Effect of Hospital Conditions on Short-Term Colorectal Cancer Outcomes: Experience of One Surgeon in Two Centers

• Published in: Turkish journal of colorectal disease Vol. 31; no. 3; pp. 210 - 216
• Main Authors: Alakuş, Ümit, Çelik, Süleyman Utku, Peker, Yaşar Subutay, Türker, Barış
• Format: Journal Article
• Language: English; Turkish
• Published: Mersin Galenos Publishing House 14.09.2021
• Subjects: Colorectal cancer; Surgeons; Surgery
• ISSN: 2536-4898; 2536-4901
• DOI: 10.4274/tjcd.galenos.2021.2020-12-2

Aim: Many factors can affect the outcomes of colorectal cancer (CRC) surgery. In addition to patient- and disease-related outcomes, factors such as surgeon volume and hospital conditions are thought to influence the results. However, only a few studies have compared the experience of a single surgeon from different centers. Thus, this study aimed to compare the short-term outcomes of CRC surgery performed by a single surgeon in secondary care (state hospital) and tertiary care (university/training research hospital) centers. Method: Data of patients who received treatment for colon cancer between April 2018 and January 2020 by a single surgeon, who had completed gastroenterology surgery fellowship, in two different centers were retrospectively analyzed. Patients were divided into two groups as those treated in a secondary center and a tertiary center and compared in terms of demographic characteristics, application types, cancer stage, perioperative transfusion requirement, operation conditions, durations of hospital and intensive care stay, postoperative complications, and pathology results. Results: Of the 39 patients included in the study, 13 (33.3%) were treated in a secondary state hospital and 26 (66.7%) in a tertiary training and research hospital. Moreover, 46.2% of the patients in the secondary center group and 11.5% of the patients in the tertiary center group underwent emergency surgery because of ileus. The transfusion rate was higher in the secondary center group than in the tertiary center group (76.9% vs 34.6%). The rate of laparoscopic surgery was higher in the tertiary center group than in the secondary center group (7.7% vs 69.2%). No significant difference was found between the two centers in terms of demographic characteristics, length of hospital stay, complications, and pathology results. Conclusion: Although the application rates are higher in advanced disease stages and emergency conditions, provided that the experience and training of the surgeon is sufficient, colorectal cancer surgery can be performed in relatively small and low-volume centers, with oncological results, morbidity, and mortality rates similar to those of large centers.