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World Journal of Surgery

Published in:

01-02-2008

CRC Surgery Trends in Kenya, 1993–2005

Authors: Hassan Saidi, Elly O. Nyaim, Joseph W. Githaiga, David Karuri

Published in: World Journal of Surgery | Issue 2/2008

Abstract

Background

CRC (CRC) rates are low but increasing in Africa. Data on detection, treatment, and outcome are scarce.

Objective

The aim of this study was to evaluate the presentation, treatment, and outcome pattern of CRC and to compare the care processes for two time periods.

Setting

The setting was Kenyatta National Hospital (KNH), a teaching and referral center.

Patients and methods

A total of 259 patients seen over two time periods (1993–1998 and 1999–2005) were analyzed for admission date, sex, subsite involvement, diagnostic process, treatment, follow-up, and outcome. The distribution of variables between the time periods were analyzed using Student’s t-test and χ² as appropriate. Survival trends were generated using Kaplan Meier method; p < 0.05 was statistically significant.

Results

The average number of CRC diagnoses showed a 2.7-fold increase during the study periods. The mean age at presentation was 49.7 years. The mean duration of symptoms was 29.6 weeks; and the commonest subsite was the rectum (55.3%). The overall resection rate was 67.7%. For rectal tumors the abdominoperineal rate was 51.4%. Mortality was higher for poorly differentiated cancer, advanced disease, age >50 years, and emergency surgery. There was no change in the age, duration of symptoms, proportion of patients <40 years, or the colon/rectal ratios of the cancer site. The second time period saw more adjuncts for diagnosis, less in-hospital mortality, and better staging data.

Conclusion

CRC peaks during the fifth decade of life in Kenyans. The disease is characterized by late presentation, rectal preponderance, and inadequate pathology data. Improved patient follow-up will unravel the true pattern of disease outcome.

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Title: CRC Surgery Trends in Kenya, 1993–2005
Authors: Hassan Saidi
Elly O. Nyaim
Joseph W. Githaiga
David Karuri
Publication date: 01-02-2008
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 2/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-007-9301-2

At a glance: The STEP trials

Springer Medicine

CRC Surgery Trends in Kenya, 1993–2005

Abstract

Background

Objective

Setting

Patients and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Setting

Patients and methods

Results

Conclusion

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