Colorectal cancer management in the provincial New Zealand setting of Nelson

Gregory O'Grady, Adrian Secker
ANZ Journal of Surgery 2007, 77 (11): 1004-8

BACKGROUND: Colorectal cancer surgery, and rectal surgery in particular, has benefited from increased regionalization and subspecialization. With increasing focus on dedicated colorectal units in tertiary centres, the role of smaller provincial hospitals in colorectal cancer surgery has been of topical interest. Little data of relevance to this issue are available from provincial centres in New Zealand. The present study determines the workload and outcomes of a general surgeon with a colorectal subspecialty interest operating in the provincial New Zealand setting of Nelson.

METHODS: A retrospective review of consecutive case notes was conducted for the period January 2000 to December 2004, including all colorectal cancer patients managed by the relevant surgeon. The complete management pathway was evaluated.

RESULTS: One hundred and fifty colorectal cancers were managed; 133 operations were conducted, including 41 anterior resections and 13 abdominoperineal (AP) resections. Of these operations, 91% were scheduled and 9% were emergencies. The postoperative mortality rate was 0.8% and unplanned return-to-theatre rate 3.1%. Anastomotic leak occurred in 4.6%, all after anterior resection (anterior resection rate: 12.2%). Two were 'major' leaks, requiring return to theatre. The local recurrence rate following anterior resection was 7.3% at a median follow-up duration of 31 months.

CONCLUSIONS: Incidence is such that high-volume colorectal surgery is possible even in a smaller New Zealand province. Surgical practice and outcomes withstood comparison to published results - a broad general surgical case mix and low-volume hospital environment were not significant barriers to quality of colorectal care. Provincial colorectal cancer management remains an important resource for patients living outside major New Zealand centres.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"