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Accelerated Recovery Protocol in Extended Combined and Single-Stage Surgery for Pelvic Cancer

https://doi.org/10.24060/2076-3093-2021-11-2-125-131

Abstract

Introduction. The study aimed to evaluate a routine accelerated recovery management in patients with extended combined pelvic surgery.

Materials and methods. We surveyed the records and outcomes in various oncological patients following the accelerated recovery protocol after a routine extended combined pelvic surgery at the Moscow City Oncology Hospital No. 1 during 2018–2020.

Results and discussion. Locally advanced tumours comprised 37 (75.5 %) cases, and the remaining 12 (24.5 %) were nonpelvic resections due to metastasis. Radical surgery was achieved in 41 (83.7 %) cases, while the other 8 (16.3 %) were symptomatic due to the emerged complications of intestinal permeability disruption, bleeding, urinary obstruction, paracancrotic abscess, internal fistulae or pain syndrome. Postoperative complications were evaluated in the Clavien-Dindo classification.

Conclusion. The results obtained suggest the feasibility of an accelerated recovery protocol-based practice in extended combined pelvic surgery.

About the Authors

V. K. Lyadov
City Clinical Oncology Hospital No. 1; Novokuznetsk State Institute for Advanced Medical Training; Russian Medical Academy of Continuous Professional Education
Russian Federation

Vladimir K. Lyadov — Dr. Sci. (Med.), Department of Oncology, Department of Oncology and Palliative Care named after A.I. Savitskiy, Oncology Unit No. 4

Moscow, Russian Federation

Novokuznetsk, Russian Federation



M. R. Garipov
City Clinical Oncology Hospital No. 1
Russian Federation

Marat R. Garipov — Oncology Unit No. 4

Moscow, Russian Federation



A. N. Moskalenko
City Clinical Oncology Hospital No. 1
Russian Federation

Aleksei N. Moskalenko — Operating Room

Moscow, Russian Federation



E. V. Cherepanova
City Clinical Oncology Hospital No. 1
Russian Federation

Ekaterina V. Cherepanova — Cand. Sci. (Med.), Oncology Unit No. 4

Moscow, Russian Federation



T. S. Dikova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Tatyana S. Dikova — Graduate Student (6th year)

Moscow, Russian Federation



References

1. Kaprin A.D., Starinsky V.V., Shakhzadova A.O. (eds.). The status of cancer care for the population of Russia in 2019. Moscow: National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation; 2020. 248 p. (In Russ.)

2. Chissov V.I., Frank G.A., Sidorov D.V., Mainovskaya O.A., Troitsky A.A., Lozhkin M.V., et al. Results of surgical and combination treatment for rectal cancer. Russian Journal of Oncology. 2012;3:4–7 (In Russ.).

3. Sidorov D.V., Alekseev B.I., Lozhkin M.V., Vorob’ev N.V., Petrov L.O., Grishin N.A., et al. 100 small pelvic exenterations in patients with locally advanced primary and recurrent rectal tumors. P.A. Herzen Journal of Oncology. 2017;6(2):5–11 (In Russ.) DOI: 10.17116/onkolog2017625-11

4. Global guidelines for the prevention of surgical site infection. Geneva: WHO; 2016.

5. Kaprin A.D., Kostin A.A., Sidorov D.V., Petrov L.O., Ilin K.A., Zamyatin A.V. (eds.) Exenteration of the small pelvis in recurrent cervical cancer: tactical and technical aspects. Guidelines. Moscow: Kvazar; 2015.

6. Lee D.J., Sagar P.M., Sadadcharam G., Tan K.Y. Advances in surgical management for locally recurrent rectal cancer: How far have we come? World J Gastroenterol. 2017;23(23):4170–80. DOI: 10.3748/wjg.v23.i23.4170

7. Sammour T., Zargar-Shoshtari K., Bhat A., Kahokehr A., Hill A.G. A programme of Enhanced Recovery After Surgery (ERAS) is a cost-effective intervention in elective colonic surgery. N Z Med J. 2010;123(1319):61–70. PMID: 20717178

8. PelvEx Collaborative. Palliative pelvic exenteration: A systematic review of patient-centered outcomes. Eur J Surg Oncol. 2019;45(10):1787–95. DOI: 10.1016/j.ejso.2019.06.011

9. Beverly A., Kaye A.D., Ljungqvist O., Urman R.D. Essential elements of multimodal analgesia in Enhanced Recovery After Surgery (ERAS) Guidelines. Anesthesiol Clin. 2017;35(2):e115–43. DOI: 10.1016/j.anclin.2017.01.018

10. Nygren J., Hausel J., Kehlet H., Revhaug A., Lassen K., Dejong C., et al. A comparison in five European Centres of case mix, clinical management and outcomes following either conventional or fast-track perioperative care in colorectal surgery. Clin Nutr. 2005;24(3):455–61. DOI: 10.1016/j.clnu.2005.02.003

11. Petersen J., Kloth B., Konertz J., Kubitz J., Schulte-Uentrop L., Ketels G., et al. Economic impact of enhanced recovery after surgery protocol in minimally invasive cardiac surgery. BMC Health Serv Res. 2021;21(1):254. DOI: 10.1186/s12913-021-06218-5

12. Sammour T., Rodriguez-Bigas M.A., Skibber J.M. Locally recurrent disease related to anal canal cancers. Surg Oncol Clin N Am. 2017;26(1):115–25. DOI: 10.1016/j.soc.2016.07.006

13. Zatevakhin I.I., Pasechnik I.N., Achkasov S.I., Gubaidullin R.R., Lyadov K.V., Protsenko D.N., et al. Clinical guidelines on implementation of enhanced-recovery-after-surgery program for elective colorectal surgery. Doctor.ru. 2016;(12-1):8–21 (In Russ.).

14. Gustafsson U.O., Scott M.J., Schwenk W., Demartines N., Roulin D., Francis N., et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS(®)) Society recommendations. World J Surg. 2013;37(2):259–84. DOI: 10.1007/s00268-012-1772-0

15. Nelson G., Bakkum-Gamez J., Kalogera E., Glaser G., Altman A., Meyer L.A., et al. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations- 2019 update. Int J Gynecol Cancer. 2019;29(4):651–68. DOI: 10.1136/ijgc-2019-000356

16. PelvExCollaborative. Pelvic exenteration for advanced nonrectal pelvic malignancy. Ann Surg. 2019;270(5):899–905. DOI: 10.1097/SLA.0000000000003533

17. Galliamov E.A., Agapov M.A., Biktimirov R.G., Sergeev V.P., Sanzharov A.E., Kochkin A.D., Volodin D.I., Malahov P.S., Gololobov G.Yu., Kakotkin V.V. Laparoscopic pelvic evisceration in male and female patients. Surgical practice. 2020;(1):15–23 (In Russ.). DOI: 10.38181/2223-2427-2020-1-15-23

18. Venchiarutti R.L., Solomon M.J., Koh C.E., Young J.M., Steffens D. Pushing the boundaries of pelvic exenteration by maintaining survival at the cost of morbidity. Br J Surg. 2019;106(10):1393–403. DOI: 10.1002/bjs.11203

19. Kostjuk I.P., Vasilev L.A., Kostin A.A., Kaprin A.D. Multivisceral resection in complex treatment of pelvic tumors. Bulletin of Pirogov National Medical & Surgical Center. 2016;11(1):108–16 (In Russ.).


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For citations:


Lyadov V.K., Garipov M.R., Moskalenko A.N., Cherepanova E.V., Dikova T.S. Accelerated Recovery Protocol in Extended Combined and Single-Stage Surgery for Pelvic Cancer. Creative surgery and oncology. 2021;11(2):125-131. (In Russ.) https://doi.org/10.24060/2076-3093-2021-11-2-125-131

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ISSN 2076-3093 (Print)
ISSN 2307-0501 (Online)