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Short-term outcomes after elective colon cancer surgery: an observational study from the Norwegian registry for gastrointestinal and HPB surgery, NoRGast

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Abstract

Background

To describe the real burden of major complications after elective surgery for colon cancer in Norway, and to assess which predictors that are significantly associated with the short-term outcome.

Methods

An observational, multi-centre analysis of prospectively registered colon resections registered into the Norwegian Registry for Gastrointestinal Surgery, NoRGast, between January 2014 and December 2016. A propensity score-adjusted subgroup analysis for surgical access groups was attempted, with laparoscopic resections grouped as intention-to-treat.

Results

Out of 1812 resections, 14.0% of patients experienced a major complication within 30 days following surgery. The over-all reoperation rate was 8.7%, and rate of reoperation for anastomotic leak was 3.8%. Twenty patients (1.1%) died within 30 days after surgery. Higher age was not a significant predictor of major complications, including 30-day mortality. After correction for all co-variables, open access surgery was associated with higher rates of major complications (OR 1.67 (CI 1.22–2.29), p = 0.002), higher 30-day mortality (OR 4.39 (CI 1.19–16.13) p = 0.026) and longer length-of-stay (HR 0.58 (CI 0.52–0.65) p < 0.001).

Conclusions

Our results indicate a low complication burden and high rate of uneventful patient journeys after elective surgery for colon cancer in Norway. Age was not associated with higher morbidity or mortality rates. Open access surgery was associated with an inferior short-term outcome.

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Author information

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, University Hospital of North Norway, 9019, Tromsø, Norway

    L. S. Nymo & S. Norderval

  2. Institute of Clinical Medicine, Faculty of Health Science, UIT, The Arctic University of Norway, 9019, Tromsø, Norway

    L. S. Nymo, S. Norderval & K. Lassen

  3. Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital, 0424, Oslo, Norway

    M. T. Eriksen

  4. Institute of Clinical Medicine, University of Oslo, 0316, Oslo, Norway

    M. T. Eriksen & B. A. Bjørnbeth

  5. Department of HPB Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway

    B. A. Bjørnbeth & K. Lassen

  6. Department of Gastrointestinal Surgery, St. Olav Hospital, Trondheim University Hospital, 7006, Trondheim, Norway

    H. H. Wasmuth

  7. Department of Gastrointestinal Surgery, Stavanger University Hospital, 4068, Stavanger, Norway

    H. Kørner

  8. Institute of Clinical Medicine, University of Bergen, Bergen, Norway

    H. Kørner & A. Viste

  9. Surgical Department, Innlandet Hospital Trust, Lillehammer, Norway

    T. Moger

  10. Haukeland University Hospital, Bergen, Norway

    A. Viste

Authors
  1. L. S. Nymo
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  2. S. Norderval
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Corresponding author

Correspondence to L. S. Nymo.

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Disclosures

On behalf of all authors: The authors constitute the board of the NoRGast registry. Linn Såve Nymo, Stig Norderval, Thomas Moger, Morten Tandberg Eriksen, Asgaut Viste, Hans Wasmuth, Bjørn-Atle Bjørnbeth and Kristoffer Lassen have no conflict of interest to disclose.

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Nymo, L.S., Norderval, S., Eriksen, M.T. et al. Short-term outcomes after elective colon cancer surgery: an observational study from the Norwegian registry for gastrointestinal and HPB surgery, NoRGast. Surg Endosc 33, 2821–2833 (2019). https://doi.org/10.1007/s00464-018-6575-4

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  • DOI: https://doi.org/10.1007/s00464-018-6575-4

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