title: Small can be beautiful: 10 years managing colorectal cancer in a rural general hospital.
abstract: There has been much recent debate on the relationship between surgical volume and outcomes. The aim of this study was to assess the ability of a rural general hospital to provide care for patients with colorectal cancer in a small-volume practice. A retrospective review of patients treated in a rural general hospital, between January 1993 and December 2002, was undertaken. Patient demographics, disease characteristics, treatments and complications were all recorded. Ninety-eight patients had a final diagnosis of colorectal cancer. There was an equal male: female ratio and an average age of 69 years (40-88 years). Eighty-five percent underwent treatment with curative intent. The postoperative complication rate was low (2% wound infections, 2.3% anastomotic leak rate) and Dukes-specific five-year survival was satisfactory (A > 80%, B and C > 60%). In conclusion, this study adds weight to the argument that even with low-volume workload, satisfactory results can still be obtained.
authors.affiliation: Aberdeen Royal Infirmary, Fort William, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Grant
authors.forename: D M
authors.initials: DM
authors.lastname: Sedgwick
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006780:Hospitals, Rural; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D019035:Rural Health Services / Q000706:statistics & numerical data; D012606:Scotland / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome; D016526:Workload