COLORECTAL-CANCER SURGERY IN A DISTRICT GENERAL-HOSPITAL

The purpose of our study was to audit colorectal cancer surgery in a l arge district hospital, compare our results with other series and high light any areas in patient management where improvements could be made . A comprehensive audit was undertaken of all patients undergoing surg ery for colorectal adenocarcinoma over a 2-year period (December 1989 to November 1991). Two hundred and twenty-two patients were studied. G eneral practitioner referrals were seen within 8 weeks in 140 (96%) of 149 cases. Delay to diagnosis was associated with barium enema examin ation. A consultant or senior registrar was present at 187 (84.2%) of operations, and only two (0.9%) were undertaken between 24.00 and 08.0 0 hours. For rectal tumours the ratio of anterior resection to abdomin o-perineal excision was 2:1. Eight of nine anastomotic leaks followed lon anterior resection. All required re-operation and three died The o verall in-hospital mortality was 17 (7.7%). Although our results compa re favourably with other published series, several areas for potential improvement in management have been identified.