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Titolo:
Colorectal surgery in rural Australia: Scars; A surgeon-based audit of workload and standards
Autore:
Birks, DM; Gunn, IF; Birks, RG; Strasser, RP;
Indirizzi:
Monash Univ, Ctr Rural Hlth, Latrobe Reg Hosp, Traralgon, Vic, Australia Monash Univ Traralgon Vic Australia Reg Hosp, Traralgon, Vic, Australia
Titolo Testata:
ANZ journal of surgery
fascicolo: 3, volume: 71, anno: 2001,
pagine: 154 - 158
SICI:
1445-1433(200103)71:3<154:CSIRAS>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
CANCER;
Keywords:
anastomotic leak; clinical indicators; colorectal cancer; colorectal surgery; rural surgery; surgical audit;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
9
Recensione:
Indirizzi per estratti:
Indirizzo: Birks, DM POB 424, Traralgon, Vic 3844, Australia POB 424 Traralgon Vic Australia 3844 algon, Vic 3844, Australia
Citazione:
D.M. Birks et al., "Colorectal surgery in rural Australia: Scars; A surgeon-based audit of workload and standards", AUST NZ J S, 71(3), 2001, pp. 154-158

Abstract

Background: The collection and measurement of colorectal surgical workload, case management and clinical indicators have been mainly based on metropolitan specialist institutions. The aim of the present study was to examine the workload and standards of colorectal surgery in rural Australia. Methods: Sixty-nine rural general surgeons in Victoria, Albury and South Australia were invited to complete a questionnaire for each transabdominal colorectal operation performed over a 12-month period from 1 May 1996. Data were collected on comorbidity, operation detail, pathology, complications and intention to use adjuvant cancer therapy. Results: Sixty-two surgeons contributed 877 data forms. The patient average age was 65 years with 60% having pre-existing disease. One-third of operations were emergency presentations of which bowel obstruction was the most common. An anastomosis was performed in 675 patients of whom 22 (3.3%) had a clinical anastomotic leak. For low rectal anastomosis the leak rate was 8.9%. Two-thirds of patients had colorectal cancer and 42% of these cancer patients had advanced (Australian clinicopathological stage C or D) disease. The perioperative mortality rate was 4.6% but in the presence of more thantwo comorbidities it was 16.4%. Mortality was higher with emergency presentations (8.3%), particularly in patients older than 80 years (15.2%). Conclusions: The study sampled a very high percentage of rural colorectal surgery performed during the audit period. Colorectal surgery clinical indicators were comparable to other Australian studies. Anti-thrombotic and adjuvant therapy were identified as two areas requiring further education. Major surgery is being performed regularly in south-eastern rural Australia ata consistently high standard by surgeons who live and work in their rural community.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 10:13:12