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BACKGROUND: Colorectal cancer is a significant health concern. Surgery remains a critical component of the multimodal treatment strategy. The laparoscopic sphincter-preserving total mesorectal excision (TME) is increasingly utilized and effective, offering enhanced quality of life for patients compared to previous traditional methods. OBJECTIVES: This study aims to determine the rate of complications and the related factors associated with complications following laparoscopic sphincter-preserving total mesorectal excision for low rectal cancer. METHODS: This retrospective study was conducted at the University Medical Center of Ho Chi Minh City from March 2022 to March 2023. It included patients aged 18 years and older diagnosed with low rectal cancer who underwent laparoscopic sphincter-preserving total mesorectal excision. Data on patient demographics, surgical details, and postoperative complications were retrospectively collected and analyzed. Follow-ups were conducted up to six months after surgery. RESULTS: Of the 83 patients included, the postoperative complications rate was 14.5%. The complications observed included surgical wound infections (five cases), anastomotic leaks (five cases, including three recto-vaginal fistulas and two pelvic abscesses), urinary retention (one case), and pneumonia (one case). A significant finding was the higher rate of distant metastases in patients with complications compared to those without (p=0.033). CONCLUSION: Laparoscopic sphincter-preserving total mesorectal excision for low rectal cancer is safe and effective, with a high success rate and low complication rate during or after surgery. Anastomotic leakage remains the most significant complication. Despite advancements in surgery, modern suturing tools, and preoperative patient optimization, complications are avoidable. Therefore, understanding the related factors and implementing preventive interventions is crucial.
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Background Rectal resection with total mesorectal excision is a difficult surgery with potential risks of complications. This study aims to assess the quality of life (QoL) of patients with low rectal cancer who have bowel function disorders equivalent to major low anterior resection syndrome (LARS) and its risk factors before treatment. Methods A descriptive cross-sectional study was conducted on 83 patients diagnosed with low rectal cancer who had not been treated. Quality of life was assessed by the European Organisation for Research and Treatment of Cancer's (EORTC) 30-Item Core Quality of Life Questionnaire (QLQ-C30) and the LARS scale. Results Fiffty-five (66.3%) patients had moderate/major low anterior resection syndrome, of which 34 (41%) patients had major low anterior resection syndrome. The study implicated that old age, smoking, and alcohol consumption were risk factors associated with high scores on the scale for LARS (p<0.05). Patients with low rectal cancer had low overall QoL score. In the symptom area of increased financial hardship scores, factors that adversely affected the poor quality of life in patients with low rectal cancer were fatigue and bowel dysfunction with p<0.05. Conclusion The percentage of rectal cancer patients with low anterior resection syndrome was high, and the associated risk factors were old age, smoking, and drinking alcohol. Before treatment, the physical and mental health of patients with low rectal cancer with major low anterior resection syndrome was very poor.
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Background: Heart attack, acute myocardial infarction, are a major cause of morbidity and mortality in Western countries and are rapidly pandemic in developing and underdeveloped countries. Periostin concentration increases in the blood of patients after acute myocardial infarction and affects the process of cardiac remodeling leading to myocardial fibrosis. Objective: To evaluate the correlation between serum periostin levels and cardiac function and acute myocardial infarction patients' short-term prognosis (three months after onset). Methods: Fifty-two acute myocardial infarction patients were prospectively enrolled in the present study, and 52 controls were established. The levels of periostin of acute myocardial infarction patients at 5-7 days after the onset were measured using enzyme-linked immunosorbent assay. Other blood tests and echocardiography were performed during the patient's hospital stay. The correlation between periostin and TIMI, GRACE scores, body mass index, laboratory findings, and 3-month post- acute myocardial infarction data, including pro-B-type natriuretic peptide and echocardiographic parameters, were investigated. Results: Serum periostin levels increased significantly in acute myocardial infarction patients compared with normal controls. There was an association between serum periostin at diagnosis and cardiac function three months after acute myocardial infarction: serum periostin was in negative correlation with ejection fraction (r = - 0.31, p = 0.028); positive association was found between serum periostin level and left ventricular end-diastolic diameter (r = 0.38, p = 0.006). Conclusion: Serum periostin levels increase in acute myocardial infarction, and serum periostin can be used to predict cardiac function three months after acute myocardial infarction.
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BACKGROUND: Video-assisted thoracoscopic surgery lobectomy combined with lymphadenectomy is widely utilized worldwide for treating non-small cell lung cancer. We evaluated the long-term survival outcomes of this approach and determined the prognostic factors of overall survival. METHODS: This prospective observational study was performed in patients with non-small cell lung cancer who were subjected to video-assisted lobectomy and lymphadenectomy from 2012 to 2016. Independent prognostic factors were determined via uni- and multivariable Cox models. RESULTS: There were 109 patients with the mean age of 59.2 years and males accounted for 54.1%. Postoperative staging determined 22.9% of stage IA, 31.2% of stage IB, 16.5% of stage IIA and 29.4% of stage IIIA. Median follow-up time was 27 months. The overall survival rate after 1, 2, 3, 4 and 5 years was 100%, 85.9%, 65.3%, 55.9% and 55.9%, respectively. In univariable analysis, smoking (hazard ratio (HR) [95% confidence interval (CI)]: 2.50 [1.18-5.31]), Tumor--nodes--metastases (TNM) stage (IIA: 7.60 [1.57-36.9]; IIIA: 14.3 [3.28-62.7] compared to IA), histological differentiation (moderately differentiated: 4.91 [1.04-23.2]; poorly differentiated: 8.25 [1.91-35.6] compared to well differentiated), lymph node size ≥1 cm (8.22 [3.11-21.7]), tumour size ≥3 cm (4.24 [1.01-17.9]), radical lymphadenectomy (6.67 [3.14-14.2]) were identified as prognostic factors of the long-term survival. In multivariable analysis, only radical lymphadenectomy was an independent prognostic factor (HR [95% CI]: 3.94 [1.41-11.0]). CONCLUSION: Video-assisted thoracoscopic lobectomy combined with lymphadenectomy is feasible, safe and effective for the treatment of non-small cell lung cancer. The long-term outcomes of this method are favourable, especially at the early stage of cancer.
