Abstract
BackgroundThe low incidence of colorectal cancer in India, coupled with absence of specialized units, contribute to lack of relevant data arising from the subcontinent. We evaluated the data of the senior author to better define the requirements that would enable development of specialized units in a country where colorectal cancer burden is increasing.MethodsWe retrospectively analyzed data of 401 consecutive colorectal resections from a prospective database of the senior author. In addition to patient demographics and types of resections, perioperative data like intraoperative blood loss, duration of surgery, complications, re-operation rates and hospital stay were recorded and analyzed.ResultsThe median age was 52 years (10-86 years). 279 were males and 122 were females. The average duration of surgery was 220.32 minutes (range 50 - 480 min). The overall complication rate was 12.2% (49/401) with a 1.2% (5/401) mortality rate. The patients having complications had an increase in their median hospital stay (from 10.5 days to 23.4 days) and the re-operation rate in them was 51%. The major complications were anastomotic leaks (2.5%) and stoma related complications (2.7%).ConclusionsThis largest ever series from India compares favorably with global standards. In a nation where colorectal cancer is on the rise, it is imperative that high volume centers develop specialized units to train future specialist colorectal surgeons. This would ensure improved quality assurance and delivery of health care even to outreach, low volume centers.
Highlights
The low incidence of colorectal cancer in India, coupled with absence of specialized units, contribute to lack of relevant data arising from the subcontinent
Indians [1], a finding that can neither be explained by heredity nor traditional diet. This high incidence in younger patients makes it imperative that colorectal cancer management evolves in India and departments are expected to develop units specialized in multidisciplinary management of colorectal cancer to face future challenges
Prior to development of colorectal cancer surgery as a specialty, it would be necessary to generate data from the Indian subcontinent. This need is hampered on account of two reasons - the incidence of colorectal cancer is very low compared to the West [1] and secondly there are very few teams performing specialized colorectal cancer surgery
Summary
The low incidence of colorectal cancer in India, coupled with absence of specialized units, contribute to lack of relevant data arising from the subcontinent. Indians [1], a finding that can neither be explained by heredity nor traditional diet This high incidence in younger patients makes it imperative that colorectal cancer management evolves in India and departments are expected to develop units specialized in multidisciplinary management of colorectal cancer to face future challenges. Prior to development of colorectal cancer surgery as a specialty, it would be necessary to generate data from the Indian subcontinent This need is hampered on account of two reasons - the incidence of colorectal cancer is very low compared to the West [1] and secondly there are very few teams performing specialized colorectal cancer surgery. Our group previously published the first large series from India on outcomes after double stapling technique for low rectal cancer [2]
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