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No Anastomotic Leaks After Colorectal Surgery in Rural Community Hospitals

No Anastomotic Leaks After Colorectal Surgery in Rural Community Hospitals In March 2009, I started to review my colorectal cases. Comparison of my results with those published in the April issue of Archives could not be timelier.1 I am a 66-year-old general surgeon, practicing in the same rural location (in 2 hospitals) for the past 18 years. The nearest tertiary care center is 70 miles away. Some patients choose to go there, believing the care there is superior. A small community is a proverbial fish bowl in which the surgeon and his or her mistakes are immediately visible to all. My complete log of operations shows that my case volume of colorectal cases was relatively low, but I have had 0 anastomotic leaks. I counted all of my colorectal cases from December 1991 until March 2009. I was surprised at the small total number: only 102. The mean patient age was 68.2 years. I “brag” of my results to put perspective on the belief that “high volume translates in superior results.” But, in the “fish bowl,” one cannot afford a single mistake. I am working on presenting my series in a formal paper. Whether it will be accepted by editors, of whom some may promote the “volume” mantra, we shall see. Correspondence: Dr Schittek, King City Surgery Center, 2605 Main St, Mt Vernon, IL 62864 (schittekmd@yahoo.com). Financial Disclosure: None reported. References 1. Damrauer SMBordeianou LBerger D Contained anastomotic leaks after colorectal surgery: are we too slow to act? Arch Surg 2009;144 (4) 333- 338, discussion 338PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

No Anastomotic Leaks After Colorectal Surgery in Rural Community Hospitals

Archives of Surgery , Volume 144 (10) – Oct 19, 2009

No Anastomotic Leaks After Colorectal Surgery in Rural Community Hospitals

Abstract

In March 2009, I started to review my colorectal cases. Comparison of my results with those published in the April issue of Archives could not be timelier.1 I am a 66-year-old general surgeon, practicing in the same rural location (in 2 hospitals) for the past 18 years. The nearest tertiary care center is 70 miles away. Some patients choose to go there, believing the care there is superior. A small community is a proverbial fish bowl in which the surgeon and his or her mistakes are...
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Publisher
American Medical Association
Copyright
Copyright © 2009 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.2009.174
Publisher site
See Article on Publisher Site

Abstract

In March 2009, I started to review my colorectal cases. Comparison of my results with those published in the April issue of Archives could not be timelier.1 I am a 66-year-old general surgeon, practicing in the same rural location (in 2 hospitals) for the past 18 years. The nearest tertiary care center is 70 miles away. Some patients choose to go there, believing the care there is superior. A small community is a proverbial fish bowl in which the surgeon and his or her mistakes are immediately visible to all. My complete log of operations shows that my case volume of colorectal cases was relatively low, but I have had 0 anastomotic leaks. I counted all of my colorectal cases from December 1991 until March 2009. I was surprised at the small total number: only 102. The mean patient age was 68.2 years. I “brag” of my results to put perspective on the belief that “high volume translates in superior results.” But, in the “fish bowl,” one cannot afford a single mistake. I am working on presenting my series in a formal paper. Whether it will be accepted by editors, of whom some may promote the “volume” mantra, we shall see. Correspondence: Dr Schittek, King City Surgery Center, 2605 Main St, Mt Vernon, IL 62864 (schittekmd@yahoo.com). Financial Disclosure: None reported. References 1. Damrauer SMBordeianou LBerger D Contained anastomotic leaks after colorectal surgery: are we too slow to act? Arch Surg 2009;144 (4) 333- 338, discussion 338PubMedGoogle ScholarCrossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 19, 2009

Keywords: colorectal surgery,hospitals, community,anastomotic leak

References