Drenagem venosa assistida a vácuo na circulação extracorpórea e necessidade de hemotransfusão: experiência de serviço Vacuum-assisted venous drainage in cardiopulmonary bypass and need of blood transfusion: experience of service

OBJETIVO: Relatar a experiência com a técnica da drenagem venosa assistida a vácuo (DVAV) na cirurgia cardíaca com circulação extracorpórea (CEC) e a necessidade de hemotransfusão. MÉTODOS: Estudo retrospectivo em prontuários médicos de 111 pacientes operados com a aplicação da DVAV, no período de outubro de 2006 a fevereiro de 2008, no Hospital Esperança, em Recife, Pernambuco. A necessidade de hemotransfusão foi verificada dentro do único grupo estudado, com o uso da DVAV, comparada às variáveis, sexo, idade e peso dos pacientes nos períodos pré-CEC e transoperatório, com uso do teste Qui-quadrado e t-Student. RESULTADOS: No período pré-CEC, apenas 10% dos pacientes necessitaram de hemotransfusão, contra 12% da amostra no transoperatório. Foi observado que 17% das mulheres receberam sangue, contra apenas 4,7% dos homens no período pré-CEC (P=0,051), assim como 38% das mulheres, contra 9% dos homens no período transoperatório (POBJECTIVE: To report the experience with the vacuum-assisted venous drainage (VAVD) technique in cardiopulmonary bypass (CPBP) and blood transfusion need. METHODS: A retrospective study was made about data from 111 patients who were operated, using VAVD between October 2006 and February 2008, at the Esperança Hospital, Recife, Pernambuco. The necessity of blood transfusion was verified on the single group of patients who underwent VAVD, comparing with sex, age and weigh, before the beginning of the CPBP and during the surgery, using Chi-square test and t-student test. RESULTS: Before the beginning of the CPBP only 10% of patients had need for blood transfusion and 12% during the surgery. It was observed that 17% of women received blood transfusion versus 4.7% of men before the beginning of CPBP (P=0.51), and 38% of women versus 9% of men during the surgery (P<0.001). The weight of patients who received blood transfusion were lower both before the beginning of the CPBP as during the surgery (P=0.049 e P=0.001, respectively). CONCLUSION: The VAVD technique has been used safely and satisfactorily, optimizing venous drainage during CPBP, in the hospital that conducted the study. However, prospective and comparative investigations between conventional drainage and VAVD are needed to better clarify this relation with blood transfusion

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery