Annals of Coloproctology

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Risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis: Jiyoung Shin, Myong Hoon Ihn, Kyung Sik Kim, Sang Hyun Kim, Jihyoun Lee, Sangchul Yun, Sung Woo Cho; Ann Coloproctol. 2023;39(1):50-58. Published online November 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00773.0110

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Purpose
We sought to identify the risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis.
Methods
The study retrospectively analyzed 497 patients who underwent laparoscopic appendectomies for uncomplicated appendicitis between January 2018 and December 2020. The patients were divided into an early discharge group (≤2 days) and a late discharge group (>2 days) based on the length of hospital stay (LOS). The patients were also divided into uneventful and complicated groups according to the need for additional treatment after standard follow-up.
Results
Thirty-seven patients (7.4%) were included in the late discharge group. The mean LOS of the late discharge groups was 3.9 days. There were significant differences according to age, preoperative C-reactive protein (CRP), and operative time between the 2 groups. Only operative time was significantly associated with prolonged LOS in multivariate analysis. Thirty-five patients (7.0%) were included in the complicated group. The mean duration of treatment in the uneventful and complicated groups was 7.4 and 25.3 days, respectively. Significant differences existed between the uneventful and complicated groups in preoperative body temperature, preoperative CRP levels, maximal appendix diameter, and the presence of appendicoliths. In multivariate analysis, preoperative CRP levels and maximal appendix diameter were independent predictors of delayed treatment completion.
Conclusion
Shorter operative time is desirable to ensure minimal hospital stay in patients with uncomplicated appendicitis. Further efforts are needed to ensure that patients with uncomplicated appendicitis do not experience delayed treatment completion after laparoscopic appendectomies.

Citations

Citations to this article as recorded by

Association between preoperative neutrophil-to-lymphocyte ratio and length of stay in pediatric patients undergoing laparoscopic appendectomy: a retrospective cohort study
Ming Liu, Yunpeng Gou, Ping Yang
BMC Pediatrics.2025;[Epub] CrossRef
Comparative Outcomes of Immediate and Delayed Wound Closure Techniques in Appendectomies for Gangrenous Appendicitis
Anzar Usman, Esha Akbar, Aliha Mukhtar, Iqra Nasir, Usama Rehman, Adil Iqbal, Muhammad Umar Umar
DEVELOPMENTAL MEDICO-LIFE-SCIENCES.2024; 1(3): 18. CrossRef
Non-linear association between C-reactive protein levels and length of stay in pediatric appendicitis patients undergoing laparoscopic appendectomy
Ming Liu, Ping Yang, Yunpeng Gou
Frontiers in Pediatrics.2024;[Epub] CrossRef
Nomogram prediction model for length of hospital stay following laparoscopic appendectomy in pediatric patients: a retrospective study
Ming Liu, Ping Yang, Yunpeng Gou, Qiang Chen, Dong Xu
Frontiers in Pediatrics.2024;[Epub] CrossRef

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy

Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer: Hyun Hee Kim, Myong Hoon Ihn, Yun Hee Lee, Jihyoun Lee, Sangchul Yun, Sung Woo Cho; Ann Coloproctol. 2020;36(4):229-242. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.10.03

6,071 View
104 Download
11 Web of Science
12 Citations

Abstract PDF Supplementary Material

Purpose
We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.
Methods
Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.
Results
Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).
Conclusion
This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

Citations

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Outcome of robotic colon surgery in older patients with colon cancer
Ellen Van Eetvelde, Manu Verweirder, Lore Decoster, Daniel Jacobs-Tulleneers-Thevissen
Journal of Geriatric Oncology.2025; 16(3): 102205. CrossRef
Survival Benefits of Postoperative Chemotherapy in Patients With Colorectal Mucinous Adenocarcinoma: An Analysis Utilizing Propensity Score Matching From the Surveillance, Epidemiology, and End Results Database
Jun Rong, Wensheng Deng
The American Surgeon™.2024; 90(11): 2969. CrossRef
Nutritional Status Indicators Predict Tolerability to Adjuvant Chemotherapy in Patients with Stage II/III Rectal Cancer Undergoing Neoadjuvant Chemoradiotherapy
Shinya Abe, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Hiroyuki Matsuzaki, Yuzo Nagai, Takahide Shinagawa, Hirofumi Sonoda, Soichiro Ishihara
Digestion.2024; 105(5): 345. CrossRef
Abdominal Aortic Calcification as a Predictor of Incomplete Adjuvant Chemotherapy in Stage III Colorectal Cancer: A Retrospective Cohort Study
Kouki Imaoka, Manabu Shimomura, Hiroshi Okuda, Takuya Yano, Shintaro Akabane, Masahiro Ohira, Yuki Imaoka, Tetsuya Mochizuki, Minoru Hattori, Hideki Ohdan
Cureus.2024;[Epub] CrossRef
Effect of continuous wound infiltration on patients using intravenous patient-controlled analgesia for pain management after reduced-port laparoscopic colorectal surgery
Hyeon Deok Choi, Sung Uk Bae
Annals of Coloproctology.2024; 40(6): 564. CrossRef
Differences in prognosis and underuse of adjuvant chemotherapy between elderly and non‐elderly patients in stage III colorectal cancer
Takuya Shiraishi, Hiroomi Ogawa, Ikuma Shioi, Naoya Ozawa, Katsuya Osone, Takuhisa Okada, Makoto Sohda, Ken Shirabe, Hiroshi Saeki
Annals of Gastroenterological Surgery.2023; 7(1): 91. CrossRef
Clinical outcomes and cost comparison of laparoscopic versus open surgery in elderly colorectal cancer patients over 80 years
Aik Yong Chok, Ivan En-Howe Tan, Yun Zhao, Madeline Yen Min Chee, Hui Lionel Raphael Chen, Kwok Ann Ang, Marianne Kit Har Au, Emile John Kwong Wei Tan
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Association between social background and implementation of postoperative adjuvant chemotherapy for older patients undergoing curative resection of colorectal cancers, sub-analysis of the HiSCO-04 study
Tomoaki Bekki, Manabu Shimomura, Yasufumi Saito, Masahiro Nakahara, Tomohiro Adachi, Satoshi Ikeda, Yosuke Shimizu, Masatoshi Kochi, Yasuyo Ishizaki, Masanori Yoshimitsu, Yuji Takakura, Wataru Shimizu, Daisuke Sumitani, Shinya Kodama, Masahiko Fujimori, M
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Operative and Survival Outcomes of Robotic-Assisted Surgery for Colorectal Cancer in Elderly and Very Elderly Patients: A Study in a Tertiary Hospital in South Korea
Hugo Cuellar-Gomez, Siti Mayuha Rusli, María Esther Ocharan-Hernández, Tae-Hoon Lee, Guglielmo Niccolò Piozzi, Seon-Hahn Kim, Cruz Vargas-De-León, Yazhou He
Journal of Oncology.2022; 2022: 1. CrossRef
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Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
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Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Adjuvant Chemotherapy in Elderly Colorectal Cancer Patients
Bengt Glimelius, Erik Osterman
Cancers.2020; 12(8): 2289. CrossRef

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