Prospective audit of colorectal resections in a peripheral public hospital.
BACKGROUND
Colorectal disease requiring surgery is common in New Zealand where there is no established national colorectal screening programme. We established an audit to review our current practice in colorectal surgery.


METHODS
Prospective audit data were collected on consecutive patients undergoing colorectal resection between April 2003 and December 2004, using a standardized pro forma.


RESULTS
In all, 170 colorectal resections were carried out of which 117 (69%) were for malignancy and 120 (71%) were elective. Median patient age was 72 years (interquartile range 62-78 years) and median length of stay was 10 days (interquartile range 8-14 days). Colonoscopy was the most common method of investigation. In elective patients with malignancy, the average delay between onset of symptoms and surgery was 25 weeks. Duke's stage C was the most common stage at presentation (44%). Complications developed in 83 (49%) of patients including 20 (12%) patients returned to theatre, 5 (3%) anastomotic leaks and 8 deaths (5%). In patients undergoing surgery aged over 80 (n = 40) the median length of stay was 10 days (7-14) with a complication rate of 21 (55%) including 5 (13%) who were returned to theatre and 6 (16%) deaths.


CONCLUSIONS
This audit has confirmed that there is an acceptable level of care at Taranaki Base Hospital when compared with those in published work. Elective patients with malignancy have a delay of nearly 6 months between the onset of symptoms and surgery. Patients in Taranaki are more likely to present with an advanced stage of tumour compared with other unscreened populations.
Gollop
Susan J
SJ
Department of Surgery, Taranaki Base Hospital, New Plymouth, Taranaki, New Zealand. susangollop@clear.net.nz
Fancourt
Michael W
MW
Gilkison
William T C
WT
Kyle
Stephen M
SM
Mosquera
Damien A
DA
D000368:Aged; D003107:Colorectal Surgery / Q000706:statistics & numerical data*; D006779:Hospitals, Public; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D009520:New Zealand; D011446:Prospective Studies