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ANASTAMOTIC LEAK RATES FOR COLORECTAL CANCER RESECTION IN A REGIONAL BASE HOSPITAL
Author(s) -
Yang S. M.,
Franz R.,
Morrissey D.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04119_8.x
Subject(s) - medicine , colorectal cancer , leak , general surgery , colectomy , audit , anastomosis , cancer , surgery , management , environmental engineering , engineering , economics
Purpose Colorectal cancer (CRC) is the most frequently reported malignancy in Australian cancer registries. A large proportion of these cancers are managed by general surgeons with no specific sub‐specialist training. Our study aims to examine anastamotic leak rates after surgery for CRC in a regional hospital, performed by non sub‐specialty trained general surgeons and to compare this data with those of other specialist colorectal units. Method An audit of all patients treated for colorectal cancer at Toowoomba Base Hospital between 1 January 1990 and 1 April 2006 was undertaken. An anastamotic leak was defined as a clinical diagnosis documented in the patients’ medical chart or operative report. Findings 580 patients were treated for colorectal cancer during the prescribed period. Of these, 444 had surgery which included a gastrointestinal anastamosis. There were 13 anastamotic leaks (2.9%). The following commonest procedures had respective leak rates of: right hemicolectomy 2.2%; anterior resection 2.2%; sigmoid colectomy 3.28%; ultra‐low anterior resection 6.67%. Of the 13 leaks, 1 occurred in Dukes A cancers (1.89%), 9 in Dukes B cancers (4%) and 3 in Dukes C cancers (1.5%). Conclusion The anastamotic leak rates over the past 16 years at Toowoomba Hospital appear to be comparable to those of other specialist colorectal surgical units. It may be that leak rates are more dependent on the quality of the individual surgeons performing the procedure and the soundness of their surgical techniques, irrespective of their level of sub‐specialization. However, research needs to be done to prospectively compare the leak rates of different surgical units before further conclusions can be made.