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Anastomotic leakage following routine mesorectal excision for rectal cancer in a national cohort of patients.

https://arctichealth.org/en/permalink/ahliterature17308
Source
Colorectal Dis. 2005 Jan;7(1):51-7
Publication Type
Article
Date
Jan-2005
Author
M T Eriksen
A. Wibe
J. Norstein
J. Haffner
J N Wiig
Author Affiliation
Department of Surgery, Buskerud Hospital, Drammen, Norway. mteriksen@start.no
Source
Colorectal Dis. 2005 Jan;7(1):51-7
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - pathology - surgery
Adolescent
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical - adverse effects
Carcinoma in Situ - mortality - pathology - surgery
Colon - surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
Norway
Prospective Studies
Rectal Neoplasms - mortality - pathology - surgery
Rectum - surgery
Research Support, Non-U.S. Gov't
Risk factors
Abstract
OBJECTIVE: Mesorectal excision is successfully implemented as the standard surgical technique for rectal cancer resections in Norway. This technique has been associated with higher rates of anastomotic leakage (AL) and the purpose of this study was to examine AL in a large national cohort of patients. METHODS: This was a prospective national cohort study of 1958 patients undergoing rectal cancer surgery with anterior resection in Norway from November 1993 to December 1999. RESULTS: The overall rate of AL was 11.6% (228 of 1958 patients). In a multivariate analysis, the risk of AL was significantly higher in males (odds ratio (OR) 1.6, 95% confidence interval (CI) 1.1-2.2), in patients receiving pre-operative radiotherapy (OR 2.2, CI 1.0-4.7) and in low level (4-6 cm) (OR 3.5, CI 1.6-7.7) and ultra-low level (
PubMed ID
15606585 View in PubMed
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Effect of hospital caseload on long-term outcome after standardization of rectal cancer surgery at a national level.

https://arctichealth.org/en/permalink/ahliterature17335
Source
Br J Surg. 2005 Feb;92(2):217-24
Publication Type
Article
Date
Feb-2005
Author
A. Wibe
M T Eriksen
A. Syse
S. Tretli
H E Myrvold
O. Søreide
Author Affiliation
Department of Surgery, St Olavs Hospital, Trondheim, Norway. arne.wibe@medisin.ntnu.no
Source
Br J Surg. 2005 Feb;92(2):217-24
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Clinical Competence
Female
Humans
Male
Middle Aged
Neoplasm Recurrence, Local
Norway
Prognosis
Prospective Studies
Rectal Neoplasms - mortality - surgery
Reference Standards
Registries
Research Support, Non-U.S. Gov't
Treatment Outcome
Workload - standards
Abstract
BACKGROUND: The purpose of this prospective study was to examine the influence of hospital caseload on long-term outcome following standardization of rectal cancer surgery at a national level. METHODS: Data relating to all 3388 Norwegian patients with rectal cancer treated for cure between November 1993 and December 1999 were recorded in a national database. Treating hospitals were divided into four groups according to their annual caseload: hospitals in group 1 (n = 4) carried out 30 or more procedures, those in group 2 (n = 6) performed 20-29 procedures, group 3 (n = 16) 10-19 procedures and group 4 (n = 28) fewer than ten procedures. RESULTS: The 5-year local recurrence rates were 9.2, 14.7, 12.5 and 17.5 per cent (P = 0.003) and 5-year overall survival rates were 64.4, 64.0, 60.8 and 57.8 per cent (P = 0.105) respectively in the four hospital caseload groups. An annual hospital caseload of less than ten procedures increased the risk of local recurrence compared with that in hospitals where 30 or more procedures were performed each year (hazard ratio 1.9 (95 per cent confidence interval (c.i.) 1.3 to 2.7); P
PubMed ID
15584060 View in PubMed
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Inadvertent perforation during rectal cancer resection in Norway.

https://arctichealth.org/en/permalink/ahliterature17944
Source
Br J Surg. 2004 Feb;91(2):210-6
Publication Type
Article
Date
Feb-2004
Author
M T Eriksen
A. Wibe
A. Syse
J. Haffner
J N Wiig
Author Affiliation
Department of Surgery, Buskerud Hospital, Drammen, Norway. mteriksen@start.no
Source
Br J Surg. 2004 Feb;91(2):210-6
Date
Feb-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Humans
Intestinal Perforation - etiology - mortality
Intraoperative Complications - etiology - mortality
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local - mortality
Norway - epidemiology
Prospective Studies
Rectal Neoplasms - mortality - surgery
Research Support, Non-U.S. Gov't
Risk factors
Survival Analysis
Abstract
BACKGROUND: Inadvertent perforation of the bowel or tumour is a relatively common complication during resection of rectal cancer. The purpose of this study was to examine intraoperative perforation following the introduction of mesorectal excision as a standard surgical technique in Norway. METHODS: This was a prospective national cohort study of 2873 patients undergoing major resection of rectal carcinoma at 54 Norwegian hospitals from November 1993 to December 1999. RESULTS: The overall perforation rate was 8.1 per cent (234 of 2873 patients). In a multivariate analysis, the risk of perforation was significantly greater in patients undergoing abdominoperineal resection (odds ratio (OR) 5.6 (95 per cent confidence interval (c.i.) 3.5 to 8.8)) and in those aged 80 years or more (OR 2.0 (95 per cent c.i. 1.2 to 3.5)). The 5-year local recurrence rate was 28.8 per cent following perforation, compared with 9.9 per cent in patients with no perforation (P
Notes
Comment In: Br J Surg. 2004 Jun;91(6):77915164455
PubMed ID
14760670 View in PubMed
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The New National Registry for Gastrointestinal Surgery in Norway: NoRGast.

https://arctichealth.org/en/permalink/ahliterature296886
Source
Scand J Surg. 2018 Sep; 107(3):201-207
Publication Type
Journal Article
Date
Sep-2018
Author
K Lassen
L S Nymo
H Kørner
K Thon
T Grindstein
H H Wasmuth
T Moger
B A Bjørnbeth
S Norderval
M T Eriksen
A Viste
Author Affiliation
1 Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway.
Source
Scand J Surg. 2018 Sep; 107(3):201-207
Date
Sep-2018
Language
English
Publication Type
Journal Article
Keywords
Digestive System Diseases - epidemiology - surgery
Digestive System Surgical Procedures - statistics & numerical data
Humans
Norway - epidemiology
Quality Improvement - statistics & numerical data
Registries - statistics & numerical data
Abstract
There is an increasing demand for high-quality data for the outcome of health care. Diseases of the gastro-intestinal tract involve large patient groups often presenting with serious or life-threatening conditions. Complications may affect treatment outcomes and lead to increased mortality or reduced quality of life. A continuous, risk-adjusted monitoring of major complications is important to improve the quality of health care to patients undergoing gastrointestinal resections. We present the development of the Norwegian Registry for Gastrointestinal Surgery, a national registry for colorectal, upper gastrointestinal, and hepato-pancreato-biliary resections in Norway.
A narrative and qualitative presentation of the development and current state of the registry.
We present the variables and the analysis tools and provide examples for the potential in quality improvement and research. Core characteristics include a strictly limited set of variables to reflect important risk factors, the procedure performed, and the clinical outcomes.
A registry with the potential to present complete national cohort data is a powerful tool for quality improvement and research.
PubMed ID
29628007 View in PubMed
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Risk factors associated with poor lymph node harvest after colon cancer surgery in a national cohort.

https://arctichealth.org/en/permalink/ahliterature114781
Source
Colorectal Dis. 2013 Jun;15(6):e301-8
Publication Type
Article
Date
Jun-2013
Author
B S Nedrebø
K. Søreide
A. Nesbakken
M T Eriksen
J A Søreide
H. Kørner
Author Affiliation
Department of Surgery, Stavanger University Hospital, Stavanger, Norway. nedreboe@me.com
Source
Colorectal Dis. 2013 Jun;15(6):e301-8
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - pathology - surgery
Age Factors
Aged
Cohort Studies
Colonic Neoplasms - pathology - surgery
Female
Humans
Logistic Models
Lymph Node Excision - standards - statistics & numerical data
Lymph Nodes - pathology - surgery
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Norway
Risk factors
Sex Factors
Sigmoid Neoplasms - pathology - surgery
Abstract
Evaluation of = 12 lymph nodes (LNs) is recommended after surgery for colon cancer. A harvest of = 8 is considered poor, but few reports have evaluated risk factors associated with a poor harvest. This aims of this study were to analyse the clinical, surgical and pathological factors associated with poor LN harvest (LNH), the total number of examined nodes and the effect of LN number on stage.
All patients reported to the Norwegian Colorectal Cancer Registry during 2007 and 2008 who underwent curative resection for Stage I-III colon cancer were studied. Risk factors for poor LNH and the proportion of Stage III disease were analysed by univariate and multivariate analyses.
A total of 2879 patients were included in the study. The median LNH was 14. Overall, 69.9% had = 12 lymph nodes and 14.4% had = 8 LN (poor harvest). Multivariate analysis showed that male sex, age > 75 years, sigmoid tumours, pT category 1-2, failure to use the pathology report template and distance of = 5 cm from the bowel resection margin were all independent factors for poor LNH. Age
PubMed ID
23582027 View in PubMed
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Surgical treatment of primary locally advanced rectal cancer in Norway.

https://arctichealth.org/en/permalink/ahliterature16528
Source
Eur J Surg Oncol. 2006 Mar;32(2):174-80
Publication Type
Article
Date
Mar-2006
Author
M T Eriksen
A. Wibe
U E Hestvik
J. Haffner
J N Wiig
Author Affiliation
Department of Surgery, Buskerud Hospital, 3004 Drammen, Norway. mteriksen@start.no
Source
Eur J Surg Oncol. 2006 Mar;32(2):174-80
Date
Mar-2006
Language
English
Publication Type
Article
Abstract
AIMS: Most reports on locally advanced rectal cancer come from specialized centres, with a selected patient material. The purpose of this study was to examine the results after surgical treatment of patients with locally advanced rectal cancer at a population level. METHODS: National cohort study of 896 patients undergoing surgery for a locally advanced primary adenocarcinoma of the rectum from November 1993 to December 2001. RESULTS: Surgery with resection was undertaken in 724 patients and 172 patients underwent palliative procedures. Of 557 patients treated for cure, a R0 resection was achieved in 342 (61%). In a multivariate analysis, pre-operative radiotherapy was the only factor with a positive association with R0 status (odds ratio 3.7, 95% confidence interval (CI) 2.1-6.4). Five-year local recurrence rates were 18% (CI 14-23) for R0 resections and 40% (CI 26-52) for R1 resections. Overall 5-year survival rate was 23%; for the group of patients with a R0 resection the survival rate was 49%. CONCLUSION: The radical resection rate and survival rates in this national study were similar to those reported from specialized centres.
PubMed ID
16412603 View in PubMed
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Survival effect of implementing national treatment strategies for curatively resected colonic and rectal cancer.

https://arctichealth.org/en/permalink/ahliterature136825
Source
Br J Surg. 2011 May;98(5):716-23
Publication Type
Article
Date
May-2011
Author
B S Nedrebø
K. Søreide
M T Eriksen
L M Dørum
J T Kvaløy
J A Søreide
H. Kørner
Author Affiliation
Department of Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Surgical Sciences, University of Bergen, Bergen, Norway.
Source
Br J Surg. 2011 May;98(5):716-23
Date
May-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Colonic Neoplasms - mortality - surgery
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Norway - epidemiology
Practice Guidelines as Topic
Rectal Neoplasms - mortality - surgery
Registries
Survival Analysis
Treatment Outcome
Abstract
The surgical management of rectal cancer has changed substantially over the past decade. There are limited data on the long-term outcome of implementing systematic management strategies.
Survival of a national cohort of patients treated surgically for colonic and rectal cancer over a 10-year interval was analysed. All 31 158 patients in Norway diagnosed with adenocarcinoma of the colon and rectum between 1994 and 2003 were identified from the Cancer Registry of Norway and the Norwegian Rectal Cancer Registry. Changes in 5-year relative survival were compared by age, stage and tumour location during the early and late years.
The study population included 19 053 patients who had a curative resection. The relative 5-year survival rate significantly improved for both colonic cancer (73·8 versus 78·0 per cent; P
PubMed ID
21341253 View in PubMed
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Total mesorectal excision for rectal cancer--what can be achieved by a national audit?

https://arctichealth.org/en/permalink/ahliterature18252
Source
Colorectal Dis. 2003 Sep;5(5):471-7
Publication Type
Article
Date
Sep-2003
Author
A. Wibe
M T Eriksen
A. Syse
H E Myrvold
O. Søreide
Author Affiliation
Department of Surgery, University Hospital Trondheim, Trondheim N-7006, Norway. arne.wibe@medisin.ntnu.no
Source
Colorectal Dis. 2003 Sep;5(5):471-7
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cohort Studies
Digestive System Surgical Procedures - standards
Female
Health Policy
Humans
Male
Medical Audit
Middle Aged
Neoplasm Recurrence, Local - prevention & control
Neoplasm Staging
Norway
Rectal Neoplasms - mortality - pathology - surgery
Registries
Research Support, Non-U.S. Gov't
Survival Analysis
Abstract
OBJECTIVE: The results of rectal cancer surgery in Norway have been poor. In a national audit for the period 1986-88, 28% of the patients developed local recurrence (LR) following treatment with a curative intent. Five-year overall survival was 55% for patients younger than 75 years. The aim of this study is to report how an initiative focusing on better surgery can improve the prognosis for rectal cancer patients on a national level. METHODS: In 1994, the Norwegian Rectal Cancer Group was founded. The aim of this initiative was to improve the surgical standard by implementing total mesorectal excision (TME) on a national level and to evaluate the results. A number of courses were arranged to teach the surgeons the TME technique, and pathologists were trained to increase the standard of both macroscopic and microscopic assessment of specimens. A rectal cancer registry was established, and all surgical departments treating rectal cancer were invited to transfer their clinical data to this registry. Each department regularly receives its own results together with the national average for comparison and quality control. RESULTS: The Rectal Cancer Registry includes all patients with rectal cancer diagnosed since November 1993. From then until December 1999, 5382 patients had a tumour located within 16 cm from the anal verge, and 3432 patients underwent rectal resection with a curative intent. Of these, 9% had adjuvant radiotherapy, and 2% were given chemotherapy. There was a rapid implementation of the new technique, as 78% underwent TME in 1994, increasing to 96% in 1998. After 39 months mean follow-up the rate of local recurrence was 8%, and 5-year overall survival was 71% for patients younger than 75 years. CONCLUSIONS: An optimized surgical technique (TME) for rectal cancer can reduce the rate of local recurrence and increase overall survival. This improved surgical treatment can be implemented on a national level within a few years. Specialization of surgeons, feedback of results and a separate rectal cancer registry are thought to be major contributors to the improved treatment.
PubMed ID
12925083 View in PubMed
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8 records – page 1 of 1.