Prasad Krishnan1,2,3,4,5, Prakash Kurumboor6,7,8,9, Deepak Varma6,7,8,9, Shweta Mallick6,7,8,10, Sudheer Othiyil Vayoth6,7,8,10, Unnikrishnan Gopalakrishnan6,7,8,10, Ramesh Hariharan6,7,8,11, Mahesh Subramaniaiyer6,7,8,11, Sylesh Aikot6,7,8,12, Rajesh Nambiar6,7,8,13, Sajeesh Sahadevan6,7,8,13, Ramesh Rajan6,7,8,14, Bonny Natesh6,7,8,14, Sindhu Radha Sadasivan6,7,8,14, Venugopal Bhaskaran6,7,8,15, Shabeerali Thudikkodan Usman6,7,8,15, Arunkumar Madhavan Leela6,7,8,16, Sathchith Sadashiva6,7,8,16, Joshy John6,7,8,17, Naduthottum Palaniswami Kamalesh6,7,8,9, Bejoy Abraham6,7,8,18, Peethambaran Muttikulangara Swaminathan6,7,8,19, Sujith Philip6,7,8,20, Raveendran Subash6,7,8,21, Vipin Iyyani Sreekumar6,7,8,9. 1. Sree Naryana Institute of Medical Sciences, Chalakka, North Kuthiathode, Ernakulam, 683 594, India. drkprasad2000@gmail.com. 2. Department of Surgical Gastroenterology, Aster Medcity Hospital, Kuttisahib Road, South Chittoor, Cheranalloor, 682 027, India. drkprasad2000@gmail.com. 3. Department of Surgical Gastroenterology, GG Hospital, Thirvanathapuram, 695 011, India. drkprasad2000@gmail.com. 4. Department of Surgical Gastroenterology, PVS Memorial Hospital, Kochi, 682 017, India. drkprasad2000@gmail.com. 5. Department of Surgical Gastroenterology, Paalana Institute of Medical Sciences, Palakkad, 678 701, India. drkprasad2000@gmail.com. 6. Department of Surgical Gastroenterology, GG Hospital, Thirvanathapuram, 695 011, India. 7. Department of Surgical Gastroenterology, PVS Memorial Hospital, Kochi, 682 017, India. 8. Department of Surgical Gastroenterology, Paalana Institute of Medical Sciences, Palakkad, 678 701, India. 9. Department of Surgical Gastroenterology, Aster Medcity Hospital, Kuttisahib Road, South Chittoor, Cheranalloor Kochi, 682 027, India. 10. Department of Surgical Gastroenterology, Amrita Institute of Medical Sciences and Research Center, Ponekkara, Kochi, 682 041, India. 11. Department of Surgical Gastroenterology, VPS Lakeshore Hospital, NH bypass Nettoor, Maradu, Ernakulam, 682 040, India. 12. Department of Surgical Gastroenterology, Baby Memorial Hospital, Indira Gandhi Road, Arayidathupalam, Kozhikode, 673 004, India. 13. Department of Surgical Gastroenterology, Aster MIMS Hospital, Mini Bypass Rd, Govindapuram, Kozhikode, 673 016, India. 14. Department of Surgical Gastroenterology, Government Medical College, Ulloor Akkulam Road Near SAT hospital, Medical College Junction, Thiruvananthapuram, 695 011, India. 15. Department of Surgical Gastroenterology, Kerala Institute of Medical Sciences, Vinod Nagar Road, Anayara, Thirvananthapuram, 695 029, India. 16. Department of Surgical Gastroenterology, Sree Gokulam Medical College and Research Foundation, Aalamthara - Bhoothamadakki Road, Venjaramoodu, 695 607, India. 17. Department of Surgical Gastroenterology, Holycross Superspeciality Hospital, Holycross Hospital Road, Kottiyam, Kollam, 691 571, India. 18. Department of Surgical Gastroenterology, Little Flower Hospital and Research Center, M C Road, Angamaly, 683 572, India. 19. Avitis Superspeciality Hospital, Pollachi-Thrissur main road, Near Japamalarani church, Nenmara, 678 508, India. 20. Department of Surgical Gastroenterology, Believers Church Medical College Hospital, St. Thomas Nagar, Kuttapuzha, Thiruvalla, 689 103, India. 21. Department of Surgical Gastroenterology, SK Hospital, Thiruvanthapuram Neyyar Dam Road, Edapazhanji, Thiruvananthapuram, 695 006, India.
Abstract
BACKGROUND: Although colorectal cancer (CRC) may not be uncommon in India, accurate data regarding its demographics and surgical outcomes is sparse. METHODS: With an aim to assess demographics and perioperative outcomes of CRC in Kerala, all members of Association of Surgical Gastroenterologists of Kerala (ASGK) were invited to participate in a registry. Data of operated cases of CRC were entered on a web-based questionnaire by participating members from January 2016. Analysis of accrued data until March 2018 was performed. RESULTS: From 25 gastrointestinal surgical centers in Kerala, 15 ASGK member hospitals contributed 1018 CRC cases to the database (M:F 621:397; median age-63.5 years [15-95 years]). Rectum (39.88%) and rectosigmoid (20.33%) cancers comprised the majority of the patients. Among them, preoperative bowel preparation was given to 37.68%, minimally invasive surgery (MIS) was performed in 73%, covering stoma in 47% and had an overall leak rate of 3.58%. In colonic malignancies, MIS was performed in 56.74%, covering stoma created in 13% and had a leak rate of 2.71%. Of 406 patients with rectal cancers, neo-adjuvant radiotherapy/chemoradiotherapy was given to 51.23%. The mean hospital stay for MIS in both rectal and colonic cancer patients was significantly shorter than open approach (10.46 ± 5.08 vs. 12.26 ± 6.03 days; p = 0.001and 10.29 ± 4.58 vs. 12.46 ± 6.014 days; p = <0.001). Mortality occurred in 2.2% patients. CONCLUSION: A voluntary non-funded registry for CRC surgery was successfully created. Initial data suggest that MIS was performed in majority, which was associated with shorter hospital stay than open approach. Overall mortality and leak rate appeared to be low.
BACKGROUND: Although colorectal cancer (CRC) may not be uncommon in India, accurate data regarding its demographics and surgical outcomes is sparse. METHODS: With an aim to assess demographics and perioperative outcomes of CRC in Kerala, all members of Association of Surgical Gastroenterologists of Kerala (ASGK) were invited to participate in a registry. Data of operated cases of CRC were entered on a web-based questionnaire by participating members from January 2016. Analysis of accrued data until March 2018 was performed. RESULTS: From 25 gastrointestinal surgical centers in Kerala, 15 ASGK member hospitals contributed 1018 CRC cases to the database (M:F 621:397; median age-63.5 years [15-95 years]). Rectum (39.88%) and rectosigmoid (20.33%) cancers comprised the majority of the patients. Among them, preoperative bowel preparation was given to 37.68%, minimally invasive surgery (MIS) was performed in 73%, covering stoma in 47% and had an overall leak rate of 3.58%. In colonic malignancies, MIS was performed in 56.74%, covering stoma created in 13% and had a leak rate of 2.71%. Of 406 patients with rectal cancers, neo-adjuvant radiotherapy/chemoradiotherapy was given to 51.23%. The mean hospital stay for MIS in both rectal and colonic cancerpatients was significantly shorter than open approach (10.46 ± 5.08 vs. 12.26 ± 6.03 days; p = 0.001and 10.29 ± 4.58 vs. 12.46 ± 6.014 days; p = <0.001). Mortality occurred in 2.2% patients. CONCLUSION: A voluntary non-funded registry for CRC surgery was successfully created. Initial data suggest that MIS was performed in majority, which was associated with shorter hospital stay than open approach. Overall mortality and leak rate appeared to be low.