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Modified physiological and operative score for the enumeration of mortality and morbidity risk assessment model in general surgery

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World Journal of Gastroenterology 2007年第38期13卷 5090-5095页

作者： Lian-An Ding Li-Qun Sun Shuang-Xi Chen Lin-Lin Qu Dong-Fang Xie Department of General Surgery Affiliated Hospital of Medical College Qingdao University Qingdao 266003 Shandong Province China Department of ICU Haici Hospital of Medical College Qingdao University Qingdao 266003 Shandong Province China

AIM: To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), and to evaluate its efficacy. METHODS: Eighty-four patients with postoperative complications or death and 172 patients without postoperative complications, who underwent surgery in our department during the previous 2 years, were retrospectively analyzed by logistic regression. Fifteen indexes were investigated including age, cardiovascular function, respiratory function, blood test results, endocrine function, central nervous system function, hepatic function, renal function, nutritional status, extent of operative trauma, and course of anesthesia. Modified POSSUM (M-POSSUM) was developed using significant risk factors with its efficacy evaluated. RESULTS: The significant risk factors were found to be age, cardiovascular function, respiratory function, hepatic function, renal function, blood test results, endocrine function, nutritional status, duration of operation, intraoperative blood loss, and course of anesthesia. These factors were all included in the scoring system. There were significant differences in the scores between the patients with and without postoperative complications, between the patients died and survived with complications, and between the patients died and survived without complications. The receiver operating characteristic curves showed that the M-POSSUM could accurately predict postoperative complications and ***: M-POSSUM correlates well with postoperative complications and mortality, and is more accurate than POSSUM.

关键词： Physiological and operative severity score for the enumeration of mortality and morbidity postoperative morbidity Mortality Preoperative assessment General surgery Critical illness

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Short-term clinical outcomes of laparoscopic vs open rectal excision for rectal cancer: A systematic review and metaanalysis

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World Journal of Gastroenterology 2017年第44期23卷 7906-7916页

作者： Aleix Martínez-Pérez Maria Clotilde Carra Francesco Brunetti Nicola de'Angelis Department of Digestive Hepatobiliary Surgery and Liver Transplantation Henri Mondor University Hospital AP-HP Université Paris Est - UPEC Department of General and Digestive Surgery Hospital Universitario Doctor Peset Rothschild Hospital AP-HP Université Paris VII

AIM To review evidence on the short-term clinical outcomes of laparoscopic(LRR) vs open rectal resection(ORR) for rectal *** A systematic literature search was performed using Cochrane Central Register, MEDLINE, EMBASE, Scopus, Open Grey and Clinical *** register for randomized clinical trials(RCTs) comparing LRR vs ORR for rectal cancer and reporting short-term clinical outcomes. Articles published in English from January 1, 1995 to June, 30 2016 that met the selection criteria were retrieved and reviewed. The Preferred Reporting Items for Systematic reviews and Meta-Analysis(PRISMA) statements checklist for reporting a systematic review was followed. Random-effect models were used to estimate mean differences and risk ratios. The robustness and heterogeneity of the results were explored by performing sensitivity analyses. The pooledeffect was considered significant when P postoperative mortality(P = 0.19) and morbidity(P = 0.75) rates. The mean operative time was 36.67 min longer(95%CI: 27.22-46.11, P postoperative morbidity and mortality.

关键词： Laparoscopic rectal resection Open rectal resection Laparoscopy Rectal cancer postoperative morbidity Short-term outcomes Systematic review Meta-analysis

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