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Volume of blood loss during surgery for colon cancer is a risk determinant for future small bowel obstruction caused by recurrence-a population-based epidemiological study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
2015 (English)In: Langenbeck's archives of surgery (Print), ISSN 1435-2443, E-ISSN 1435-2451, Vol. 400, no 5, 599-607 p.Article in journal (Refereed) Published
Abstract [en]

Small bowel obstruction (SBO) is a serious late complication after abdominal surgery. The pathogenesis of intra-abdominal adhesions has been extensively studied and reviewed, but the cascade of mechanisms involved is still not understood. The objective was to test the hypothesis that increasing volume of blood loss during surgery for colon cancer increases the risk for future SBO, mainly due to adhesions. Data were retrieved from the Regional Quality Register for all patients undergoing locally radical surgery for colon cancer 1997-2003 (n = 3 554) and matched with the Swedish National Patient Register data on surgery and admission for SBO. Records were reviewed to determine the etiology of surgery for SBO. Uni- and multivariate Cox analyses were used. One hundred ten patients (3.1 %) underwent surgery for SBO > 30 days after the index operation. Blood loss a parts per thousand yen250 ml was an independent risk factor for surgery for SBO due to recurrence (HR 2.20; 95 % CI 1.12-4.31). Amount of blood loss did not affect the risk for surgery for SBO due to adhesions. Furthermore, blood loss of a parts per thousand yen250 ml increased the risk for hospital admission for SBO not requiring surgery. Blood loss a parts per thousand yen250 ml during surgery for colon cancer is an independent risk factor for later surgery for SBO caused by tumor recurrence, not by adhesions.

Place, publisher, year, edition, pages
2015. Vol. 400, no 5, 599-607 p.
Keyword [en]
Hemorrhage, Perioperative bleeding, Colorectal neoplasm, Intestinal obstruction, SBO
National Category
Surgery
Identifiers
URN: urn:nbn:se:uu:diva-259673DOI: 10.1007/s00423-015-1317-8ISI: 000357495700009PubMedID: 26100567OAI: oai:DiVA.org:uu-259673DiVA: diva2:845153
Available from: 2015-08-11 Created: 2015-08-10 Last updated: 2017-12-04Bibliographically approved

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