Volume-outcome relationship in colon cancer surgery: another biased logical short cut towards questionable centralization policies.

The association between hospital high volumes and good outcomes after complex surgery has given rise to a worldwide controversial debate. Important and unsolved questions have followed, both theoretical and practical, which could have repercussions on health care and health economic policies, such as the centralization/regionalization of major surgical procedures.We read a recent study on the impact of surgery volumes on short-term outcomes after colon cancer resection in Emilia Romagna, Italy, the same geographic area where we operate.

Functional outcome of total anorectal reconstruction: incontinence or constipation?

Background And Aims: Besides incontinence, constipation is important after TAR. We aimed at evaluating their correlation and role in functional outcome.

Materials And Methods: 81 diaries in 16 patients (up to 8 years) were assessed, by a specific scoring system, regarding incontinence and evacuation.

Surgical results and functional outcome after total anorectal reconstruction by double graciloplasty supported by external-source electrostimulation and/or implantable pulse generators: an 8-year experience.

Background And Aims: Surgical and functional results after abdominoperineal resection and total anorectal reconstruction by electrostimulated gracilis muscle transposition are still poorly documented. This study prospectively evaluated surgical and functional outcome over time in our patients.

Patients And Methods: Twenty-three patients underwent abdominoperineal resection, coloperineal pullthrough, double graciloplasty, and loop abdominal stoma.

A patient-rated, surgeon-corrected scale for functional assessment after total anorectal reconstruction. An adaptation of the Working Party on Anal Sphincter Replacement scoring system.

Background And Aims: To test current systems evaluating for fecal continence after total anorectal reconstruction (TAR) we adapted the incontinence plus evacuation scoring system proposed by the Working Party on Anal Sphincter Replacement (WPASR).

Patients And Methods: We examined 51 monthly diaries recorded by 14 patients after TAR or at yearly checks (up to 5 years). A form detailing all items and frequencies of the WPASR system was given to 12 patients who assigned a rating to each item in a frequency cell.