334 Chapter 14 providing PFFC in hospitals in general. Family-centered care extends beyond simply having family members present during hospitalization; it encompasses active involvement and participation of families in all aspects of care delivery 67. In the surgical realm, the active participation of family caregivers in essential care tasks holds promise for enhancing healthrelated outcomes, such as QoL and discomfort levels 68. Based on the interpretations of part III of this thesis, we believe this care approach can positively influence patients’ experiences during and after the development of a colorectal leak for several reasons 69. By involving patients and their families in care decisions, empowerment and engagement are fostered, enabling active participation in treatment processes 70. This engagement also promotes clear and transparent communication between healthcare providers, patients, and their family, ensuring that treatment decisions are aligned with patient preferences and values. The latter was mentioned as very important during the patient interviews in chapter 10. Moreover, a holistic approach to care is emphasized, addressing not only the physical health needs but also the psychosocial aspects of patient well-being 66. These needs became clear while conducting the patient interviews. Additionally, PFCC supports patients in self-managing their care and recovery, facilitating better adherence to postoperative instructions and treatment plans, which were reported to be difficult sometimes by the patients. By gathering continuous feedback from patients and their family, healthcare providers can identify areas for improvement and implement quality enhancement initiatives, ultimately leading to better patient outcomes and experiences throughout the diagnostic, treatment and followup journey 66, 68. This approach is not only necessary during the development of an AL, but during their whole oncological treatment journey. As presented in the introduction of this thesis, current evidence regarding long-term oncological outcomes after AL is conflicting 71-79. Whether it does or does not influence the risk of distant metastases, it is always important to minimize the risk of metachronous development of tumor deposits after primary surgery to improve patients’ outcomes. PART IV: PREVENTION OF METACHRONOUS PERITONEAL METASTASES AFTER COLORECTAL CANCER SURGERY In part IV of this thesis highlighted the importance of discovering specific biomarkers for metachronous PM in primary colorectal tumors for deploying efficient preventive measures in patients. PM, which involve the dissemination of CRC cells to the peritoneal cavity, pose a substantial hurdle in cancer care owing to their aggressiveness and scant treatment choices. Nevertheless, early identification of particular biomarkers linked to PM might empower clinicians to investigate preventive strategies, thereby enhancing their efficacy in addressing high-risk patients.
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