Elective and emergency surgery for colorectal cancer in a district general hospital: impact of surgical training on patient survival.

Abstract

A total of 640 patients were studied retrospectively after surgery for colorectal cancer over a 5-year period at a district general hospital. The complications, perioperative survival figures, and 5-year survival figures were recorded with particular reference to the grade of surgeon carrying out the original operation. The number and type of complications were similar for consultants and for surgeons-in-training with the exception of operative injury to the ureters and postoperative anastomotic strictures, which were more common in cases operated on by consultants. Perioperative mortality rates were similar after elective and emergency operations, but emergency surgery was associated with a significant increase in mortality when compared with elective surgery if the operation was undertaken by a trainee. Although the 5-year survival rate rose when a consultant surgeon carried out the original operation, the difference was not significant.