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Colorectal surgery is an important aspect of our current health system, due to the high incidence of colorectal cancer combined with an ageing population, improved long-term outcomes after colorectal surgery, and the perfectioning of the operative and postoperative aspects through laparoscopy and enhanced recovery programs.

However, postoperative complications painfully remain, despite efforts of amelioration of perioperative care. Research for molecular pathways and non-surgical treatment modalities of colorectal cancer and inflammatory bowel disease is rising in importance, however the improvement of quality and safety of colorectal surgery should remain and become ever more a key element for all colorectal surgeons. This thesis aims to add to this improvement

Slieker, J.C. (Juliette)

__Abstract__
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\nColorectal surgery is an important aspect of our current health system, due to the high incidence of colorectal cancer combined with an ageing population, improved long-term outcomes after colorectal surgery, and the perfectioning of the operative and postoperative aspects through laparoscopy and enhanced recovery programs.
\nHowever, postoperative complications painfully remain, despite efforts of amelioration of perioperative care. Research for molecular pathways and non-surgical treatment modalities of colorectal cancer and inflammatory bowel disease is rising in importance, however the improvement of quality and safety of colorectal surgery should remain and become ever more a key element for all colorectal surgeons. This thesis aims to add to this improvement

Erasmus University Digital Repository

Stellingen behorende bij het proefschrift “Improving quality in colorectal surgery”  1. Quantification of calcification of the aorto-iliac arteries is useful to estimate the risk of colorectal anastomotic leakage (this thesis).  2. Low tie is preferable over high tie regarding central vascular ligation during rectum resection for carcinoma (this thesis).  3. The peri-operative prescription of corticosteroids for prevention of postoperative pulmonary complications should be abandoned in colorectal resections with anastomosis (this thesis).  4. Preoperative mechanical bowel preparation is beneficial in laparoscopic colorectal surgery (this thesis).  5. Current available sealants should not be used on colorectal anastomosis in a clinical setting (this thesis).  6. Fast-track programs such as ERAS are advantageous for all patients undergoing colorectal surgery, unregarded age and comorbidities.  7. Faecal- and urogenital dysfunction after radiotherapy for rectum cancer should be systematically documented, in evaluation of the benefit of non-surgical treatment of rectum cancer in patients having complete response after neoadjuvant radiochemotherapy.  8. The extent of resection of colon carcinoma is not evidence-based.   9. Colon or rectum resection in presence of faecal peritonitis is no absolute contra-indication for the construction of an anastomosis, regardless of age.  10. Peer-review should undergo quality-control and be rewarded, in order to increase the quality of published studies.  11. Surgical courses are more fun in Switzerland: you’re allowed to go skiing. 

Improving Quality in Colorectal Surgery

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