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Lookup NU author(s): Seamus Kelly, Ronald Wilson, Alastair Gunn
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Background: Several studies have shown a relationship between surgeon volume and outcomes in colorectal cancer surgery. The aim of this study was to determine the impact of surgeon volume and specialization on primary tumour resection rate, restoration of bowel continuity following rectal cancer resection, anastomotic leakage and perioperative mortality. Methods: The Northern Region Colorectal Cancer Audit Group conducts a population-based audit of patients with colorectal cancer managed by surgeons. This study examined 8219 patients treated between 1998 and 2002. Outcomes were modelled using multivariate logistic regression analysis. Results: Tumour resection was performed in 6949 (93.8 per cent) of 7411 patients. High-volume surgeons with an annual caseload of at least 18.5 (odds ratio (OR) 1.53 (95 per cent confidence interval (c.i.) 1.10 to 2.12); P = 0.012) and colorectal specialists (OR 1.42 (95 per cent c.i. 1.06 to 1.90); P = 0.018) were more likely to perform elective sphincter-saving rectal surgery. In elective surgery, the risk of perioperative death was lower for high-volume surgeons (OR 0.58 (95 per cent c.i. 0.44 to 0.76); P < 0.001), but this was not the case in emergency surgery. Conclusion: High-volume surgeons had lower perioperative mortality rates for elective surgery, and were more likely to use restorative rectal procedures.
Author(s): Borowski DW, Kelly SB, Bradburn DM, Wilson RG, Gunn A, Ratcliffe AA, and the members of the Northern Region Colorectal Cancer Audit Group
Publication type: Article
Publication status: Published
Journal: British Journal of Surgery
Year: 2007
Volume: 94
Issue: 7
Pages: 880-889
ISSN (print): 0007-1323
ISSN (electronic): 1365-2168
Publisher: John Wiley & Sons Ltd.
URL: http://dx.doi.org/10.1002/bjs.5721
DOI: 10.1002/bjs.5721
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