caa a22 4500 606247882 CHVBK 20210128101347.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s12262-015-1281-0 doi (NATIONALLICENCE)springer-10.1007/s12262-015-1281-0 Is Radical Bowel Cancer Resection Under Local Anaesthesia and Sedation Feasible? [Elektronische Daten] [J. Sebastian, H. Sran, D. Marzouk] Some patients with bowel cancer have significant comorbidities, making them unfit for major surgery under general anaesthesia. However, treatment without surgery offers no possibility of cure, and furthermore, symptom control may be poor. We investigated the possibility of performing these resections under local anaesthesia in patients with a slim body habitus in a cohort of patients rejected for general anaesthesia. Eight patients (4 M, 4 F) aged 77-89 were included in this study. All had significant comorbidities and were deemed unfit for general anaesthesia by the consultant anaesthetist in charge of pre assessing high-risk patients. All patients had undergone a thorough assessment, which included P-POSSUM scoring. The recruited patients underwent a careful and fully informed consenting process, leading to standard cancer resections. These resections occurred between 2005 and 2012, under combined local anaesthesia and sedation. The operations undertaken were four right hemicolectomies (for caecal cancer), two Hartmann's procedures (for sigmoid cancer), one Hartmann's procedure with en bloc small bowel resection (for sigmoid cancer invading small bowel) and one transverse colectomy (for mid transverse colon cancer). Seven patients survived radical surgery without complications, although one died from an unrelated cause 8months after surgery. One of these surviving patients subsequently underwent CABG and further bowel surgery under GA 2years later for a metachronous sigmoid cancer. There was one postoperative death due to cardiogenic shock on the third postoperative day. Radical cancer resections under local anaesthesia are feasible in suitably selected high-risk patients with acceptable mortality and comparable medium- to long-term results. Association of Surgeons of India, 2015 Bowel cancer nationallicence Resection nationallicence Local anaesthesia nationallicence Sedation nationallicence Sebastian J. Queen Elizabeth the Queen Mother Hospital, Margate, Kent, UK aut Sran H. Queen Elizabeth the Queen Mother Hospital, Margate, Kent, UK aut Marzouk D. Queen Elizabeth the Queen Mother Hospital, Margate, Kent, UK aut Indian Journal of Surgery Springer India 77/4(2015-08-01), 260-264 0972-2068 77:4<260 2015 77 12262 https://doi.org/10.1007/s12262-015-1281-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-015-1281-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sebastian J. Queen Elizabeth the Queen Mother Hospital, Margate, Kent, UK aut NATIONALLICENCE 700 1- Sran H. Queen Elizabeth the Queen Mother Hospital, Margate, Kent, UK aut NATIONALLICENCE 700 1- Marzouk D. Queen Elizabeth the Queen Mother Hospital, Margate, Kent, UK aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77/4(2015-08-01), 260-264 0972-2068 77:4<260 2015 77 12262