L S Nymo1,2, S Norderval3,4, M T Eriksen5,6, H H Wasmuth7, H Kørner8,9, B A Bjørnbeth6,10, T Moger11, A Viste9,12, K Lassen4,10. 1. Department of Gastrointestinal Surgery, University Hospital of North Norway, 9019, Tromsø, Norway. linnsnymo@gmail.com. 2. Institute of Clinical Medicine, Faculty of Health Science, UIT, The Arctic University of Norway, 9019, Tromsø, Norway. linnsnymo@gmail.com. 3. Department of Gastrointestinal Surgery, University Hospital of North Norway, 9019, Tromsø, Norway. 4. Institute of Clinical Medicine, Faculty of Health Science, UIT, The Arctic University of Norway, 9019, Tromsø, Norway. 5. Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital, 0424, Oslo, Norway. 6. Institute of Clinical Medicine, University of Oslo, 0316, Oslo, Norway. 7. Department of Gastrointestinal Surgery, St. Olav Hospital, Trondheim University Hospital, 7006, Trondheim, Norway. 8. Department of Gastrointestinal Surgery, Stavanger University Hospital, 4068, Stavanger, Norway. 9. Institute of Clinical Medicine, University of Bergen, Bergen, Norway. 10. Department of HPB Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 11. Surgical Department, Innlandet Hospital Trust, Lillehammer, Norway. 12. Haukeland University Hospital, Bergen, Norway.
Abstract
BACKGROUND: To describe the real burden of major complications after elective surgery for colon cancer in Norway, and to assess which predictors that are significantly associated with the short-term outcome. METHODS: An observational, multi-centre analysis of prospectively registered colon resections registered into the Norwegian Registry for Gastrointestinal Surgery, NoRGast, between January 2014 and December 2016. A propensity score-adjusted subgroup analysis for surgical access groups was attempted, with laparoscopic resections grouped as intention-to-treat. RESULTS: Out of 1812 resections, 14.0% of patients experienced a major complication within 30 days following surgery. The over-all reoperation rate was 8.7%, and rate of reoperation for anastomotic leak was 3.8%. Twenty patients (1.1%) died within 30 days after surgery. Higher age was not a significant predictor of major complications, including 30-day mortality. After correction for all co-variables, open access surgery was associated with higher rates of major complications (OR 1.67 (CI 1.22-2.29), p = 0.002), higher 30-day mortality (OR 4.39 (CI 1.19-16.13) p = 0.026) and longer length-of-stay (HR 0.58 (CI 0.52-0.65) p < 0.001). CONCLUSIONS: Our results indicate a low complication burden and high rate of uneventful patient journeys after elective surgery for colon cancer in Norway. Age was not associated with higher morbidity or mortality rates. Open access surgery was associated with an inferior short-term outcome.
BACKGROUND: To describe the real burden of major complications after elective surgery for colon cancer in Norway, and to assess which predictors that are significantly associated with the short-term outcome. METHODS: An observational, multi-centre analysis of prospectively registered colon resections registered into the Norwegian Registry for Gastrointestinal Surgery, NoRGast, between January 2014 and December 2016. A propensity score-adjusted subgroup analysis for surgical access groups was attempted, with laparoscopic resections grouped as intention-to-treat. RESULTS: Out of 1812 resections, 14.0% of patients experienced a major complication within 30 days following surgery. The over-all reoperation rate was 8.7%, and rate of reoperation for anastomotic leak was 3.8%. Twenty patients (1.1%) died within 30 days after surgery. Higher age was not a significant predictor of major complications, including 30-day mortality. After correction for all co-variables, open access surgery was associated with higher rates of major complications (OR 1.67 (CI 1.22-2.29), p = 0.002), higher 30-day mortality (OR 4.39 (CI 1.19-16.13) p = 0.026) and longer length-of-stay (HR 0.58 (CI 0.52-0.65) p < 0.001). CONCLUSIONS: Our results indicate a low complication burden and high rate of uneventful patient journeys after elective surgery for colon cancer in Norway. Age was not associated with higher morbidity or mortality rates. Open access surgery was associated with an inferior short-term outcome.
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: J Clin Epidemiol Date: 2008-04 Impact factor: 6.437
Authors: Marco E Allaix; Giuseppe Giraudo; Massimiliano Mistrangelo; Alberto Arezzo; Mario Morino Journal: Surg Endosc Date: 2014-08-09 Impact factor: 4.584
Authors: Santiago Gonzalez-Ayora; Carlos Pastor; Hector Guadalajara; Jose Manuel Ramirez; Pablo Royo; Elizabeth Redondo; Antonio Arroyo; Pedro Moya; Damian Garcia-Olmo Journal: Int J Colorectal Dis Date: 2016-07-04 Impact factor: 2.571
Authors: Masoud Babaei; Yesilda Balavarca; Lina Jansen; Adam Gondos; Valery Lemmens; Annika Sjövall; Tom Brge Johannesen; Michel Moreau; Liberale Gabriel; Ana Filipa Gonçalves; Maria José Bento; Tony van de Velde; Lana Raffaela Kempfer; Nikolaus Becker; Alexis Ulrich; Cornelia M Ulrich; Petra Schrotz-King; Hermann Brenner Journal: Medicine (Baltimore) Date: 2016-05 Impact factor: 1.889
Authors: Michael P M de Neree Tot Babberich; Julia T van Groningen; Evelien Dekker; Theo Wiggers; Michel W J M Wouters; Willem A Bemelman; Pieter J Tanis Journal: Surg Endosc Date: 2018-01-17 Impact factor: 4.584