERAS program compliance (70.1% and 69.8%, respectively, p=0.32).
Conclusions: Neither post-operative length of stay nor the rate of serious complications differed significantly despite longer surgeries, greater blood loss, and more opioid use among obese patients. An ERAS program was safe, effective, and feasible for obese patients with suspected gynecologic cancer.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310617 | PMC |
| http://dx.doi.org/10.1136/ijgc-2020-001663 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Enhanced recovery after surgery (ERAS) in stoma reversal surgery: a systematic review and meta-analysis.
Updates Surg
January 2025
TriHealth Good Samaritan Hospital, Cincinnati, OH, USA.
Stoma reversal surgery is known for relatively high complication rates. While Enhanced Recovery After Surgery (ERAS) protocols are extensively validated for colorectal surgery, their use in stoma reversal remains underexplored. This systematic review and meta-analysis evaluates clinical outcomes of stoma reversal surgery under ERAS protocols compared to standard care (SC) practices.
View Article and Find Full Text PDFA sensory neuroprosthesis enhances recovery from treadmill-induced stumbles for individuals with lower limb loss.
Sci Rep
January 2025
Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA.
Over 50% of individuals with lower limb loss report a fear of falling and avoiding daily activities partly due to a lack of plantar sensation. Providing direct somatosensory feedback via neural stimulation holds promise for addressing this issue. In this study, three individuals with lower limb loss received a sensory neuroprosthesis (SNP) that provided plantar somatosensory feedback corresponding to prosthesis-floor interactions perceived as arising from the missing foot generated by electrically activating the peripheral nerves in the residuum.
View Article and Find Full Text PDFImpact of diabetes mellitus on postoperative complications in patients undergoing pancreatic surgery.
HPB (Oxford)
December 2024
Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland. Electronic address:
Background: Enhanced Recovery After Surgery (ERAS) protocols decrease postoperative complications, but data on their effect on diabetic patients undergoing pancreatectomy are scarce. This study assessed whether diabetes mellitus (DM) was a morbidity predictor after pancreatectomy within an ERAS program.
Methods: A cross-sectional study including all patients who underwent pancreatectomy (2012-2022) and followed an ERAS pathway was performed.
Post-COVID metabolic enzyme alterations in K18-hACE2 mice exacerbate alcohol-induced liver injury through transcriptional regulation.
Free Radic Biol Med
January 2025
Korea Mouse Phenotyping Center, Seoul National University, Seoul 08826, Republic of Korea; Laboratory of Developmental Biology and Genomics, Research Institute for Veterinary Science, and BK21 PLUS Program for Creative Veterinary Science Research, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea; Interdisciplinary Program for Bioinformatics, Program for Cancer Biology and BIO-MAX/N-Bio Institute, Seoul National University, Seoul 08826, Republic of Korea. Electronic address:
Article Synopsis
- COVID-19, caused by SARS-CoV-2, poses serious global health risks, including the potential for secondary liver injury related to metabolic enzyme changes.
- This study explores how prior infection with SARS-CoV-2 affects alcohol-induced liver damage, using transgenic mice that express human ACE2.
- Results showed that infected mice experienced worsened liver injury after alcohol consumption, with alterations in metabolic enzymes and increased levels of a toxic alcohol byproduct, indicating a complex interaction between COVID-19 and alcohol effects on the liver.
Anaerobic sludge digestion enhancement with bioelectrochemical and electrically conductive materials augmentation: a state of the art review.
Chemosphere
January 2025
DICAR University of Pavia, 27100 Pavia, Italy. Electronic address:
Excess biological sludge processing and disposal have a significant impact on the energy balance and economics of wastewater treatment operations, and on receiving environments. Anaerobic digestion is probably the most widespread in-plant sludge processing method globally, since it stabilizes and converts biosolids organic matter into biogas, allowing partial recovery of their embedded chemical energy. A considerable number of studies concerning applicable techniques to improve biogas production, both in quantity and quality, include pre-treatment strategies to promote biosolids disintegration aimed at the release and solubilisation of intracellular energy compounds, inorganic/biological amendments aimed at improving process performance, and sludge thermal pre-treatment.
View Article and Find Full Text PDFWant 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!