OCR Text |
Show 127 school of medicine and health sciences The risk of developing colorectal cancers is dramatically increased in obese persons. A component of the metabolic syndrome, obesity has been estimated to affect up to 50% of the population, and has been associated with fatty infiltration of the liver in up to 20% of individuals, leading to steatohepatitis and overt cirrhosis in the most severe cases. Surgery is the cornerstone of treatment in the case of colorectal malignancies, and thus it is inevitable that surgeons will encounter patients with both dis-eases. Cirrhotic patients exhibit demonstrably greater surgical morbidity, which often conflicts with their need for surgical intervention. The aim of this study was to reconcile these contradictions. After appropriate IRB approval, patients were identified through ICD-9 codes by the University of Utah Health Sciences Enterprise Data warehouse team (Table 1). A chart review was performed extracting data from laboratory values, clinical procedures, medical histories and survival outcomes. Using a matched 20:1 case/control design, patients were selected by type of malignancy, stage, gender, and age. Linear regression models and odds ratio analyses were performed. Patients presenting with liver dysfunction exhibit a trend toward a more complicated hospital course, demonstrated by higher levels of key indicators of risk (Table 2). Compromised liver function is a predictor of significant morbidity for colorectal cancer patients, who possess markedly elevated blood loss during surgery, subsequent blood products utilized, duration of hospital stay, as well as time spent on ventilator assisted respiration and in the intensive care unit. Of greatest significance, all patients with failing livers experienced complications associated with their treatment and most were deceased within approximately 3 years of surgical intervention. From these preliminary results, we conclude that patients with evidence of cirrhosis or liver disease undergoing major colorectal procedures for oncologic indications are likely to suffer a set of signifi-cant complications both intra-operatively and post-operatively. Because of these complications, it is incumbent upon clinicians to screen for these disorders so that complications can be mitigated. RETROSPECTIVE ANALYSIS OF PATIENTS EXPERIENCING COLORECTAL CANCER IN CONJUNCTION WITH LIVER DYSFUNCTION James Lelis (Zachary Arnold, Heather Thiesset, Greg Stoddard, Jason Schwartz, John Sorensen) Department of General Surgery, Section of Transplantation University of Utah School of Medicine UNDERGRADUATE RESEARCH ABSTRACTS James Lelis Zachary Arnold John Sorensen |