Audit of colorectal cancer surgery by non-specialist surgeons.
BACKGROUND
Some authorities recommend that colorectal cancer should be treated in specialist units but evidence that non-specialist units demonstrate comparatively poor results may be lacking.


METHODS
Between 1987 and 1991, 267 patients were operated on by four general surgeons, none of whom was a specialist in colorectal surgery. Procedure-related complications, postoperative mortality and disease-related survival rates were analysed.


RESULTS
There were four cases of intraperitoneal sepsis (1 per cent) and five of 189 patients (3 per cent) had clinical anastomotic dehiscence; there was no case of wound dehiscence. The postoperative mortality rate after elective and emergency surgery was 2 and 13 per cent respectively. The 5-year disease-related survival rate for curative and palliative surgery was 67 and 9 per cent respectively. There were no significant differences between the surgeons.


CONCLUSIONS
Disease-related variables such as early-stage disease and fewer patients presenting as emergencies may have a greater favourable influence on ultimate survival than surgeon-related variables.
Singh
K K
KK
Department of Surgery, Dumfries and Galloway Royal Infirmary, UK.
Barry
M K
MK
Ralston
P
P
Henderson
M A
MA
McCormick
J S
JS
Walls
A D
AD
Auld
C D
CD
D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery*; D003253:Consultants; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D010166:Palliative Care; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome