We included all complications that patients presented during chemotherapy treatment,
hence global morbidity rate being 26.8%. It was not necessary to contraindicate surgery in any of the eighteen patients who presented complications. Blood levels of haemoglobin, www.selleckchem.com/products/ly2109761.html leukocytes and platelets were analyzed and all of them were within the accepted range in order to perform a safe surgery. Global complications that appeared after primary tumor resection were assessed, including cases where another surgical intervention was simultaneously performed. Five surgical and six clinical complications were observed. Inhibitors,research,lifescience,medical The complication global rate was 16.4%, which is comparable to another reported series (15-17) and much lower than the morbidity prediction for this group of patients (16.4% vs. 58.3%). Different speciality-specific POSSUM models have been developed, like O-POSSUM (18) or CR-POSSUM (19). POSSUM Inhibitors,research,lifescience,medical and P-POSSUM have been considered a good predictor of surgical complications (20) although some studies suggest an overprediction for colon cancer surgery with these scores (21). No cases of surgical conversion from laparoscopic to open approach were observed and the reoperation rate was little
lower than what has been described by other authors: 2.9% vs. 3.8-5.8% (15,22). These two cases of reoperation were secondary to an Inhibitors,research,lifescience,medical anastomotic Inhibitors,research,lifescience,medical leakage. One should mention the low blood transfusion requirement. The hospital admission period is within the same range as other colorectal surgery series. It is known that the previous comorbidity is a risk factor of
surgical complications and hospital stay (23). Fifty five percent of our patients had some important copathology. No cases of perioperative mortality were registered. If patients with unresectable metastatic colon cancer should undergo primary tumor resection still remains controversial. Some authors prefer primary Inhibitors,research,lifescience,medical chemotherapy (24-26), while others think that primary colectomy improves OS compared with only chemotherapy (27-29). In stage IV CRC patients who complete all treatment steps, classical (primary tumour resection, liver metastases-directed chemotherapy followed by hepatic resection) and reversed (liver metastases-directed chemotherapy, hepatic resection and then, primary tumour resection) sequential managements have been associated with similar survival rates (30). We can find medroxyprogesterone some limitations in this study, such as the unicentric and retrospective character and the use of different chemotherapy regimens before surgery. On the other hand, this is a selected group of patients that were able to achieve the surgical treatment after chemotherapy. Although chemotherapy treatment was administrated before surgery, our results are within the accepted postoperative complication limits of colorectal surgery.