Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 25 September 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Abdominoperineal excision for rectal adenocarcinoma

July's issue of Gut performs risk adjusted benchmarking of abdominoperineal excision for rectal adenocarcinoma in the context of the Belgian PROCARE improvement project.

News image

The abdominoperineal excision rate, a quality of care indicator in rectal cancer surgery, has been criticized if not adjusted for confounding factors.

Dr Freddy Penninckx and colleagues from Belgium evaluates variability in abdominoperineal excision rate between centers participating in PROCARE, a Belgian improvement initiative, before and after risk adjustment.

The team explored the effect of merging the Hartmann resections rate with that of abdominoperineal excision on benchmarking.

Data of 3197 patients who underwent elective radical resection for invasive rectal adenocarcinoma up to 15 cm were registered between 2006 and 2011 by 59 centers, each with at least 10 patients in the registry.

The research team analyzed variability of abdominoperineal excision or merged abdominoperineal excision/Hartmann resections rates between centers before and after adjustment for gender, age, ASA score, tumor level, depth of tumor invasion and preoperative incontinence.

The team found that the overall abdominoperineal excision rate was 21%.

The overall abdominoperineal excision rate was 21%
Gut

The doctors noted that significant variation of the abdominoperineal excision rate was observed before and after risk adjustment.

For cancers in the lower rectal third, the overall abdominoperineal excision rate increased to 46%.

Also, variation between centers increased.

The team of doctors found that risk adjustment influenced the identification of outliers.

Hazard ratios were performed in only about 3% of patients.

However, merging of risk adjusted abdominoperineal excision and hazard ratio rates identified other centers with outlying definitive colostomy rates than abdominoperineal excision rate alone.

Dr Penninckx 's team concluded, "Significant variation of the abdominoperineal excision rate was observed."

"Adjustment for confounding factors as well as merging hazard ratios with abdominoperineal excision rates were found to be important for the assessment of performances."

Gut 2013; 62: 1005-1011
27 June 2013

Go to top of page Email this page Email this page to a colleague

 23 September 2016 
Sleep quality in nonalcoholic cirrhotic patients
 23 September 2016 
Exercise for NAFLD
 23 September 2016 
BMI history and fatty liver
 22 September 2016 
Predicting small-bowel Crohn’s disease
 22 September 2016 
Colectomy outcomes for ulcerative colitis
 22 September 2016 
Technology vs intervention for weight loss
 21 September 2016 
Cardiopulmonary exercise testing in liver transplant candidates
 21 September 2016 
Employment status and IBD
 21 September 2016 
Patients vs providers on nutrition in IBD
 20 September 2016 
Improving healthcare systems for viral Hepatitis
 20 September 2016 
GI benefits of COX-2 selective inhibitors
 20 September 2016 
Predicting relapse in Crohn's
 19 September 2016 
Prevalence of esophageal cancer in Barrett's
 19 September 2016 
Fecal microbiota transplantation and CDI in IBD
 19 September 2016 
Antibiotic resistance in Helicobacter pylori
 16 September 2016 
Low-residue diet before colonoscopy and bowel cleansing
 16 September 2016 
Genome-wide association in gastric cancer
 16 September 2016 
H. pylori in children with asthma
 15 September 2016 
Improving survival in cholangitis-associated septic shock
 15 September 2016 
Colorectal cancer survival and hospital volumes
 15 September 2016 
Primary sclerosing cholangitis and IBD
 14 September 2016 
Intestinal malabsorption and olmesartan
 14 September 2016 
Infection reduction strategy after colorectal resection
 14 September 2016 
Predicting long-term infliximab use in Crohn's
 13 September 2016 
Predicting survival in refractory celiac disease
 13 September 2016 
Cancer risk stratification in Barrett’s
 13 September 2016 
Screening vs non-screening colonoscopy
 12 September 2016 
Screening in familial colorectal cancer
 12 September 2016 
Metformin improves survival in pancreatic ductal cancer
 12 September 2016 
Consent guidelines for GI endoscopy procedures
 09 September 2016 
Development of IBS
 09 September 2016 
Safe and effective treatment for NASH
 09 September 2016 
Scale for stool measurement in diarrhea-IBS
 08 September 2016 
Prognostic factors for infliximab in Crohn's
 08 September 2016 
Chronic Hep B vs chronic Hep C and mortality
 08 September 2016 
Hematological malignancies in IBD
 07 September 2016 
IBD relapse during pregnancy
 07 September 2016 
New treatments for ulcerative colitis
 07 September 2016 
Alternative to nucleic acid testing in HCV
 06 September 2016 
Endoscopy clinic no-shows
 06 September 2016 
Risk of infection after elective colorectal surgery
 06 September 2016 
EHealth technologies in IBD
 05 September 2016 
Esophageal impedance monitoring
 05 September 2016 
Family history and IBD clinical course
 05 September 2016 
Biomarker for IBD and GI cancer
 02 September 2016 
Dietary carbohydrate intake, insulin resistance and GERD 
 02 September 2016 
Postpolypectomy bleeding in the colorectum
 02 September 2016 
Postop recurrence of Crohn's
 01 September 2016 
Prognostic test for liver transplants
 01 September 2016 
Recovery after colorectal surgery in elderly patients
 01 September 2016 
Obesity and post-ERCP pancreatitis
 30 August 2016 
NAFLD and carotid atherosclerosis
 30 August 2016 
Quality improvement program after colorectal surgery
 30 August 2016 
Gut microbial diversity in smokers with Crohn's
 29 August 2016 
Reducing Hep B-related HCC
 29 August 2016 
Hep B immunization of infants for liver cancer
 29 August 2016 
Risk factor for post-ERCP pancreatitis
 26 August 2016 
Reasons for premature surveillance colonoscopy
 26 August 2016 
Celiac disease therapeutics
 26 August 2016 
Bleeding after endoscopic dissection-induced gastric ulcers

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us