Abstract
To describe the real burden of major complications after elective surgery for colon cancer in Norway, and to assess which predictors that are significantly associated with the short-term outcome. An observational, multi-centre analysis of prospectively registered colon resections registered into the Norwegian Registry for Gastrointestinal Surgery, NoRGast, between January 2014 and December 2016. A propensity score-adjusted subgroup analysis for surgical access groups was attempted, with laparoscopic resections grouped as intention-to-treat. Out of 1812 resections, 14.0% of patients experienced a major complication within 30 days following surgery. The over-all reoperation rate was 8.7%, and rate of reoperation for anastomotic leak was 3.8%. Twenty patients (1.1%) died within 30 days after surgery. Higher age was not a significant predictor of major complications, including 30-day mortality. After correction for all co-variables, open access surgery was associated with higher rates of major complications (OR 1.67 (CI 1.22-2.29), p = 0.002), higher 30-day mortality (OR 4.39 (CI 1.19-16.13) p = 0.026) and longer length-of-stay (HR 0.58 (CI 0.52-0.65) p < 0.001). Our results indicate a low complication burden and high rate of uneventful patient journeys after elective surgery for colon cancer in Norway. Age was not associated with higher morbidity or mortality rates. Open access surgery was associated with an inferior short-term outcome.
Highlights
To describe the real burden of major complications after elective surgery for colon cancer in Norway, and to assess which predictors that are significantly associated with the short-term outcome
Data from 2778 colon resections performed between 1 January 2014 and 15 December 2016 were retrieved from the Norwegian Registry for Gastrointestinal surgery (NoRGast) database
A total of 960 resections (53.0%) were completed by laparoscopic technique, 109 resections (10.2% of all commenced as laparoscopy) were converted to open technique, and 743 (41.0%) were primarily open procedures
Summary
To describe the real burden of major complications after elective surgery for colon cancer in Norway, and to assess which predictors that are significantly associated with the short-term outcome. Results Out of 1812 resections, 14.0% of patients experienced a major complication within 30 days following surgery. Higher age was not a significant predictor of major complications, including 30-day mortality. After correction for all co-variables, open access surgery was associated with higher rates of major complications (OR 1.67 (CI 1.22–2.29), p = 0.002), higher 30-day mortality (OR 4.39 (CI 1.19–16.13) p = 0.026) and longer length-of-stay (HR 0.58 (CI 0.52–0.65) p < 0.001). Conclusions Our results indicate a low complication burden and high rate of uneventful patient journeys after elective surgery for colon cancer in Norway. Open access surgery was associated with an inferior short-term outcome
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