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Killian JT, Holcomb CN, Graham LA, Richman JS, Hawn MT. Delays in Surgery for Patients With Coronary Stents Placed After Diagnosis of Colorectal Cancer. JAMA Surg. 2016;151(1):86–88. doi:10.1001/jamasurg.2015.3130
Patients who received a diagnosis of colorectal cancer and who underwent a percutaneous coronary intervention represent a unique population with competing goals for timing of surgical care. The 2014 guidelines on perioperative management1 recommend delaying elective surgery for 30 days for bare metal stents and for 6 months to 1 year for drug-eluting stents. The current literature presents conflicting results regarding whether delay in the surgical treatment of colorectal cancer affects outcomes.2,3 We sought to determine whether the presence of a coronary stent affected the timing of colorectal cancer resection and the postoperative outcomes.
Patients with a history of coronary artery disease who underwent elective resection for colorectal cancer were identified from a previously described cohort of Veterans Affairs (VA) patients.4 Patients with a coronary stent were identified in the VA Medical SAS data sets. Surgical data were collected from the VA Surgical Quality Improvement Program. The date of the colonoscopy, with a corresponding International Classification of Diseases, Ninth Revision cancer diagnosis code preceding surgery, was identified using VA and Centers for Medicaid and Medicare Services administrative data. This study was approved by the institutional review board of the Birmingham VA Medical Center with a waiver of informed consent. An α level of .05 was considered statistically significant.
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