Nouvelles interventions pour améliorer les résultats des chirurgies colorectales électives et d'urgence

 

Marylise Boutros

CIUSSS du Centre-Ouest-de-l'Île-de-Montréal

 

Domaine : santé des populations

Programme Chercheurs-boursiers cliniciens - Junior 1

Concours 2018-2019

Colorectal surgery has improved over the last decades, however, despite excellent skills, these operations have a significant risk of complications (25%). My research program focuses on improving the outcomes of colorectal operations through new innovations and interventions.

My first project tackles a postoperative complication associated with a common operation used for rectal cancer. Many patients who have rectal cancer surgery, also get a temporary bag that collects stool (loop ileostomy). After they recover, they require another operation for the intestines to be reconnected and to remove the bag. During this operation, a complication called "ileus" might develop. Ileus refers to "lazy gut after surgery" and may happen when part of the intestines has not been used in a while. Ileus causes discomfort and intolerance to food, and requires a longer hospital stay. Our study aims to see whether this unused intestine can be stimulated in the clinic before surgery to prevent ileus after surgery. The second project focuses on improving outcomes of severe Clostridium difficile, a bacterial infection that can cause serious inflammation of the colon. The current treatment for this severe infection is total removal of the colon with an ileostomy ("a bag").

Even after this big operation, the risk of death (>30%) and severe complications (>50%) are high. The purpose of our study is to determine if a loop ileostomy and washing the colon to eliminate bacterial toxins, can result in better outcomes than entire removal of the colon. The third project focuses on improving common (50-70%) lifestyle-related complications (losing stool, frequent stools, urgency and leaking) in rectal cancer survivors who have undergone surgery. This will be done by studying all available resources worldwide on this issue, through the internet and then developing a robust education tool to empower patients in self-management for these difficult problems.