Cost-effectiveness and quality of life in surgeon versus general practitioner-organised colon cancer surveillance: a randomised controlled trial.

Objective: To assess whether colon cancer follow-up can be organised by general practitioners (GPs) without a decline in the patient's quality of life (QoL) and increase in cost or time to cancer diagnoses, compared to hospital follow-up.

Design: Randomised controlled trial.

Setting: Northern Norway Health Authority Trust, 4 trusts, 11 hospitals and 88 local communities.

Should the surgeon or the general practitioner (GP) follow up patients after surgery for colon cancer? A randomized controlled trial protocol focusing on quality of life, cost-effectiveness and serious clinical events.

Background: All patients who undergo surgery for colon cancer are followed up according to the guidelines of the Norwegian Gastrointestinal Cancer Group (NGICG). These guidelines state that the aims of follow-up after surgery are to perform quality assessment, provide support and improve survival. In Norway, most of these patients are followed up in a hospital setting.

[Complaints before and after cholecystectomy].

Background: It may be difficult to decide whether a patient's discomfort is related to known gallbladder stones.

Material And Methods: A questionnaire regarding pre- and postoperative complaints and satisfaction with treatment was sent to 211 patients a median 51 months after they had undergone cholecystectomy at Rana district hospital during the May 1993 to March 2001 period.

Results: 97% of the patients returned our questionnaire.

[Gallbladder surgery in a district hospital--a prospective registration].

Background: Health authorities and patients are expected to be more active in inquiring about the outcome of surgery for each specific hospital. Prospective registration performed in a district hospital has to go on for years until the results can be evaluated. Specific data for gallbladder surgery performed in Norwegian district hospitals have not been reported before.

[Agenesis of the gallbladder].

Background: Agenesis of the gallbladder, first described in 1701, is a rare, congenital malformation with an incidence of 0.01% to 0.04%.

[Scintigraphic localization of colonic bleeding].

Background: Endoscopy and, occasionally, X-ray studies are used to discover the focus of a gastrointestinal bleeding.

Material And Methods: We describe a case of severe gastrointestinal bleeding where these methods failed. Scintigraphy after labelling of erythrocytes with 99m technetium was performed in a continuous manner for 60 minutes.

[Can surgeons be in charge of an obstetric department?].

At Rana sykehus there are neither obstetricians nor pediatricians. The obstetric ward is run by the surgeons. Pregnant women suspected of being at increased risks are transferred to Nordland Sentralsykehus before the expected delivery.

[Puerperal inversion of the uterus].

Inversion of the uterus is a rare but very serious complication of childbirth. We present a case-report from a hospital with 350 to 400 births a year where since we have no gynecologist, the surgeons are in charge of obstetrics. The patient was successfully operated after an attempt to replace the inverted uterus had failed.