Colorectal cancer surgery in a district general hospital.
The purpose of our study was to audit colorectal cancer surgery in a large district hospital, compare our results with other series and highlight any areas in patient management where improvements could be made. A comprehensive audit was undertaken of all patients undergoing surgery for colorectal adenocarcinoma over a 2-year period (December 1989 to November 1991). Two hundred and twenty-two patients were studied. General practitioner referrals were seen within 8 weeks in 140 (96%) of 149 cases. Delay to diagnosis was associated with barium enema examination. A consultant or senior registrar was present at 187 (84.2%) of operations, and only two (0.9%) were undertaken between 24.00 and 08.00 hours. For rectal tumours the ratio of anterior resection to abdomino-perineal excision was 2:1. Eight of nine anastomotic leaks followed low anterior resection. All required re-operation and three died. The overall in-hospital mortality was 17 (7.7%). Although our results compare favourably with other published series, several areas for potential improvement in management have been identified.
Wakefield
S E
SE
Northampton General Hospital, UK.
Baigrie
R J
RJ
MacLeod
A J
AJ
Berry
A R
AR
D000230:Adenocarcinoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006767:Hospitals, District / Q000592:standards*; D006769:Hospitals, General / Q000592:standards*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012017:Referral and Consultation; D016896:Treatment Outcome; D006113:United Kingdom