Safety and oncological quality of colorectal cancer surgery in a Teaching Hospital.

Abstract

Background: It is essential that every surgical team audit the quality of their surgeries, moreover in a teaching center that must guarantee appropriate training of oncological surgery.

Aim: evaluate the quality of oncological surgery for colorectal cancer in a teaching hospital.

Material and methods: a retrospective study based on a prospective database of patients operated for colorectal cancer at Pasteur hospital, between 2017-2021. Safety of surgery, oncological quality of resection and training level of the main surgeon were analyzed. Results: of the 89 patients, there were no gender differences. Median age was 69 years. PT3 (50%) and pT4 (36.5%), pN0 (60%) and pN1 (29%) were most frequent. The main performed procedures were right colectomy (43%) and anterior rectal resection (40%). Laparoscopic approach was 69%, and conversion rate 5%. Anastomotic dehiscence was 9.8%, more frequent in ileotransverse (13%) and manual (16%) anastomoses. There were 10% of moderate-severe surgical complications (3 and 4 of Clavien-Dindo classification). Reoperation rate was 11% and mortality 2%. Median hospital stay was 7 days. The number of resected lymph nodes had a median of 16. There was no compromise of the distal margin, and the circumferential margin was free in 85%. The rectal fascia was complete/almost complete in 93%. Almost 70% of the surgeries were performed by young surgeons.

Conclusion: in our center, colorectal cancer surgery achieved international standards of oncological safety and quality. Most of the procedures were performed by the young, mentored by senior staff.