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Elective surgery for colorectal cancer in a defined Swedish population.

Jestin, Pia, (författare)
Uppsala universitet, Institutionen för kirurgiska vetenskaper
Heurgren, Mona (författare)
Påhlman, Lars (författare)
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Glimelius, Bengt (författare)
Gunnarsson, Ulf (författare)
Pahlman, L (författare)
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Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet. Medicinska fakulteten. Institutionen för kirurgiska vetenskaper. (creator_code:org_t)
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet. Medicinska fakulteten. Institutionen för kirurgiska vetenskaper. (creator_code:org_t)
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Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet. Medicinska fakulteten. Institutionen för onkologi, radiologi och klinisk immunologi. (creator_code:org_t)
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2004
Engelska.
Ingår i: Eur J Surg Oncol. - 0748-7983. ; 30:1, s. 26-33
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • AIMS: The aim of this study was to describe variability in compliance to clinical guidelines in colorectal cancer surgery related to hospital structure.METHODS: All patients registered in the databases of the Regional Oncologic Centre, operated upon electively for colon cancer between the start of the register in 1997 until 2000 (n=1771) and for rectal cancer between the start of the register in 1995 until 2000 (n=1841) were selected for analysis.RESULTS: There was no difference in 5-year survival rate between colon and rectal cancer (mean follow-up 2.6 and 3.0 years, respectively; p=0.22). There was a significant difference in frequency of preoperative liver scan depending on hospital category with an increase in colon cancer from 39 to 46% (p=0.02) and in rectal cancer from 42 to 64% (p<0.001). For colon cancer there was no difference, according to hospital category, in quotient sigmoid and high anterior resection to left-sided resection. Furthermore, high anterior resection was more common at university and general district hospitals (8%) compared with district hospitals (4%) (p=0.01). Sphincter-saving surgery was more common at university hospitals and district general hospitals than at district hospitals (low anterior/abdomino-perineal resection quotients 2.3, 2.4 and 1.6, respectively; p<0.001).CONCLUSIONS: Population-based audit forms an appropriate and valuable basis for quality assurance projects. In addition to describing compliance to guidelines and pointing to process steps that can be improved, such investigations may also indicate changes due to scientific development. Linked to case-costing data, such results may form an important basis for decisions about modifications in health care.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Adenocarcinoma/economics/mortality/*surgery
Aged
Colonic Neoplasms/economics/mortality/*surgery
Digestive System Surgical Procedures/economics/methods
Female
Guideline Adherence
Hospitals
District/statistics & numerical data
Hospitals
University/statistics & numerical data
Humans
Male
Quality Assurance
Health Care
Rectal Neoplasms/economics/mortality/*surgery
Registries
Surgical Procedures
Elective/economics
Survival Rate
MEDICINE Surgery Oncology
MEDICIN Kirurgi Onkologi
Hospitals; District/statistics & numerical data
Hospitals; University/statistics & numerical data
Quality Assurance; Health Care
Research Support; Non-U.S. Gov't
Surgical Procedures; Elective/economics
Sweden

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