Incidence trends and predictors for cost and average lengths of stay in colorectal cancer surgery

AIM:To evaluate the changing trends and outcomes of colorectal cancer(CRC)surgery performed at a large single institution in Taiwan.METHODS:This study retrospectively analyzed 778patients who received colorectal cancer surgery at E-Da Hospital in Taiwan from 2004 to 2009.These patients were from health examination,inpatient or emergency settings.The following attributes were analyzed in patients who had undergone CRC surgical procedures:gender,age,source,surgical type,tumor number,tumor size,number of lymph node metastasis,pathologic differentiation,chemotherapy,distant metastases,tumor site,tumor stage,average hospitalization cost and average lengths of stay(ALOS).The odds ratio and95%confidence intervals were calculated to assess the relative rate of change.Regression models were employed to predict average hospitalization cost and ALOS.RESULTS:The study sample included 458(58.87%)males and 320(41.13%)females with a mean age of64.53 years(standard deviation,12.33 years;range,28-86 years).The principal patient source came from inpatient and emergency room(96.02%).The principal tumor sites were noted at the sigmoid colon(35.73%)and rectum(30.46%).Most patients exhibited a tumor stage of 2(37.28%)or 3(34.19%).The number of new CRC surgeries performed per 100000 persons was12.21 in 2004 and gradually increased to 17.89 in 2009,representing a change of 46.52%.During the same period,the average hospitalization cost and ALOS decreased from$5303 to$4062 and from 19.7 to 14.4 d,respectively.The following factors were associated with considerably decreased hospital resource utilization:age,source,surgical type,tumor size,tumor site,and tumor stage.CONCLUSION:These results can be generalized to patient populations elsewhere in Taiwan and to other countries with similar patient profiles.

Delayed ischemic gangrene change of distal limb despite optimal decompressed colostomy constructed in obstructedsigmoid colon cancer:A case report

为解压缩创造喷水孔结肠开口术能为一个严重地削弱的案例向一个节省时间、有效的外科的过程提供一种完全妨碍的颜色表面的癌症。复杂并发症作为脱垂，收回，和 paracolostomal 脓肿被报导。然而，复杂并发症与一是化学家远侧的手足没被报导。我们为减轻恶意的 S 字形的冒号阻塞在减压结肠开口术以后报导批评 intra 腹的疾病的一个案例；一个潜在的致命的条件应该被警告。76 岁的男性与肮脏气味的呕吐为与妨碍的 S 字形的结肠肿瘤有关的症状访问了我们的紧急情况部门我们包含象粪便一样材料。对妨碍的 S 字形的损害近似的突现的喷水孔结肠开口术被创造，并且完全的冒号阻塞的分辨率被追求。不幸地，有有白细胞减少的高发烧的像板的腹部和骤起的广泛的腹的痛苦的膨胀随后发展了。如此的急腹症与 S 字形的肿瘤的切除术显示了第二等的剖腹术与一起一是近似地定位直到以前创造的结肠开口术的化学家冒号片断。最后，病人让一所平静手术后的医院留下来。在现在的文章，我们在喷水孔结肠开口术以后描述了远侧的手足局部缺血的骤起的一个突现的条件并且断定尽管有减压结肠开口术，那将高效地解决尖锐恶意的冒号阻塞；逼近是化学家肠可以与可能的不可逆的腹膜炎进行。任何病人，没有妨碍的损害的切除术，经历减压结肠开口术，应该经常与白血球计数和腹的条件调查被监视。