AUDIT OF COLORECTAL-CANCER SURGERY BY NONSPECIALIST SURGEONS

Background Some authorities recommend that colorectal cancer should be treated in specialist units but evidence that non-specialist units de monstrate comparatively poor results may be lacking. Methods Between 1 987 and 1991, 267 patients were operated on by four general surgeons, none of whom was a specialist in colorectal surgery. Procedure-related complications, postoperative mortality and disease-related survival r ates were analysed. Results There were four cases of intraperitoneal s epsis (1 per cent) and five of 189 patients (3 per cent) had clinical anastomotic dehiscence; there was no rase of wound dehiscence. The pos toperative mortality rate after elective and emergency surgery was 2 a nd 13 per cent respectively. The 5-year disease-related survival rate for curative and palliative surgery was 67 and 9 per cent respectively . There were no significant differences between the surgeons. Conclusi on Disease-related variables such as early-stage disease and fewer pat ients presenting as emergencies may have a greater favourable influenc e on ultimate survival than surgeon-related variables.