Perioperative and oncologic outcomes of interval colectomy performed by acute care surgeons after stenting as a bridge to surgery for left-sided malignant colonic obstruction are non-inferior to the outcomes of colorectal surgeons in the elective setting: single center experience

Aranda-Narváez, José Manuel; González-Cano, J.; González-Sánchez, Antonio Jesús; Titos-García, A.; Cabrera-Serna, I.; Romacho-López, L.; González-Poveda, I.; Mera-Velasco, S; Vázquez-Pedreño, L.; Santoyo-Santoyo, J.

doi:10.1007/s00068-022-02015-9

Cited by 3 publications

(1 citation statement)

References 35 publications

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“…Smaller-or low-volume hospitals usually do not have this division of specialized teams, and colorectal surgery as well as emergency surgery is performed by general surgeons with or without colorectal specialization. Some studies suggest that surgical specialization, hospital volume and caseload are important prognostic factors in elective colorectal cancer surgery [11][12][13][14], whereas the impact of surgical specialization on emergent colon cancer is more elusive [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Who should operate patients presenting with emergent colon cancer? A comparison of short- and long-term outcome depending on surgical sub-specialization

2023

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Background Colorectal cancer presents as emergencies in 20% of the cases. Emergency resection is associated with high postoperative morbidity and mortality. The specialization of the operating team in the emergency settings differs from the elective setting, which may have an impact on outcome. The aim of this study was to evaluate short- and long-term outcomes following emergent colon cancer surgery depending on sub-specialization of the operating team. Methods This is a retrospective population study based on data from the Swedish Colorectal Cancer Registry (SCRCR). In total, 656 patients undergoing emergent surgery for colon cancer between 2011 and 2016 were included. The cohort was divided in groups according to specialization of the operating team: (1) colorectal team (CRT); (2) emergency surgical team (EST); (3) general surgical team (GST). The impact of specialization on short- and long-term outcomes was analyzed. Results No statistically significant difference in 5-year overall survival (CRT 48.3%; EST 45.7%; GST 42.5%; p = 0.60) or 3-year recurrence-free survival (CRT 80.7%; EST 84.1%; GST 77.7%21.1%; p = 0.44) was noted between the groups. Neither was any significant difference in 30-day mortality (4.4%; 8.1%; 5.5%, p = 0.20), 90-day mortality (8.8; 11.9; 7.9%, p = 0.37) or postoperative complication rate (35.5%, 35.9 30.7, p = 0.52) noted between the groups. Multivariate analysis adjusted for case-mix showed no difference in hazard ratios for long-term survival or postoperative complications. The rate of permanent stoma after 3 years was higher in the EST group compared to the CRT and GST groups (34.5% vs. 24.3% and 23.9%, respectively; p < 0.0.5). Conclusion Surgical sub-specialization did not significantly affect postoperative complication rate, nor short- or long-term survival after emergent operation for colon cancer. Patients operated by emergency surgical teams were more likely to have a permanent stoma after 3 years.

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Section: Introductionmentioning

confidence: 99%

Who should operate patients presenting with emergent colon cancer? A comparison of short- and long-term outcome depending on surgical sub-specialization

2023

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Colorectal Oncologic Emergencies

Sullivan,

Donohue,

Brown

2024

Surgical Clinics of North America

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Does Operating Volume On-Call Vary by Surgeon? Analysis of On-Call Cases in an Academic Colorectal Practice

McKenna,

Mirande,

Bews

et al. 2024

The American Surgeon™

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The aim was to determine whether on-call case volumes differ amongst colorectal surgeons, and what cases are performed on-call in an academic colorectal surgery practice. The on-call schedule for the year 2021 of a colorectal surgery practice was analyzed. Details of the case origin and operative details were collected. Average cases performed per call per surgeon were compared. Ten surgeons were included, and average cases per call ranged from .5 to 1.4 with 1.0 the overall average ( P = .007). Analyzing individual pairs, differences existed between the 2 busiest and the least busy on-call surgeon (both P < .05). Most patients operated on-call were admitted via the emergency department (59%), and the most common operations were exams under anesthesia (39%) and bowel resections (33%). On average, 1 on-call case was performed per day. Surgeon on-call volume was similar aside from the busiest and least busy on-call surgeons.

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Perioperative and oncologic outcomes of interval colectomy performed by acute care surgeons after stenting as a bridge to surgery for left-sided malignant colonic obstruction are non-inferior to the outcomes of colorectal surgeons in the elective setting: single center experience

Cited by 3 publications

References 35 publications

Who should operate patients presenting with emergent colon cancer? A comparison of short- and long-term outcome depending on surgical sub-specialization

Who should operate patients presenting with emergent colon cancer? A comparison of short- and long-term outcome depending on surgical sub-specialization

Colorectal Oncologic Emergencies

Does Operating Volume On-Call Vary by Surgeon? Analysis of On-Call Cases in an Academic Colorectal Practice

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