Quality of Colon Cancer Care in Patients Undergoing Emergency Surgery
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Setting and Design
2.2. Outcomes and Baseline Variables
2.3. Statistical Analysis
2.4. Ethics Approval
3. Results
3.1. Baseline Variables
3.2. Outcome Comparison
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Emergency Cases (n = 23) | Elective Cases (n = 46) | p-Value |
---|---|---|---|
Age (years), median (IQR) | 73 (64.4–79.7) | 73.7 (63.3–81.7) | 0.843 |
Male sex (%) | 13 (56.5%) | 26 (56.5%) | 1.00 |
ASA Class (%) | 0.01 | ||
I | 0 (0%) | 1 (2.2%) | |
II | 1 (4.4%) | 3 (6.5%) | |
III | 9 (39.1%) | 34 (73.9%) | |
IV | 13 (56.5%) | 8 (17.4%) | |
V | 0 (0%) | 0 (0%) | |
BMI, median (IQR) | 31.9 (27.4–34.7) | 27.9 (24.1–30.9) | 0.412 |
Subspecialized Surgeon a (%) | 21 (91.3%) | 46 (100%) | 0.042 |
Type of Operation | 0.046 | ||
Open right hemicolectomy (%) | 7 (30.4%) | 4 (8.7%) | |
Laparoscopic right hemicolectomy (%) | 9 (39.1%) | 23 (50.0%) | |
Segmental colectomy (%) | 2 (8.7%) | 0 (0%) | |
Laparoscopic segmental colectomy (%) | 3 (13.0%) | 9 (19.6%) | |
Laparoscopic low anterior resection (%) | 1 (4.4%) | 8 (17.4%) | |
Open low anterior resection (%) | 0 (0%) | 1 (2.2%) | |
Laparoscopic low anterior resection + diversion (%) | 1 (4.4%) | 0 (0%) | |
Laparoscopic Hartmann’s procedure (%) | 0 (0%) | 1 (2.2%) | |
Approach | 0.001 | ||
Open (%) | 9 (39.1%) | 3 (6.5%) | |
Laparoscopic (%) | 9 (39.1%) | 39 (84.8%) | |
Converted (%) | 2 (8.7%) | 2 (4.4%) | |
Laparoscopic Assisted (%) | 3 (13.0%) | 2 (4.4%) | |
Tumour Location | 0.468 | ||
Right (%) | 15 (65.2%) | 27 (58.7%) | |
Transverse (%) | 3 (13.0%) | 4 (8.7%) | |
Left (%) | 2 (8.7%) | 2 (4.4%) | |
Sigmoid (%) | 3 (13.0%) | 13 (28.3%) | |
Cancer diagnosed pre-operatively | 0.108 | ||
Yes | 20 (87%) | 45 (97.8%) | |
No | 1 (4.4%) | 1 (2.2%) | |
On differential but unconfirmed | 2 (8.7%) | 0 (0%) | |
Pre-operative pathology status | 0.299 | ||
Negative | 2 (8.7%) | 2 (4.4%) | |
Positive | 14 (60.9%) | 40 (87.0%) | |
Pre-operative colonoscopy | <0.001 | ||
Yes | 16 (69.6%) | 44 (95.7%) | |
No | 7 (30.4%) | 0 (0%) | |
Attempted but uncompleted | 0 (0%) | 2 (4.4%) | |
Pathologic T Stage | 0.092 | ||
1 (%) | 0 (0%) | 1 (2.2%) | |
2 (%) | 1 (4.4%) | 6 (13.0%) | |
3 (%) | 15 (65.2%) | 35 (76.1%) | |
4 (%) | 7 (30.4%) | 4 (8.7%) | |
Pathologic N Stage | 0.255 | ||
0 (%) | 11 (47.8%) | 22 (47.8%) | |
1 (%) | 4 (17.4%) | 15 (32.6%) | |
2 (%) | 8 (34.8%) | 9 (19.6%) | |
Pathologic M Stage | 1.000 | ||
0 (%) | 23 (100%) | 46 (100%) | |
1 (%) | 0 (0%) | 0 (0%) |
Variable | Emergency Cases (n = 23) | Elective Cases (n = 46) | Odds Ratio (95% CI) | p-Value |
---|---|---|---|---|
CT staging within 30 days (%) | 20 (87%) | 46 (100%) | N/A | 0.012 |
CEA within 30 days (%) | 16 (70%) | 44 (97%) | 0.104 (0.020–0.553) | 0.020 |
Longitudinal margin | 1.000 | |||
Gross negative | 23 (100%) | 46 (100%) | N/A | |
Microscopic negative | 23 (100%) | 46 (100%) | N/A | |
Circumferential margin | ||||
Gross negative | 23 (100%) | 46 (100%) | N/A | 1.000 |
Microscopic negative | 20 (87%) | 45 (97.8%) | N/A | 0.069 |
Nodal yield, median (IQR) | 28 (19–33.5) | 27 (20–37) | N/A | 0.819 |
Time from operation to pathology report, median days (IQR) | 16 (13.5–19.5) | 13.5 (10.25–18.75) | N/A | 0.058 |
Length of stay, days, median (IQR) | 9 (6–13) | 2.5 (1–5) | N/A | <0.001 |
30-day readmission (%) | 6 (26%) | 2 (4%) | 3.706 (0.928–14.803) | 0.053 |
Medical oncology referral a | 16 (70%) | 39 (85%) | 0.737 (0.236–2.303) | 0.599 |
Time from operation to medical oncology referral, days, median (IQR) | 30 (18–33) | 27 (21.5–34) | N/A | 0.346 |
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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
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 StyleGuidolin, Keegan, Rebecca Withers, Farhana Shariff, Shady Ashamalla, and Ashlie Nadler. 2021. "Quality of Colon Cancer Care in Patients Undergoing Emergency Surgery" Current Oncology 28, no. 3: 2079-2086. https://doi.org/10.3390/curroncol28030192
APA StyleGuidolin, K., Withers, R., Shariff, F., Ashamalla, S., & Nadler, A. (2021). Quality of Colon Cancer Care in Patients Undergoing Emergency Surgery. Current Oncology, 28(3), 2079-2086. https://doi.org/10.3390/curroncol28030192