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Techniques in Coloproctology

Erschienen in:

01.01.2021 | Review

The influence of diabetes on postoperative complications following colorectal surgery

verfasst von: D. J. H. Tan, C. Y. L. Yaow, H. T. Mok, C. H. Ng, C. H. Tai, H. Y. Tham, F. J. Foo, C. S. Chong

Erschienen in: Techniques in Coloproctology | Ausgabe 3/2021

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Abstract

Background

Diabetes mellitus has been commonly associated with poor surgical outcomes. The aim of this meta-analysis was to assess the impact of diabetes on postoperative complications following colorectal surgery.

Methods

Medline, Embase and China National Knowledge Infrastructure electronic databases were reviewed from inception until May 9th 2020. Meta-analysis of proportions and comparative meta-analysis were conducted. Studies that involved patients with diabetes mellitus having colorectal surgery, with the inclusion of patients without a history of diabetes as a control, were selected. The outcomes measured were postoperative complications.

Results

Fifty-five studies with a total of 666,886 patients comprising 93,173 patients with diabetes and 573,713 patients without diabetes were included. Anastomotic leak (OR 2.407; 95% CI 1.837–3.155; p < 0.001), surgical site infections (OR 1.979; 95% CI 1.636–2.394; p < 0.001), urinary complications (OR 1.687; 95% CI 1.210–2.353; p = 0.002), and hospital readmissions (OR 1.406; 95% CI 1.349–1.466; p < 0.001) were found to be significantly higher amongst patients with diabetes following colorectal surgery. The incidence of septicemia, intra-abdominal infections, mechanical failure of wound healing comprising wound dehiscence and disruption, pulmonary complications, reoperation, and 30-day mortality were not significantly increased.

Conclusions

This meta-analysis and systematic review found a higher incidence of postoperative complications including anastomotic leaks and a higher re-admission rate. Risk profiling for diabetes prior to surgery and perioperative optimization for patients with diabetes is critical to improve surgical outcomes.

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Mok HT, Ong ZH, Yaow CYL, Ng CH, Buan BJL, Wong NW, Chong CS (2020) Indocyanine green fluorescent imaging on anastomotic leakage in colectomies: a network meta-analysis and systematic review. Int J Colorectal Dis. https://doi.org/10.1007/s00384-020-03723-7CrossRefPubMed

Titel: The influence of diabetes on postoperative complications following colorectal surgery
verfasst von: D. J. H. Tan
C. Y. L. Yaow
H. T. Mok
C. H. Ng
C. H. Tai
H. Y. Tham
F. J. Foo
C. S. Chong
Publikationsdatum: 01.01.2021
Verlag: Springer International Publishing
Erschienen in: Techniques in Coloproctology / Ausgabe 3/2021
Print ISSN: 1123-6337
Elektronische ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-020-02373-9

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Abstract

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Methods

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Conclusions

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