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Quality of Colon Cancer Care in Patients Undergoing Emergency Surgery

1
Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
2
Department of Surgery, McMaster University, Hamilton, ON L8S 4K1, Canada
3
Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(3), 2079-2086; https://doi.org/10.3390/curroncol28030192
Received: 10 May 2021 / Accepted: 1 June 2021 / Published: 3 June 2021
(This article belongs to the Section Gastrointestinal Oncology)
Thirty percent of colon cancer diagnoses occur following emergency presentations, often with bowel obstruction or perforation requiring urgent surgery. We sought to compare cancer care quality between patients receiving emergency versus elective surgery. We conducted an institutional retrospective matched (46 elective:23 emergency; n = 69) case control study. Patients who underwent a colon cancer resection from January 2017 to February 2019 were matched by age, sex, and cancer stage. Data were collected through the National Surgical Quality Improvement Program and chart review. Process outcomes of interest included receipt of cross-sectional imaging, CEA testing, pre-operative cancer diagnosis, pre-operative colonoscopy, margin status, nodal yield, pathology reporting, and oncology referral. No differences were found between elective and emergency groups with respect to demographics, margin status, nodal yield, oncology referral times/rates, or time to pathology reporting. Patients undergoing emergency surgery were less likely to have CEA levels, CT staging, and colonoscopy (p = 0.004, p = 0.017, p < 0.001). Emergency cases were less likely to be approached laparoscopically (p = 0.03), and patients had a longer length of stay (p < 0.001) and 30-day readmission rate (p = 0.01). Patients undergoing emergency surgery receive high quality resections and timely post-operative referrals but receive inferior peri-operative workup. The adoption of a hybrid acute care surgery model including short-interval follow-up with a surgical oncologist or colorectal surgeon may improve the quality of care that patients with colon cancer receive after acute presentations. Surgeons treating patients with colon cancer emergently can improve their care quality by ensuring that appropriate and timely disease evaluation is completed. View Full-Text
Keywords: colon cancer; emergency surgery; acute care surgery; quality of care; quality of cancer care colon cancer; emergency surgery; acute care surgery; quality of care; quality of cancer care
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MDPI and ACS Style

Guidolin, K.; Withers, R.; Shariff, F.; Ashamalla, S.; Nadler, A. Quality of Colon Cancer Care in Patients Undergoing Emergency Surgery. Curr. Oncol. 2021, 28, 2079-2086. https://doi.org/10.3390/curroncol28030192

AMA Style

Guidolin K, Withers R, Shariff F, Ashamalla S, Nadler A. Quality of Colon Cancer Care in Patients Undergoing Emergency Surgery. Current Oncology. 2021; 28(3):2079-2086. https://doi.org/10.3390/curroncol28030192

Chicago/Turabian Style

Guidolin, Keegan; Withers, Rebecca; Shariff, Farhana; Ashamalla, Shady; Nadler, Ashlie. 2021. "Quality of Colon Cancer Care in Patients Undergoing Emergency Surgery" Curr. Oncol. 28, no. 3: 2079-2086. https://doi.org/10.3390/curroncol28030192

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