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38 records – page 1 of 4.

An integrated system-wide strategy for quality improvement in cancer surgery.

https://arctichealth.org/en/permalink/ahliterature165790
Source
Br J Surg. 2007 Jan;94(1):3-5
Publication Type
Article
Date
Jan-2007
Author
B. Langer
H. Stern
Author Affiliation
Surgical Oncology Program, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario M5G 2L7, Canada. Bernard.langer@cancercare.on.ca
Source
Br J Surg. 2007 Jan;94(1):3-5
Date
Jan-2007
Language
English
Publication Type
Article
Keywords
Colorectal Neoplasms - surgery
Health Policy
Humans
Neoplasms - surgery
Ontario
Pancreatic Neoplasms - surgery
Practice Guidelines as Topic - standards
Quality of Health Care - standards
PubMed ID
17205507 View in PubMed
Less detail
Source
Can Oncol Nurs J. 2014;24(3):218-9
Publication Type
Article
Date
2014
Author
Blair Henry
Source
Can Oncol Nurs J. 2014;24(3):218-9
Date
2014
Language
English
French
Publication Type
Article
Keywords
Canada
Clinical Trials as Topic
Colorectal Neoplasms - surgery
Ethics, Research
Humans
PubMed ID
25189062 View in PubMed
Less detail
Source
Ugeskr Laeger. 2004 Aug 9;166(33):2820; author reply 2820-2
Publication Type
Article
Date
Aug-9-2004
Author
Ove Bendtsen
Source
Ugeskr Laeger. 2004 Aug 9;166(33):2820; author reply 2820-2
Date
Aug-9-2004
Language
Danish
Publication Type
Article
Keywords
Colorectal Neoplasms - surgery
Colorectal Surgery - methods - trends
Denmark
Humans
Societies, Medical
Notes
Comment On: Ugeskr Laeger. 2004 Jan 26;166(5):34915017726
PubMed ID
15344869 View in PubMed
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A comparison in five European Centres of case mix, clinical management and outcomes following either conventional or fast-track perioperative care in colorectal surgery.

https://arctichealth.org/en/permalink/ahliterature17022
Source
Clin Nutr. 2005 Jun;24(3):455-61
Publication Type
Article
Date
Jun-2005
Author
Jonas Nygren
Jonatan Hausel
Henrik Kehlet
Arthur Revhaug
Kristoffer Lassen
Cornelius Dejong
Jens Andersen
Maarten von Meyenfeldt
Olle Ljungqvist
Kenneth Christopher Fearon
Author Affiliation
Centre for Surgical Sciences, Division of Surgery, Karolinska Institutet and Centre of Gastrointestinal Disease, Ersta Hospital, PO Box 4622, 11691 Stockholm, Sweden.
Source
Clin Nutr. 2005 Jun;24(3):455-61
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Colorectal Neoplasms - surgery
Colorectal Surgery - methods
Comparative Study
Female
Humans
Length of Stay
Male
Patient Readmission
Perioperative Care - methods
Postoperative Care - methods
Postoperative Complications
Retrospective Studies
Risk assessment
Abstract
BACKGROUND & AIMS: This study reviewed the case mix, clinical management, and clinical outcomes of patients undergoing colorectal resection in five European centres performing different forms of conventional or 'fast-track' perioperative care. METHODS: The perioperative care programme and surgical practice in each centre was defined. Patient data were collected by case-note review on an internet-based audit system. Case mix was determined using ASA classification and the P-POSSUM scoring system. RESULTS: A total of 451 consecutive patients from units practicing either conventional (Sweden, n=109; UK, n=87; Netherlands, n=76, Norway, n=61) or fast-track surgery (Denmark, n=118), were studied between 1998 and 2001. Elements of perioperative practice varied widely both between units practicing 'traditional' care and the reference 'fast-track' unit (Denmark). Based on the P-POSSUM scores, the case mix was similar between centres. There were no differences in morbidity or 30-day mortality between the different centres. The median length of stay was 2 days in Denmark and 7-9 days in the other centres (P
PubMed ID
15896433 View in PubMed
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Compliance, attitudes and barriers to post-operative colorectal cancer follow-up.

https://arctichealth.org/en/permalink/ahliterature158020
Source
J Eval Clin Pract. 2008 Jun;14(3):407-15
Publication Type
Article
Date
Jun-2008
Author
Jonathan Cardella
Natalie G Coburn
Anna Gagliardi
Barbara-Anne Maier
Elisa Greco
Linda Last
Andrew J Smith
Calvin Law
Frances Wright
Author Affiliation
Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Source
J Eval Clin Pract. 2008 Jun;14(3):407-15
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
Attitude to Health
Canada
Colorectal Neoplasms - surgery
Continuity of Patient Care
Female
Health Care Surveys
Humans
Male
Medical Audit
Middle Aged
Patient compliance
Postoperative Care
Retrospective Studies
Abstract
Meta-analyses demonstrate that surveillance following curative-intent colorectal cancer (CRC) surgery can improve survival. Our multidisciplinary team adopted a stringent CRC follow-up (FU) guideline in 2000. The purpose of this study was to assess adherence and barriers to FU for CRC.
Patients with primary CRC aged 19-75 years, treated with curative intent surgery from July 2000 to December 2002 were identified from a prospective database. Compliance with FU was assessed primarily by chart review. We also surveyed patients and providers to explore attitudes and barriers to surveillance adherence using tenets of the Health Belief Model.
96 patients met inclusion criteria and were appropriate for FU. Median FU was 34 months. Guideline targets were met for 70% of clinic visits; 49% of carcinoembryonic antigen (CEA) determinations; and 62% of abdominal imaging studies. Post-operative colonoscopy did not occur in 6/93 patients. Seventy per cent of health care providers and 55% of patients completed a survey. Access to testing and confusion about which provider orders investigations were identified as important barriers to FU.
Patterns of CRC FU were widely variable despite implementation of a guideline. Despite patient and provider agreement with the principles of CRC FU, adoption was inhibited by confusion among multiple providers regarding investigation coordination.
PubMed ID
18373578 View in PubMed
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Core temperature--the intraoperative difference between esophageal versus nasopharyngeal temperatures and the impact of prewarming, age, and weight: a randomized clinical trial.

https://arctichealth.org/en/permalink/ahliterature264211
Source
AANA J. 2015 Apr;83(2):99-105
Publication Type
Article
Date
Apr-2015
Author
Anne Erdling
Anders Johansson
Source
AANA J. 2015 Apr;83(2):99-105
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Anesthesia, General - adverse effects
Body mass index
Body Temperature - physiology
Body Weight
Colorectal Neoplasms - surgery
Esophagus - physiology
Female
Humans
Hypothermia - diagnosis - etiology
Intraoperative Period
Male
Middle Aged
Nasopharynx - physiology
Perioperative Care - methods
Sweden
Thermometry - methods - standards
Abstract
Unplanned perioperative hypothermia is a well-known complication to anesthesia. This study compares esophageal and nasopharyngeal temperature measured in the same patient for a period of 210 minutes of anesthesia. Forty-three patients undergoing colorectal surgery were randomly assigned in 2 groups, with or without a prewarming period (group A = prewarming [n = 21] or group B = no prewarming [n = 22]). Demographics were similar in both groups. Mean temperatures at 210 minutes were statistically different between the groups at both sites of measurement. Esophageal temperature in group A was 36.5 ? 0.6 vs 35.8 ? 0.7 in group B (P = .001), and nasopharyngeal temperature was 36.7 ? 0.6 and 36.0 ? 0.6 in group A and group B, respectively (P = .002). A negative correlation was found between esophageal temperature and age (r2 = -.381, P
PubMed ID
26016168 View in PubMed
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Development of quality indicators for colorectal cancer surgery, using a 3-step modified Delphi approach.

https://arctichealth.org/en/permalink/ahliterature171146
Source
Can J Surg. 2005 Dec;48(6):441-52
Publication Type
Article
Date
Dec-2005
Author
Anna R Gagliardi
Marko Simunovic
Bernard Langer
Hartley Stern
Adalsteinn D Brown
Author Affiliation
Sunnybrook and Women's College Health Sciences Centre, Toronto.
Source
Can J Surg. 2005 Dec;48(6):441-52
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Benchmarking
Colorectal Neoplasms - surgery
Colorectal Surgery - standards
Consensus
Delphi Technique
Female
Health Care Surveys
Humans
Male
Ontario
Quality Indicators, Health Care
Sensitivity and specificity
Abstract
Little performance measurement has been undertaken in the area of oncology, particularly for surgery, which is a pivotal event in the continuum of cancer care. This work was conducted to develop indicators of quality for colorectal cancer surgery, using a 3-step modified Delphi approach.
A multidisciplinary panel, comprising surgical and methodological co-chairs, 9 surgeons, a medical oncologist, a radiation oncologist, a nurse and a pathologist, reviewed potential indicators extracted from the medical literature through 2 consecutive rounds of rating followed by consensus discussion. The panel then prioritized the indicators selected in the previous 2 rounds.
Of 45 possible indicators that emerged from 30 selected articles, 15 were prioritized by the panel as benchmarks for assessing the quality of surgical care. The 15 indicators represent 3 levels of measurement (provincial/regional, hospital, individual provider) across several phases of care (diagnosis, surgery, adjuvant therapy, pathology and follow-up), as well as broad measures of access and outcome. The indicators selected by the panel were more often supported by evidence than those that were discarded.
This project represents a unique initiative, and the results may be applicable to colorectal cancer surgery in any jurisdiction.
Notes
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PubMed ID
16417050 View in PubMed
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[Efficiency of introduction of the program for quality management of medical care of oncological patients]

https://arctichealth.org/en/permalink/ahliterature91849
Source
Lik Sprava. 2008 Jan-Feb;(1-2):119-23
Publication Type
Article
Author
Ziukov O L
Source
Lik Sprava. 2008 Jan-Feb;(1-2):119-23
Language
Ukrainian
Publication Type
Article
Keywords
Colorectal Neoplasms - surgery
Delivery of Health Care - organization & administration - standards - trends
Humans
Program Development
Program Evaluation
Quality Indicators, Health Care
Total Quality Management - methods
Ukraine
Abstract
The performance indicators of city hospital oncological proctological department have been analysed before and after the introduction of the program of quality management to medical care. The detailed analysis of indexes with the use of methods of variation statistics allowed to confirm positive influence of organizational experiment on intensification of the use of bed fund for oncological patients and improvement of performance indicators, in particular, frequencies of postoperative complications.
PubMed ID
18822855 View in PubMed
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Endoscopic submucosal dissection in the colorectum: Feasibility in the Canadian setting.

https://arctichealth.org/en/permalink/ahliterature105675
Source
Can J Gastroenterol. 2013 Dec;27(12):689-93
Publication Type
Article
Date
Dec-2013
Author
Marietta Iacucci
Gregory Eustace
Toshio Uraoka
Yutaka Saito
Miriam Fort Gasia
Jon Love
Naohisa Yahagi
Source
Can J Gastroenterol. 2013 Dec;27(12):689-93
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Canada
Carcinoma - surgery
Colonoscopy - education - instrumentation
Colorectal Neoplasms - surgery
Dissection - adverse effects - education - instrumentation
Feasibility Studies
Humans
Intestinal Mucosa - surgery
Abstract
Endoscopic submucosal dissection is a minimally invasive endoscopic technique for the removal of gastrointestinal tumours that is increasingly being used for colonic neoplasms to spare resection of colon in selected patients. Colonic endoscopic submucosal dissection is technically challenging and was initially pioneered in Japan but increasingly used in selected western centres. Its use in Canada is currently limited, and the authors review the challenges and opportunities, in addition to the unique training infrastructure required to practice the procedure under supervision. Specific tools are required to perform endoscopic submucosal dissection and meticulous attention to detail is essential. The authors provide a combined Japanese and Canadian perspective to this technique, and discuss training and performance of endoscopic submucosal dissection as well as potential indications.
PubMed ID
24340310 View in PubMed
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Extralevator abdominoperineal excision (ELAPE) for rectal cancer--short-term results from the Swedish Colorectal Cancer Registry. Selective use of ELAPE warranted.

https://arctichealth.org/en/permalink/ahliterature261355
Source
Int J Colorectal Dis. 2014 Aug;29(8):981-7
Publication Type
Article
Date
Aug-2014
Author
Mattias Prytz
Eva Angenete
Jan Ekelund
Eva Haglind
Source
Int J Colorectal Dis. 2014 Aug;29(8):981-7
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Abdomen - surgery
Aged
Colorectal Neoplasms - surgery
Demography
Digestive System Surgical Procedures - methods
Female
Humans
Male
Middle Aged
Perineum - surgery
Rectal Neoplasms - surgery
Registries
Sweden
Time Factors
Abstract
Local recurrences are more common after abdominoperineal excision (APE) than after anterior resection of rectal cancer. Extralevator APE was introduced to address this problem. This prospective registry-based population study aims to investigate the efficacy of extralevator APE (ELAPE) in improving short-term oncological outcome.
All Swedish patients operated with any kind of abdominoperineal excision and registered in the Swedish Rectal Cancer Registry 2007-2009 were included (n?=?1,397) and analyzed with emphasis on the perineal part of the operation. Short-term perioperative and oncological results were collected from the registry.
Extralevator APE did not result in fewer intraoperative perforations or involved circumferential resection margins as compared to standard APE for the entire group. Intraoperative perforations were significantly fewer for patients with low tumours (=4 cm) (ELAPE: n?=?28/386 versus APE: n?=?9/58) (p?=?0.043) and for early (T0-T2) T-stages (ELAPE: n?=?3/172 versus APE: n?=?6/75) (p?=?0.025). There were significantly more post-operative wound infections for ELAPE than for APE (n?=?106 (20.4 %) versus n?=?25 (12.0 %), p?=?0.011).
The short-term results indicate that selective use of extralevator APE can be warranted, for example, for subgroups with low tumours. In conclusion, selective use of the extralevator APE is advocated as not all patients seem to benefit from the technique, and there are significantly more short-term complications after extralevator APE.
Notes
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PubMed ID
24950793 View in PubMed
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38 records – page 1 of 4.