Colorectal Cancer: Improving Outcomes After Surgery

Abstract

High-quality care is important for a well-functioning society. It enables children to excel in education, adults to be productive members of society and the elderly to enjoy longer and healthier lives. Unfortunately, healthcare costs are steadily rising and this process has even accelerated as a result of the covid-19 pandemic. Nevertheless, the government has set the goal of reducing the increase in healthcare costs to 0% while simultaneously improving the quality of healthcare. In other words; with the same money we have to provide more and better care. In this thesis, we look at quality improvement in colorectal cancer surgery due to the relatively high percentage of postoperative complications and the large degree of variation between Dutch hospitals, which indicates that the quality is not equally good everywhere. The thesis focuses on the pre-, peri- and postoperative phase and investigates the effect of: - Preventing emergency surgery and optimizing nutritional and physical condition through prehabilitation (prospective observational) - The long-term effects of emergency surgery and open surgery (retrospective) - Intraoperative hypothermia (retrospective) - An innovative tool during surgery (RCT) - Routine postoperative ICU admission in the over-80s (prospective observational)