The organization and results after cystectomy in Denmark are unknown.
Based upon the Danish National Hospital Register and discharge notes, postoperative hospitalization, readmission within 30 days, re-operations and mortality after cystectomy in Denmark in the period January 1, 2000-December 31, 2005 were assessed.
There were 995 cystectomies with a median postoperative hospital stay of 18.9 days (including readmissions) and hospital mortality of 3.7%. The operations were performed in seven departments without difference in outcome between departments. Morbidity was observed in 58%, 16.8% of which were re-operated for wound or urinary diversion complications.
It is concluded that cystectomy should be performed in only five departments in Denmark, and the results suggest that an intensified multicenter collaboration should be initiated to improve outcome.
Comment In: Ugeskr Laeger. 2008 Jun 16;170(25):2260; author reply 226118581651
The epidemiology of appendicitis seems to be changing; the proportion of complicated appendicitis cases is growing. The outcome of childhood appendectomy in Denmark has not previously been evaluated nationwide in Denmark.
Data on all Danish children treated for appendicitis were obtained from the National Patient Registry. Reoperation, readmittance or length of hospital stay (LOS) exceeding five days were considered nonsatisfactory outcomes.
A total of 2,617 children, 55% boys and 45% girls, were operated at 32 hospitals. Their mean age was 11.1 years. Mortality was 0%. A laparoscopic procedure was used in 34% of the cases. The medians of the postoperative LOS were one day for both the open and laparoscopic appendectomy groups, the corresponding means were 2.5 and 2.0 days (p5 days or readmittance. The typical reasons were wound infection, need for prolonged antibiotics treatment and simple, prolonged recovery.
The Danish practice for appendicitis has acceptable rates of reoperation, medians and means of LOS, and a rate of readmission which is comparable to that reported in other studies. However, a nonsatisfactory outcome after appendectomy in about 20% calls for improvement and further studies.