Abstract:
:This study described the various components of access to care for resectable colorectal cancer, and correlated the timeliness of these components with patient satisfaction. With a prospective/retrospective cohort design, all patients undergoing surgical resection for primary colorectal cancer from 2/1/01 to 15/12/01, were identified during their admission for surgery. A comprehensive, standardized method of ascertaining specific time intervals, which included a patient interview, was used. A patient satisfaction questionnaire was developed, tested, and used in consenting patients. Over the study period, 118 patients underwent colorectal cancer resection. Of these, 110 (93%) consented to participate and 101 (86%) completed the satisfaction questionnaire, including test-retest. The median time intervals (interquartile range) for the various components of access to care were as follows: symptoms to first physician visit, 32 days (10-75); first physician visit to diagnosis, 88 days (44-218); diagnosis to surgery, 19 days (10-44); surgery to chemotherapy (where applicable), 54 days (47-72). On multivariate analysis, tumor location in the rectum was associated with longer prediagnosis intervals, whereas increasing tumor stage was associated with shorter intervals from diagnosis to surgery. Variation in the time interval from diagnosis to surgery was associated with patient satisfaction (r = 0.49; P < 0.0001). Substantially less correlation was identified between patient satisfaction and the time from first physician visit to diagnosis (r = 0.25, P = 0.04). No significant correlation was identified between patient satisfaction scores and the time interval from symptoms to first physician visit (r = 0.11; P = 0.7). Despite concerns regarding surgical waitlists, the longest time intervals experienced by colorectal cancer patients precede diagnosis. However, variations in the relatively short time period from diagnosis to surgery appeared to have the most impact on patient satisfaction. Interventions which improve the timeliness of specific components of access to care may not necessarily result in improved patient satisfaction.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Porter GA,Inglis KM,Wood LA,Veugelers PJdoi
10.1007/s00268-005-7955-1keywords:
subject
Has Abstractpub_date
2005-11-01 00:00:00pages
1444-51issue
11eissn
0364-2313issn
1432-2323journal_volume
29pub_type
杂志文章abstract::The release of the neuronal protein S-100B into the circulation has been suggested as an early indication of cellular brain damage. The objective of this prospective pilot study was to determine S-100B serum levels in patients undergoing cross-clamping during carotid endarterectomy (CEA) and to correlate the results w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6547-6
更新日期:2002-10-01 00:00:00
abstract::To clarify the clinical significance of the status of surgical margins, especially the dissected margin in the transverse direction, a clinicopathologic study was performed on 60 patients with carcinoma of the bile duct who underwent radical resection. The patients in group A (n = 28) had no cancer invasion within 5 m...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00298931
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:The skin is closed in open appendectomy traditionally with few interrupted nonabsorbable sutures. The use of this old method is based on a suggestion that this technique decreases wound infections. In pediatric surgery, skin closure with running intradermal absorbable sutures has been found to be as safe as ...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-012-1664-3
更新日期:2012-10-01 00:00:00
abstract::Fifty patients reoperated for failed Nissen fundoplication are presented; 29 patients (group 2) were operated between 1983 and 1988 while 21 patients (group 1) were operated before 1983. In group 1, the "slipped Nissen" had been the most frequent cause of reoperation (48%). In group 2, the most frequent causes for the...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658439
更新日期:1989-11-01 00:00:00
abstract::Factors responsible for recurrence of esophageal cancer were investigated in 90 patients who underwent extended radical esophagectomy with three-field dissection for a squamous cell carcinoma in the thoracic esophagus. The initial tumor recurrence was grouped as either locoregional (site of the primary tumor, anastomo...
journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Critical illness disproportionately affects people in low-income countries (LICs). Efforts to improve critical care in LICs must account for differences in demographics and infrastructure compared to high-income settings. Part of this effort includes the development and validation of intensive care unit (ICU...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05078-9
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Stapled anopexia was introduced as a surgical method in 1993. Long-term data with special interest in functional results and relapse symptoms are rarely presented. Urinary discomfort and problems with fecal urge incontinence are addressed as severe side effects. We present our long-term results (using data f...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9818-z
更新日期:2009-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05915-2
更新日期:2021-01-16 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05917-0
更新日期:2021-01-22 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3663-2
更新日期:2017-01-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02104447
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:The quality of surgical performance depends on the technical skills of the surgical team as well as on non-technical skills, including teamwork. The present study evaluated the impact of familiarity among members of the surgical team on morbidity in patients undergoing elective open abdominal surgery. METHO...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2680-2
更新日期:2014-12-01 00:00:00
abstract::Familial Mediterranean fever (FMF) also known as hereditary polyserositis, is an inherited disorder commonly found in Armenians, Turks, Arabs, Balkans, and Jews originating from North African countries. The diagnosis of FMF is based on clinical findings and family history, as no specific diagnostic test is yet availab...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00348205
更新日期:1994-01-01 00:00:00
abstract::The most appropriate approach to treating hepatocellular carcinoma (HCC) in the caudate lobe has not yet been determined. A series of 197 patients who had undergone curative hepatic resection for HCC were analyzed. Fifteen patients had HCC in the caudate lobe: three in the Spiegel lobe (SP), three in the caudate proce...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7341-4
更新日期:2004-07-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05912-5
更新日期:2021-01-13 00:00:00
abstract:BACKGROUND:A recent analysis found bradycardia during laparoscopy as a potential early warning sign of cardiac arrest. Knowledge regarding bradycardia frequency and its consequences during laparoscopy is limited. METHODS:Using the computerized record database, files of 9915 patients undergoing laparoscopic surgery, be...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-04935-x
更新日期:2019-06-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00294409
更新日期:1994-03-01 00:00:00
abstract::Most adrenal incidentalomas are nonfunctioning cortical adenomas that do not require surgery. Operative treatment is indicated if the incidentaloma has malignant features as seen during the radiologic workup, is hormonally active, or grows during follow-up. A conservative attitude is justified in asymptomatic patients...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910095
更新日期:2000-05-01 00:00:00
abstract::Precise localization of cervical node metastasis of papillary thyroid carcinoma is rarely described. The aim of this retrospective study was to map their cervical involvement. Between 1974 and 1996 a series of 119 patients had total thyroidectomy with bilateral cervical lymph node dissection. Patients who had secondar...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900609
更新日期:1999-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0819-3
更新日期:2011-04-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0055-4
更新日期:2005-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0904-7
更新日期:2011-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658825
更新日期:1990-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05884-6
更新日期:2021-01-08 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0361-x
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The open abdomen (OA) is commonly utilized as a technique during damage control laparotomy (DCL). We propose that a selected group of these OA patients can be extubated prior to abdominal closure to decrease ventilator days and risk of pneumonia. METHODS:A retrospective chart review was performed at a Level...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4610-1
更新日期:2018-10-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2503-5
更新日期:2014-08-01 00:00:00
abstract::Different types of vagotomy have been widely used in the treatment of peptic ulcer disease. A close relationship between the vagus nerve and the release or action of gastrointestinal hormones is necessary for the optimal activation of the gastrointestinal tract. The serum concentrations of the antral hormone gastrin a...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01654771
更新日期:1979-09-20 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-1906-z
更新日期:2013-04-01 00:00:00
abstract:INTRODUCTION:Cardiovascular dysfunction (CVD) is a well-recognized complication in patients with hyperthyroidism and is the major cause of mortality. Very few studies have compared the outcome of CVD following different treatment modalities. In this study we intended to compare treatment modalities (antithyroid drugs v...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4571-4
更新日期:2018-05-01 00:00:00