scholarly journals Do Outcomes in Elective Colon and Rectal Cancer Surgery Differ by Weekday? An Observational Study Using Data From the Dutch ColoRectal Audit

2019 ◽  
Vol 17 (7) ◽  
pp. 821-828
Author(s):  
Daniëlle D. Huijts ◽  
Onno R. Guicherit ◽  
Jan Willem T. Dekker ◽  
Julia T. van Groningen ◽  
Leti van Bodegom-Vos ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Elective Surgery ◽  
Cancer Surgery ◽  
Case Mix ◽  
Rectal Cancer Surgery ◽  
Failure To Rescue ◽  
Complication Risk ◽  
Colon And Rectal Cancer ◽  
Case Mix Adjustment ◽  
Elective Colon

AbstractBackground: Previous studies showing higher mortality after elective surgery performed on a Friday were based on administrative data, known for insufficient case-mix adjustment. The goal of this study was to investigate the risk of adverse events for patients with colon and rectal cancer by day of elective surgery using clinical data from the Dutch ColoRectal Audit. Patients and Methods: Prospectively collected data from the 2012–2015 Dutch ColoRectal Audit (n=36,616) were used to examine differences in mortality, severe complications, and failure to rescue by day of elective surgery (Monday through Friday). Monday was used as a reference, analyses were stratified for colon and rectal cancer, and case-mix adjustments were made for previously identified variables. Results: For both colon and rectal cancer, crude mortality, severe complications, and failure-to-rescue rates varied by day of elective surgery. After case-mix adjustment, lower severe complication risk was found for rectal cancer surgery performed on a Friday (odds ratio, 0.84; 95% CI, 0.72–0.97) versus Monday. No significant differences were found for colon cancer surgery performed on different weekdays. Conclusions: No weekday effect was found for elective colon and rectal cancer surgery in the Netherlands. Lower severe complication risk for elective rectal cancer surgery performed on a Friday may be caused by patient selection.

scholarly journals Level of arterial ligation in sigmoid colon and rectal cancer surgery

2016 ◽  
Vol 14 (1) ◽  
Author(s):  
Koji Yasuda ◽  
Kazushige Kawai ◽  
Soichiro Ishihara ◽  
Koji Murono ◽  
Kensuke Otani ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Sigmoid Colon ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Arterial Ligation ◽  
Colon And Rectal Cancer

scholarly journals Differences in organization of care are associated with mortality, severe complication and failure to rescue in emergency colon cancer surgery

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Daniëlle D Huijts ◽  
Jan willem T Dekker ◽  
Leti van bodegom-vos ◽  
Julia T van groningen ◽  
Esther Bastiaannet ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Operating Room ◽  
Cancer Surgery ◽  
Severe Complication ◽  
Case Mix ◽  
Failure To Rescue ◽  
Complication Risk ◽  
Colon Cancer Surgery ◽  
Room Time ◽  
Operating Room Time

Abstract Background Emergency colon cancer surgery is associated with increased mortality and complication risk, which can be due to differences in the organization of hospital care. This study aimed. Objective To explore which structural factors in the preoperative, perioperative and postoperative periods influence outcomes after emergency colon cancer surgery. Methods An observational study was performed in 30 Dutch hospitals. Medical records from 1738 patients operated in the period 2012 till 2015 were reviewed on the type of referral, intensive care unit (ICU) level, surgeon specialization and experience, duration of surgery and operating room time, blood loss, stay on specialized postoperative ward, complication occurrence, reintervention and day of surgery and linked to case-mix data available in the Dutch Colorectal Audit. Multivariate logistic regression analysis was used to estimate the influence of these factors on 30-day mortality, severe complication and failure to rescue (FTR), after adjustment for case-mix. Results Patients operated by a non-Gastro intestinal/oncology specialized surgeon have significantly increased mortality (Odds Ratio (OR) 2.28 [95% confidence interval (95% CI) 1.23–4.23]) and severe complication risk (OR 1.61 [95% CI 1.08–2.39]). Also, duration of stay in the operating room was significantly associated with increased risk on severe complication (OR 1.03 [95% CI 1.01–1.06]). Patients admitted to a non-specialized ward have significantly increased mortality (OR 2.25 [95% CI 1.46–3.47]) and FTR risk (OR 2.39 [95% CI 1.52–3.75]). A low ICU level (basic ICU) was associated with a lower severe complication risk (OR 0.72 [95% CI 0.52–1.00]). Surgery on Tuesday was associated with a higher mortality risk (OR 2.82 [95% CI 1.24–6.40]) and a severe complication risk (OR 1.77, [95% CI 1.19–2.65]). Conclusion This study identified a non-specialized surgeon and ward, operating room, time and day of surgery to be risk factors for worse outcomes in emergency colon cancer surgery.

Surgical Treatment for Colorectal Cancer

2011 ◽  
Vol 96 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Art Hiranyakas ◽  
Yik-Hong Ho
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Surgical Treatment ◽  
Surgical Techniques ◽  
Cancer Surgery ◽  
Oncologic Outcomes ◽  
Rectal Cancer Surgery ◽  
Short Term ◽  
Colon And Rectal Cancer ◽  
Laparoscopic Colon

Abstract The rapid in development of surgical technology has had a major effect in surgical treatment of colorectal cancer. Laparoscopic colon cancer surgery has been proven to provide better short-term clinical and oncologic outcomes. However this quickly accepted surgical approach is still performed by a minority of colorectal surgeons. The more technically challenging procedure of laparoscopic rectal cancer surgery is also on its way to demonstrating perhaps similar short-term benefits. This article reviews current evidences of both short-term and long-term outcomes of laparoscopic colorectal cancer surgery, including the overall costs comparison between laparoscopic surgery and conventional open surgery. In addition, different surgical techniques for laparoscopic colon and rectal cancer are compared. Also the relevant future challenge of colorectal cancer robotic surgery is reviewed.

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