Knut Magne Augestad

• Johnsen, Oddne Fjellstad; Riis, Rolf; Meltzer, Sebastian; Ree, Anne Hansen & Augestad, Knut Magne (2026). Long-term disease-free survival in young-onset rectal cancer patients surgically treated with curative intent: a retrospective cohort study. International Journal of Colorectal Disease. ISSN 0179-1958. 41(1). doi: 10.1007/s00384-026-05191-x. Full text in Research Archive
• Gravdahl, Eva-Kristin Norum; Augestad, Knut Magne; Sandblost, Tonje; Clausen, Maria & Fredheim, Olav Magnus Søndenå (2026). Symptom management, outcomes and decision-making in malignant bowel obstruction: a retrospective cohort study. BMJ Supportive & Palliative Care. ISSN 2045-435X. doi: 10.1136/spcare-2026-006200. Full text in Research Archive
• Bravo, José Jorge Martinez; Gögenur, Mikail; Gögenur, Ismail; Kiran, Ravi Pokala; Benth, Jurate Saltyte & Augestad, Knut Magne (2026). A prediction model for disease-free survival following R0/R1 rectal cancer resection: A retrospective longitudinal study based on the Norwegian and Danish colorectal cancer quality registries. European Journal of Surgical Oncology. ISSN 0748-7983. 52(4). doi: 10.1016/j.ejso.2026.111514. Full text in Research Archive Show summary

  Background Prediction models may assist clinicians in communicating prognostic outcomes to cancer survivors. The Norwegian and Danish colorectal cancer registers (NCCR and DCCG) are valuable data sources for developing such models. Although few models exist for rectal cancer, their development and validation remain limited. Methods We assessed data from 21,116 stage I-III rectal cancer patients who underwent R0/R1 surgery. The assessment included clinicopathological predictors of DFS, with the index date being the date of the pathological report. A multivariable Cox regression model with inverse probability weighting was estimated for DFS, as outcome, defined as the time from diagnosis to death, recurrence or end of follow-up with at least 90-day follow-up. Results The analysis included 10,234 NCCR and 6691 DCCG patients, with 40·3% and 38·3% being female, mean age of 67·9 (11·7) and 67·9 (10·6) years, median follow-up times of 93·4 (95% CI (91·0-96·0)) and 79·1 (77·4-80·6) months, and 5-year DFS of 29·9% and 24·3%. Sex, age, pathological stage, circumferential resection margin, lymph node yield, malignant lymph nodes, and surgical procedures were significant predictors. The C-index was 0·69 (R2 0·24), and 0·65 (R2 0·07) for the external validation cohort. The calibration slope was 1·22 (SE 0·05). Predicted probabilities for the NCCR and DCCG cohorts closely matched the observed probabilities. Conclusion Accessible through RECTI.net, the model predicts disease-free survival for up to 12·5 years after surgery, aiding clinicians to provide prognostic outcomes to rectal cancer survivors. To improve the generalisability of the model, further validation in other populations is needed.

• Johnsen, Oddne Fjellstad; Riis, Rolf; Meltzer, Sebastian & Augestad, Knut Magne (2025). Increasing age, neural invasion, extramural vascular invasion, and short-course radiotherapy in locally advanced rectal cancer are associated with decreased tumor regression: a retrospective cohort study. Techniques in Coloproctology. ISSN 1123-6337. 29(1). doi: 10.1007/s10151-025-03180-w. Full text in Research Archive Show summary

  Background We investigated factors associated with pathologic complete response (pCR) and tumor regression grade (TRG) on the basis of clinical and pathological variables and their impact on cancer-free survival (CFS) after surgery for locally advanced rectal cancer (LARC). Methods All patients with LARC undergoing neoadjuvant treatment before curative total mesorectal excision surgery were included in a prospective institutional database connected to the National Mortality Registry. One-way analysis of variance and Pearson’s chi-squared test were utilized to compare TRG groups. The Kaplan–Meier method and regression models were used to evaluate CFS, radiation modality, and staging factors. Results Of 700 patients operated on for rectal cancer between 2014 and 2024, 159 (22.7%) had LARC without known systemic cancer. Twenty-seven patients had pCR (TRG 0, 17.0%), 46 TRG 1 (29.0%), 70 TRG 2 (44.0%), and 16 TRG 3 (10%). Poor tumor regression was associated with increasing age (p = 0.009), vascular (p < 0.001) and neural invasion (p = 0.005), less differentiated tumors (p < 0.001), short-course 5 Gy × 5 (p < 0.001) rather than long-course 2 Gy × 25 radiotherapy, and omission of neoadjuvant chemotherapy (p < 0.001). Older age was a predictor of short-course radiotherapy and omission of chemotherapy (p < 0.001). Follow-up time was 46.6 months (IQR 20–80.3 months). No differences were found in CFS between TRG groups 0–3 (p = 0.18), however pCR was associated with improved CFS (p = 0.047). Conclusions Decreased tumor regression was associated with reduced radiotherapy and chemotherapy, neural and vascular invasion, poor differentiation, and increasing age. The latter may reflect reduced application of neoadjuvant treatment in older patients. Complete responders experienced increased cancer-free survival.

• Gravdahl, Eva-Kristin Norum; Dale, Ola; Benth, Jurate Saltyte; Steine, Siri; Augestad, Knut Magne & Fredheim, Olav Magnus Søndenå (2025). Pharmacokinetics of subcutaneous and intravenous bolus doses of morphine in palliative care cancer patients receiving infusion of morphine: A pharmacokinetic substudy of a randomized controlled trial. British Journal of Clinical Pharmacology. ISSN 0306-5251. 91(12), p. 3422–3431. doi: 10.1002/bcp.70191. Full text in Research Archive Show summary

  Aims To compare the pharmacokinetics of intravenous (IV) and subcutaneous (SC) morphine bolus doses in palliative care patients receiving patient-controlled analgesia. Methods This pharmacokinetic substudy of a double-blinded, randomized controlled trial included 20 patients with advanced cancer requiring morphine infusion. After 20–48 h of patient-controlled analgesia, a baseline blood sample was drawn before bolus administration, followed by 16 samples over 2 h. Time to maximum concentration, maximum concentration and area under the curve to 60 min (AUC0–60) were determined. Group differences were assessed using linear mixed-effects modelling. Results Median (Q1, Q3) time to maximum concentration was significantly shorter for IV (2 [2, 2] min) compared to SC (10 [5, 15] min, P < .001). Dose-adjusted maximum concentration was 3 times higher in the IV group. Linear mixed-effects modelling showed on average, significantly higher serum concentrations for IV during the 0–60 min period postbolus, although differences in AUC0–60 were not statistically significant (mean AUC0–60: SC, 7621 nmol min/L [95% confidence interval: 5714–10 163]; IV, 9382 nmol min/L [95% confidence interval: 5914–14 884]). At steady state, higher infusion rates were associated with markedly higher concentrations in the IV group. Low albumin correlated with higher serum morphine concentrations. No differences in respiratory rates or sedation were observed. Conclusions IV morphine showed faster absorption with substantially higher peak concentrations compared to SC. Further research is needed to assess the clinical relevance of these differences.

• Gravdahl, Eva-Kristin Norum; Steine, Siri; Benth, Jurate Saltyte; Augestad, Knut Magne & Fredheim, Olav Magnus Søndenå (2025). Subcutaneous versus intravenous route switch from oral to parenteral morphine in patients with cancer: Randomised controlled trial. BMJ Supportive & Palliative Care. ISSN 2045-435X. doi: 10.1136/spcare-2025-005593. Full text in Research Archive
• Jalava, Karoliina; Sallinen, Ville; Lampela, Hanna; Malmi, Hanna; Steinholt, Ingeborg Haug & Augestad, Knut Magne [Show all 8 contributors for this article] (2025). Role of Preoperative Antibiotic Treatment While Awaiting Appendectomy: The PERFECT-Antibiotics Randomized Clinical Trial. JAMA Surgery. ISSN 2168-6254. 160(7), p. 745–754. doi: 10.1001/jamasurg.2025.1212. Full text in Research Archive
• Butt, Khayam Ashraf; Jonas, Olav Salterød; Trichet, Laurent Olivier; Sjo, Ole Helmer; Edwin, Bjørn von Gohren & Hartvigsen, Gunnar [Show all 7 contributors for this article] (2024). Surgical telementoring as teaching tool in the operating room: trans-Nordic IDEAL stage 2a telementored series of a robotic ventral mesh rectopexy learning curve. British Journal of Surgery. ISSN 0007-1323. 111(6). doi: 10.1093/bjs/znae123. Full text in Research Archive
• Bernklev, Linn; Nilsen, Jens Aksel; Augestad, Knut Magne; Holme, Øyvind & Pilonis, Nastazja Dagny (2024). Management of non-curative endoscopic resection of T1 colon cancer. Baillière's Best Practice & Research Clinical Gastroenterology. ISSN 1521-6918. 68. doi: 10.1016/j.bpg.2024.101891. Full text in Research Archive Show summary

  Endoscopic resection techniques enable en-bloc resection of T1 colon cancers. A complete removal of T1 colon cancer can be considered curative when histologic examination of the specimens shows none of the high-risk factors for lymph nodes metastases. Criteria predicting lymph nodes metastases include deep submucosal invasion, poor differentiation, lymphovascular invasion, and high-grade tumor budding. In these cases, complete (R0), local endoscopic resection is considered sufficient as negligible risk of lymph nodes metastases does not outweigh morbidity and mortality associated with surgical resection. Challenges arise when endoscopic resection is incomplete (RX/R1) or high-risk histological features are present. The risk of lymph node metastasis in T1 CRC ranges from 1% to 36.4%, depending on histologic risk factors. Presence of any risk factor labels the patient “high risk,” warranting oncologic surgery with mesocolic lymphadenectomy. However, even if 70%–80% of T1-CRC patients are classified as high-risk, more than 90% are without lymph node involvement after oncological surgery. Surgical overtreatment in T1 CRC is a challenge, requiring a balance between oncologic safety and minimizing morbidity/mortality. This narrative review explores the landscape of managing non-curative T1 colon cancer, focusing on the choice between advanced endoscopic resection techniques and surgical interventions. We discuss surveillance strategies and shared decision-making, emphasizing the importance of a multidisciplinary approach.

• Harrison, Ewen M.; Gobin, N.; Freitas, A.V.; Hall, N.; Kim, S. & Negida, A. [Show all 2,935 contributors for this article] (2024). Development and external validation of the 'Global Surgical-Site Infection' (GloSSI) predictive model in adult patients undergoing gastrointestinal surgery. British Journal of Surgery. ISSN 0007-1323. 111(6). doi: 10.1093/bjs/znae129. Full text in Research Archive
• Augestad, Knut Magne; Skyrud, Katrine Damgaard; Lindahl, Anne Karin & Helgeland, Jon (2023). Hospital variations in failure to rescue after abdominal surgery: a nationwide, retrospective observational study. BMJ Open. 13(11). doi: 10.1136/bmjopen-2023-075018. Full text in Research Archive Show summary

  Objectives This study aims to determine hospital variation and intensive care unit characteristics associated with failure to rescue after abdominal surgery in Norway. Design A nationwide retrospective observational study. Setting All 52 hospitals in Norway performing elective and acute abdominal surgery. Participants All 598 736 patients undergoing emergency and elective abdominal surgery from 2011 to 2021. Primary outcome measure Primary outcome was failure to rescue within 30 days (FTR30), defined as in-hospital or out-of-hospital death within 30 days of a surgical patient who developed at least one complication within 30 days of the surgery (FTR30). Other outcome variables were surgical complications and hospital FTR30 variation. Statistical analysis was conducted separately for general surgery and abdominal surgery. Results The 30-day postoperative complication rate was 30.7 (183 560 of 598 736 surgeries). Of general surgical complications (n=25 775), circulatory collapse (n=6127, 23%), cardiac arrhythmia (n=5646, 21%) and surgical infections (n=4334, 16 %) were most common and 1507 (5.8 %) patients were reoperated within 30 days. One thousand seven hundred and forty patients had FTR30 (6.7 %). The severity of complications was strongly associated with FTR30. In multivariate analysis of general surgery, adjusted for patient characteristics, only the year of surgery was associated with FTR30, with an estimated linear trend of −0.31 percentage units per year (95% CI (−0.48 to –0.15)). The driving distance from local hospitals to the nearest referral intensive care unit was not associated with FTR30. Over the last decade, FTR30 rates have varied significantly among similar hospitals. Conclusions Hospital factors cannot explain Norwegian hospitals’ significant FTR variance when adjusting for patient characteristics. The national FTR30 measure has dropped around 30% without a corresponding fall in surgical complications. No association was seen between rural hospital location and FTR30. Policy-makers must address microsystem issues causing high FTR30 in hospitals.

• Gravdahl, Eva-Kristin Norum; Steine, Siri; Augestad, Knut Magne & Fredheim, Olav Magnus Søndenå (2023). Use and safety of peripherally inserted central catheters and midline catheters in palliative care cancer patients: a retrospective review. Supportive Care in Cancer. ISSN 0941-4355. 31. doi: 10.1007/s00520-023-08045-2. Full text in Research Archive Show summary

  Abstract Purpose Some cancer patients in palliative care require intravenous administration of symptom relieving drugs. Peripherally inserted central catheters (PICCs) and midline catheters (MCs) provide easy and accessible intravenous access. However, limited evidence supports the use of these devices in palliative care. The aim was to assess the use, safety, and efficacy of PICC and MC in this patient population. Methods A retrospective study of all palliative care cancer patients who received PICC or MC at the Department of Palliative Medicine at Akershus University Hospital between 2020 and 2022. Results A total of 374 patients were included; 239 patients received a PICC and 135 an MC with a total catheterization duration of 11,698 days. The catheters remained in place until death in 91% of patients, with a median catheter dwell time of 21 days for PICCs and 2 days for MCs. The complication rate was 3.3 per 1000 catheter days, with minor bleeding and accidental dislocation as the most common. The catheters were utilized primarily for opioids and other symptom directed treatments, and 89% of patients received a patient or nurse-controlled analgesia pump. Patients with PICC or MC discharged to home or nursing homes spent 81% of their time out of hospital. Conclusion PICC and MC provide safe parenteral access for palliative care cancer patients where intravenous symptom treatment is indicated. Their use can facilitate intravenous symptom treatment beyond the confines of a hospital and supplement the traditional practice relying on subcutaneous administration.

• Adisa, Adawale; Bahrami-Hessari, Michael; Bhangu, Aneel; George, Christina; Ghosh, Dhruv & Glasbey, James [Show all 50 contributors for this article] (2023). Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries. BJS Open. 110(7). doi: 10.1093/bjs/znad092. Full text in Research Archive Show summary

  Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was coprioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results: In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion: This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.

• Argandykov, Dias; Gallastegi, Ander Dorken; Moheb, Mohamed El; Gebran, Anthony; Proaño-Zamudio, J.A. & Bokenkamp, Mary [Show all 51 contributors for this article] (2023). Is perioperative COVID-19 really associated with worse surgical outcomes? A nationwide COVIDSurg propensity-matched analysis. Journal of Trauma and Acute Care Surgery. ISSN 2163-0755. 94(4), p. 513–524. doi: 10.1097/TA.0000000000003859. Full text in Research Archive Show summary

  BACKGROUND Patients undergoing surgery with perioperative COVID-19 are suggested to have worse outcomes, but whether this is COVID-related or due to selection bias remains unclear. We aimed to compare the postoperative outcomes of patients with and without perioperative COVID-19. METHODS Patients with perioperative COVID-19 diagnosed within 7 days before or 30 days after surgery between February and July 2020 from 68 US hospitals in COVIDSurg, an international multicenter database, were 1:1 propensity score matched to patients without COVID-19 undergoing similar procedures in the 2012 American College of Surgeons National Surgical Quality Improvement Program database. The matching criteria included demographics (e.g., age, sex), comorbidities (e.g., diabetes, chronic obstructive pulmonary disease, chronic kidney disease), and operation characteristics (e.g., type, urgency, complexity). The primary outcome was 30-day hospital mortality. Secondary outcomes included hospital length of stay and 13 postoperative complications (e.g., pneumonia, renal failure, surgical site infection). RESULTS A total of 97,936 patients were included, 1,054 with and 96,882 without COVID-19. Prematching, COVID-19 patients more often underwent emergency surgery (76.1% vs. 10.3%, p

• Riis, Rolf; Riis, Margit; Benth, Jurate Saltyte & Augestad, Knut Magne (2023). Beyond the transanal total mesorectal excision moratorium: local and distant recurrence among patients operated for low rectal tumours—5-year follow-up from a Norwegian University Hospital. British Journal of Surgery. ISSN 0007-1323. 110(11), p. 1547–1548. doi: 10.1093/bjs/znad275. Full text in Research Archive
• Jalava, Karoliina; Sallinen, Ville; Lampela, Hanna; Malmi, Hanna; Steinholt, Ingeborg Haug & Augestad, Knut Magne [Show all 8 contributors for this article] (2023). Role of preoperative in-hospital delay on appendiceal perforation while awaiting appendicectomy (PERFECT): a Nordic, pragmatic, open-label, multicentre, non-inferiority, randomised controlled trial. The Lancet. ISSN 0140-6736. 402(10412), p. 1552–1561. doi: 10.1016/S0140-6736(23)01311-9. Full text in Research Archive
• Kachapila, Mwayi; Monahan, Mark; Ademuyiwa, Adesoji O.; Adinoyi, Yakubu Momohsani; Biccard, Bruce M. & George, Christina [Show all 1,785 contributors for this article] (2023). Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries. BJA Open. 7. doi: 10.1016/j.bjao.2023.100207. Full text in Research Archive Show summary

  Background This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was $216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with $195 for low FiO2 leading to a −$11 (95% CI: −$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was $1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.

• Sgrò, A.; Blanco-Colino, R.; Ahmed, W.U.R; Brindl, N.; Gujjuri, R.R. & Lapolla, P. [Show all 51 contributors for this article] (2023). EuroSurg Collaborative. Safety and efficacy of intraperitoneal drain placement after emergency colorectal surgery: An international, prospective cohort study. Colorectal Disease. ISSN 1462-8910. 25, p. 2043–2053. doi: 10.1111/codi.16737. Full text in Research Archive Show summary

  Abstract Aim: Intraperitoneal drains are often placed during emergency colorectal surgery. However, there is a lack of evidence supporting their use. This study aimed to describe the efficacy and safety of intraperitoneal drain placement after emergency colorectal surgery. Method: COMPlicAted intra-abdominal collectionS after colorectal Surgery (COMPASS) is a prospective, international, cohort study into which consecutive adult patients undergoing emergency colorectal surgery were enrolled (from 3 February 2020 to 8 March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included rate and time-to-diagnosis of postoperative intraperitoneal collections, rate of surgical site infections (SSIs), time to discharge and 30-day major postoperative complications (Clavien–Dindo III–V). Multivariable logistic and Cox proportional hazards regressions were used to estimate the independent association of the outcomes with drain placement. Results: Some 725 patients (median age 68.0 years; 349 [48.1%] women) from 22 countries were included. The drain insertion rate was 53.7% (389 patients). Following multivariable adjustment, drains were not significantly associated with reduced rates (odds ratio [OR] = 1.56, 95% CI: 0.48–5.02, p = 0.457) or earlier detection (hazard ratio [HR] = 1.07, 95% CI: 0.61–1.90, p = 0.805) of collections. Drains were not significantly associated with worse major postoperative complications (OR = 1.26, 95% CI: 0.67–2.36, p = 0.478), delayed hospital discharge (HR = 1.11, 95% CI: 0.91–1.36, p = 0.303) or increased risk of SSIs (OR = 1.61, 95% CI: 0.87–2.99, p = 0.128). Conclusion: This is the first study investigating placement of intraperitoneal drains following emergency colorectal surgery. The safety and clinical benefit of drains remain uncertain. Equipoise exists for randomized trials to define the safety and efficacy of drains in emergency colorectal surgery.

• Simoes, Joana FF; Adamina, Michel; Ademuyiwa, Adesoji; Adisa, Adewale; Bhangu, Aneel A & Bravo, Ana Minaya [Show all 51 contributors for this article] (2022). The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study. Colorectal Disease. ISSN 1462-8910. 24, p. 708–726. doi: 10.1111/codi.16117. Full text in Research Archive Show summary

  Aim The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. Methods This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January–April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. Results Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90–1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69–1.27, P = 0.672). Longer delays were not associated with poorer outcomes. Conclusion One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease.

• Sgrò, A; Blanco-Colino, R; Ahmed, WUR; Brindl, N; Gujjuri, RR & Lapolla, P [Show all 49 contributors for this article] (2022). Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study. British Journal of Surgery. ISSN 0007-1323. 109, p. 520–529. doi: 10.1093/bjs/znac069. Full text in Research Archive
• Glasbey, James C; Abbott, Tom EF; Ademuyiwa, Adesoji; Adisa, Adewale; Alameer, Ehab & Alshryda, Sattar [Show all 51 contributors for this article] (2022). Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries. The Lancet. ISSN 0140-6736. 400(10363), p. 1607–1617. doi: 10.1016/S0140-6736(22)01846-3. Full text in Research Archive Show summary

  Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45·6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84·5 (95% CI 84·1–84·9), which varied between HIC (88·5 [89·0–88·0]), MIC (81·8 [82·5–81·1]), and LIC (66·8 [64·9–68·7]) settings. In the third phase, 1217 (74·6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51·4%) were from HIC, 538 (44·2%) from MIC, and 54 (4·4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3·6% (95% CI 3·0–4·1; p<0·0001) increase in SVR. This was consistent in HIC (4·8% [4·1–5·5]; p<0·0001), MIC (2·8 [2·0–3·7]; p<0·0001), and LIC (3·8 [1·3–6·7%]; p<0·0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs. Funding National Institute for Health Research (NIHR) Global Health Research Unit on Global Surgery, NIHR Academy, Association of Coloproctology of Great Britain and Ireland, Bowel Research UK, British Association of Surgical Oncology, British Gynaecological Cancer Society, and Medtronic.

• Skyrud, Katrine Damgaard; Helgeland, Jon; Lindahl, Anne Karin & Augestad, Knut Magne (2022). Abdominal surgical trajectories associated with failure to rescue. A nationwide analysis. International Journal for Quality in Health Care. ISSN 1353-4505. 34(4). doi: 10.1093/intqhc/mzac084. Full text in Research Archive Show summary

  Abstract Objective The ability to detect and treat complications of surgery early is essential for optimal patient outcomes. The failure-to-rescue (FTR) rate is defined as the death rate among patients who develop at least one complication after the surgical procedure and may be used to monitor a hospital’s quality of surgical care. The aim of this observational study was to explore FTR in Norway and to see if we could identify surgical trajectories associated with high FTR. Method Data on all abdominal surgeries in Norwegian hospitals from 2011 to 2017 were obtained from the Norwegian Patient Registry and linked with the National Population Register. Surgical and other postoperative complication rates and FTR within 30 days (deaths occurring in and out of the hospital) were assessed. We identified surgical trajectories (type of procedures—type of complication—dead/alive at 30 days after operation) associated with the highest volume of deaths (high volume of FTR [FTR-V]) and highest risk of death after a postoperative complication. Results Of the total 626 052 primary abdominal procedures, 224 871 (35.8%) had at least one complication, which includes 83 037 patients. The most common postoperative complications were sepsis (N = 14 331) and respiratory failure (N = 7970). The high-volume trajectories (FTR-V) were endoscopic retrograde cholangiopancreatography—sepsis—death (N = 294, 13.8%); open colon resections—sepsis—death (N = 279, 28.1%) and procedures with stoma formation—sepsis—death (N = 272, 27%). Similarly, patients operated with embolectomy of the visceral arteries and experiencing postoperative sepsis were associated with an extremely high risk of 30-day FTR of 81.5%. In general, an FTR patient had a higher mean age, an increased rate of emergency surgery and more comorbidity. Hospital size was not associated with FTR. Conclusion At a national level, there exist high-volume and high-risk surgical trajectories associated with FTR. These trajectories represent major targets for quality improvement initiatives.

• Alser, Osaid; Gallastegi, Ander Dorken; Gebran, Anthony; Breen, Kerry; Moheb, Mohamed El & Gaitanidis, Apostolos [Show all 50 contributors for this article] (2022). Outcomes and Their State-level Variation in Patients Undergoing Surgery With Perioperative SARS-CoV-2 Infection in the USA: A Prospective Multicenter Study. Annals of Surgery. ISSN 0003-4932. 275(2), p. 247–251. doi: 10.1097/SLA.0000000000005310. Full text in Research Archive
• Reuter, Anna; Rogge, Lisa; Monahan, Mark; Kachapila, Mwayi; Morton, Dion G & Davies, Justine I [Show all 50 contributors for this article] (2022). Global economic burden of unmet surgical need for appendicitis. British Journal of Surgery. ISSN 0007-1323. 109(10), p. 995–1003. doi: 10.1093/bjs/znac195. Full text in Research Archive Show summary

  Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was USD 92 492 million using approach 1 and USD 73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was USD 95 004 million using approach 1 and USD 75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially.

• Mckay, Siobhan C; Drake, Thomas M.; Spiers, Harry VM; Bassi, Claudio; Giovinazzo, Fransesco & Citterio, Davide [Show all 50 contributors for this article] (2022). Outcomes of patients undergoing elective liver and pancreas cancer surgery during the SARS-CoV-2 pandemic: an international, multicentre, prospective cohort study. HPB. ISSN 1365-182X. 24(10), p. 1668–1678. doi: 10.1016/j.hpb.2022.03.002. Full text in Research Archive
• Gebran, Anthony; Gaitanidis, Apostolos; Argandykov, Dias; Maurer, Lydia R; Gallastegi, Ander Dorken & Bokenkamp, Mary [Show all 50 contributors for this article] (2022). Mortality and pulmonary complications in emergency general surgery patients with COVID-19: A large international multicenter study. Journal of Trauma and Acute Care Surgery. ISSN 2163-0755. 93(1), p. 59–65. doi: 10.1097/TA.0000000000003577. Full text in Research Archive
• Butt, Khayam & Augestad, Knut Magne (2021). Educational value of surgical telementoring. Journal of Surgical Oncology. ISSN 0022-4790. 124(2), p. 231–240. doi: 10.1002/jso.26524. Full text in Research Archive Show summary

  Educating surgeons is a time-consuming process. In addition to theoretical knowledge, the practical tasks of surgical procedures must be mastered. Translation of such knowledge from mentor to mentee may be efficiently done by surgical telementoring (ST). This is a review on surgical telementoring. Recent technological advances have made this tool in surgical education more available and applicable but future applications of ST have to be wisely guided by high-quality trials.

• Khatri, C.; Ward, AE; Nepogodiev, D; Ahmed, I; Chaudhry, D & Dhaif, F [Show all 51 contributors for this article] (2021). Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study. BMJ Open. 11. doi: 10.1136/bmjopen-2021-050830. Full text in Research Archive Show summary

  Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis. Setting Prospective, international, multicentre, observational cohort study. Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative). Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality. Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787). Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.

• Schache, Andrew G; Shaw, Richard; Ho, Michael Wing Sung; Winter, Stuart C; Glasbey, James & Ganly, Ian [Show all 51 contributors for this article] (2021). Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery. BJS Open. doi: 10.1093/bjsopen/zrab112. Full text in Research Archive Show summary

  Background During the initial COVID-19 outbreak up to 28.4 million elective operations were cancelled worldwide, in part owing to concerns that it would be unsustainable to maintain elective surgery capacity because of COVID-19-related surgeon absence. Although many hospitals are now recovering, surgical teams need strategies to prepare for future outbreaks. This study aimed to develop a framework to predict elective surgery capacity during future COVID-19 outbreaks. Methods An international cross-sectional study determined real-world COVID-19-related absence rates among surgeons. COVID-19-related absences included sickness, self-isolation, shielding, and caring for family. To estimate elective surgical capacity during future outbreaks, an expert elicitation study was undertaken with senior surgeons to determine the minimum surgical staff required to provide surgical services while maintaining a range of elective surgery volumes (0, 25, 50 or 75 per cent). Results Based on data from 364 hospitals across 65 countries, the COVID-19-related absence rate during the initial 6 weeks of the outbreak ranged from 20.5 to 24.7 per cent (mean average fortnightly). In weeks 7–12, this decreased to 9.2–13.8 per cent. At all times during the COVID-19 outbreak there was predicted to be sufficient surgical staff available to maintain at least 75 per cent of regular elective surgical volume. Overall, there was predicted capacity for surgeon redeployment to support the wider hospital response to COVID-19. Conclusion This framework will inform elective surgical service planning during future COVID-19 outbreaks. In most settings, surgeon absence is unlikely to be the factor limiting elective surgery capacity.

• Simoes, Joana FF; Li, Elizabeth; Glasbey, James C; Omar, Omar M; Arnaud, Alexis P & Blanco-Colino, Ruth [Show all 50 contributors for this article] (2021). COVID-19-related absence among surgeons: development of an international surgical workforce prediction model. BJS Open. doi: 10.1093/bjsopen/zraa021. Full text in Research Archive Show summary

  Abstract Background During the initial COVID-19 outbreak up to 28.4 million elective operations were cancelled worldwide, in part owing to concerns that it would be unsustainable to maintain elective surgery capacity because of COVID-19-related surgeon absence. Although many hospitals are now recovering, surgical teams need strategies to prepare for future outbreaks. This study aimed to develop a framework to predict elective surgery capacity during future COVID-19 outbreaks. Methods An international cross-sectional study determined real-world COVID-19-related absence rates among surgeons. COVID-19-related absences included sickness, self-isolation, shielding, and caring for family. To estimate elective surgical capacity during future outbreaks, an expert elicitation study was undertaken with senior surgeons to determine the minimum surgical staff required to provide surgical services while maintaining a range of elective surgery volumes (0, 25, 50 or 75 per cent). Results Based on data from 364 hospitals across 65 countries, the COVID-19-related absence rate during the initial 6 weeks of the outbreak ranged from 20.5 to 24.7 per cent (mean average fortnightly). In weeks 7–12, this decreased to 9.2–13.8 per cent. At all times during the COVID-19 outbreak there was predicted to be sufficient surgical staff available to maintain at least 75 per cent of regular elective surgical volume. Overall, there was predicted capacity for surgeon redeployment to support the wider hospital response to COVID-19. Conclusion This framework will inform elective surgical service planning during future COVID-19 outbreaks. In most settings, surgeon absence is unlikely to be the factor limiting elective surgery capacity.

• Glasbey, James C; Ademuyiwa, Adesoji; Adisa, Adewale; Alameer, Ehab; Arnaud, Alexis P & Ayasra, Faris [Show all 54 contributors for this article] (2021). Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study. The Lancet Oncology. ISSN 1470-2045. doi: 10.1016/S1470-2045(21)00493-9. Full text in Research Archive Show summary

  Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index <20), moderate lockdowns (20–60), and full lockdowns (>60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.

• Drake, Thomas M.; Pata, Francesco; Ghosh, Dhruv; Ademuyiwa, Adesoji O; Arnaud, Alexis P & Bhangu, Aneel [Show all 56 contributors for this article] (2020). Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study. BMJ Global Health. doi: 10.1136/bmjgh-2020-003429. Full text in Research Archive Show summary

  Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

• Syltern, Julie; Jørgensen, Geir Torvik; Norstein, Jarle & Augestad, Knut Magne (2020). Fracture and embolization of an implantable venous access device in patient with atrial septal defect. Journal of Surgical Case Reports (JSCR). 2020(12), p. 1–3. doi: 10.1093/jscr/rjaa548. Full text in Research Archive Show summary

  Totally implantable venous access devices (TIVADs) are frequently used for the administration of chemotherapy or parenteral nutrition and have proved to be safe and improve patient quality of life during treatment. Catheter-related infections are the most common complication, whereas catheter fracture and embolization is rarely seen. We present a case of a 61-year-old cancer patient in which the TIVAD fractured and embolized to the patient’s left knee 18 months after its initial placement. An endovascular procedure with intraoperative imaging revealed that the catheter had embolized to the popliteal artery and was successfully removed, the only explanation being the presence of an atrial septal defect. A bubble echocardiogram was unsuccessful in confirming the diagnosis. The catheter fracture could be related to an intravascular procedure that was performed 18months prior to remove fibrin sheaths as a cause of port malfunction, or it could be a case of pinch-off syndrome.

• Helgeland, Jon; Skyrud, Katrine Damgaard; Lindahl, Anne Karin; Keller, Deborah S. & Augestad, Knut Magne (2020). Benchmarking of abdominal surgery: a study evaluating the HARM score in a European national cohort. BJS Open. 4(4), p. 637–644. doi: 10.1002/bjs5.50284. Full text in Research Archive Show summary

  Background:Reliable, easily accessible metrics of surgical quality are currently lacking. The HARM(HospitAl length of stay, Readmission and Mortality) score is a composite measure that has been validatedacross diverse surgical cohorts. The aim of this study was to validate the HARM score in a nationalpopulation of patients undergoing abdominal surgery.Methods:Data on all abdominal surgery in Norwegian hospitals from 2011 to 2017 were obtainedfrom the Norwegian Patient Registry. Readmissions and 30-day postoperative complications as well asdeaths in and out of hospital were evaluated. The HARM scoring algorithm was tested after adjustmentby establishing a newly proposed length of stay score. The correlation between the HARM score andcomplications, as well as the ability of aggregated HARM scores to discriminate between hospitals, wereanalysed. Risk adjustment models were developed for nationwide hospital comparisons.Results:The data consisted of 407 113 primary operations on 295 999 patients in 85 hospitals. TheHARM score was associated with complications and complication severity (Goodman–Kruskal𝛄value0⋅59). Surgical specialty was the dominating variable for risk adjustment. Based on 1-year data, therisk-adjusted score classified 16 hospitals as low HARM score and 16 as high HARM score of the 53hospitals that had at least 30 operations.Conclusion:The HARM score correlates with major outcomes and is associated with the presenceand severity of complications. After risk adjustment, the HARM score discriminated strongly betweenhospitals in a European population of abdominal surgery.

• Glasbey, James C; Nepogodiev, Dmitri; Simoes, Joana FF; Omar, Omar; Li, Elizabeth & Venn, Mary L [Show all 50 contributors for this article] (2020). Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study. Journal of Clinical Oncology. ISSN 0732-183X. 39(1), p. 66–78. doi: 10.1200/JCO.20.01933. Full text in Research Archive Show summary

  PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks.

• Paul, Thais Reif de; Augestad, Knut Magne; Keller, Deborah S & Kiran, Ravi (2020). Management of the positive pathologic circumferential resection margin in rectal cancer: A national cancer database (NCDB) study. European Journal of Surgical Oncology. ISSN 0748-7983. doi: 10.1016/j.ejso.2020.07.033. Full text in Research Archive
• Augestad, Knut Magne; Sneve, Anna Mohn & Lindsetmo, Rolv-Ole (2020). Telemedicine in postoperative follow-up of STOMa PAtients: a randomized clinical trial (the STOMPA trial). British Journal of Surgery. ISSN 0007-1323. 107, p. 509–518. doi: 10.1002/bjs.11491. Full text in Research Archive
• Sgrò, A; Blanco-Colino, R; Ahmed, WUR; Brindl, N; Gujjuri, RR & Lapolla, P [Show all 50 contributors for this article] (2020). Management of COMPlicAted intra-abdominal collectionS after colorectal Surgery (COMPASS): protocol for a multicentre, observational, prospective international study of drain placement practices in colorectal surgery. Colorectal Disease. ISSN 1462-8910. 22, p. 2315–2321. doi: 10.1111/codi.15275. Full text in Research Archive
• Nepogodiev, Dmitri; Glasbey, James C; Li, Elizabeth; Omar, Omar M; Simoes, Joana FF & Abbott, Tom EF [Show all 50 contributors for this article] (2020). Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. The Lancet. ISSN 0140-6736. 396(10243), p. 27–38. doi: 10.1016/S0140-6736(20)31182-X. Full text in Research Archive Show summary

  Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p<0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p<0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p<0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery.

• Nepogodiev, Dmitri; Omar, Omar M; Glasbey, James C; Li, Elizabeth; Simoes, Joana FF & Abbott, Tom EF [Show all 50 contributors for this article] (2020). Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. British Journal of Surgery. ISSN 0007-1323. 107(11), p. 1440–1449. doi: 10.1002/bjs.11746. Full text in Research Archive Show summary

  Background The COVID‐19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID‐19. Methods A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β‐regression model was used to estimate 12‐week cancellation rates for 190 countries. Elective surgical case‐mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country‐level surgical volumes. The 12‐week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. Results The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID‐19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12‐week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID‐19 disruption. Conclusion A very large number of operations will be cancelled or postponed owing to disruption caused by COVID‐19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely.

• Augestad, Knut Magne (2020). Delaying surgery for patients with a previous SARS-CoV-2 infection. British Journal of Surgery. ISSN 0007-1323. p. e601–e602. doi: 10.1002/bjs.12050. Full text in Research Archive
• Thomas, Hannah S.; Weiser, Thomas G.; Drake, Thomas M.; Knight, Stephen R.; Fairfield, Cameron & Ademuyiwa, Adesoji O. [Show all 50 contributors for this article] (2019). Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy. British Journal of Surgery. ISSN 0007-1323. 106(2), p. 103–112. doi: 10.1002/bjs.11051. Full text in Research Archive Show summary

  Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89·6 per cent) compared with that in countries with a middle (753 of 1242, 60·6 per cent; odds ratio (OR) 0·17, 95 per cent c.i. 0·14 to 0·21, P < 0·001) or low (363 of 860, 42·2 per cent; OR 0·08, 0·07 to 0·10, P < 0·001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high‐HDI countries (risk difference −9·4 (95 per cent c.i. −11·9 to −6·9) per cent; P < 0·001), but the relationship was reversed in low‐HDI countries (+12·1 (+7·0 to +17·3) per cent; P < 0·001). In multivariable models, checklist use was associated with a lower 30‐day perioperative mortality (OR 0·60, 0·50 to 0·73; P < 0·001). The greatest absolute benefit was seen for emergency surgery in low‐ and middle‐HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low‐HDI countries was half that in high‐HDI countries.

• Glasbey, James C.; Adisa, Adewale O.; Costas-Chavarri, Ainhoa; Qureshi, Ahmad U.; Allen-Ingabire, Jean C. & Salem, Hosni Khairy [Show all 50 contributors for this article] (2019). Global variation in anastomosis and end colostomy formation following left-sided colorectal resection. BJS Open. 3, p. 403–414. doi: 10.1002/bjs5.50138. Full text in Research Archive Show summary

  Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.

• Augestad, Knut Magne; Butt, Khayam; Ignjatovic, Dejan; Keller, Deborah S. & Kiran, Ravi (2019). Video-based coaching in surgical education: a systematic review and meta-analysis. Surgical Endoscopy. ISSN 0930-2794. 34(2), p. 521–535. doi: 10.1007/s00464-019-07265-0. Full text in Research Archive
• Brady, JT; Augestad, Knut Magne & Delaney, CP (2018). Application of a simple, affordable quality metric tool to colorectal, upper gastrointestinal, hernia, and hepatobiliary surgery patients: the HARM score. Surgical Endoscopy. ISSN 0930-2794. Full text in Research Archive
• Augestad, Knut Magne (2018). Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study. The Lancet Infectious Diseases. ISSN 1473-3099. Full text in Research Archive
• Stimec, Bojan V.; Andersen, Bjarte Tidemann; Benz, Stefan R.; Fasel, Jean H. D.; Augestad, Knut Magne & Ignjatovic, Dejan (2018). Retromesenteric course of the middle colic artery?challenges and pitfalls in D3 right colectomy for cancer. International Journal of Colorectal Disease. ISSN 0179-1958. 33(6), p. 771–777. doi: 10.1007/s00384-018-2987-9. Full text in Research Archive
• Augestad, Knut Magne; Keller, Deborah S.; Bakaki, Paul M.; Rose, Johnie; Koroukian, Siran M. & Øresland, Tom [Show all 7 contributors for this article] (2018). The impact of rectal cancer tumor height on recurrence rates and metastatic location: A competing risk analysis of a national database. Cancer Epidemiology. ISSN 1877-7821. 53, p. 56–64. doi: 10.1016/j.canep.2018.01.009. Full text in Research Archive
• Jensen, Kasper; Cristina, Soguero-Ruiz; Mikalsen, Karl Øyvind; Lindsetmo, Rolv-Ole; Kouskoumvekaki, Irene & Girolami, Mark [Show all 8 contributors for this article] (2017). Analysis of free text in electronic health records for identification of cancer patient trajectories. Scientific Reports. 7. doi: 10.1038/srep46226. Full text in Research Archive Show summary

  With an aging patient population and increasing complexity in patient disease trajectories, physicians are often met with complex patient histories from which clinical decisions must be made. Due to the increasing rate of adverse events and hospitals facing financial penalties for readmission, there has never been a greater need to enforce evidence-led medical decision-making using available health care data. In the present work, we studied a cohort of 7,741 patients, of whom 4,080 were diagnosed with cancer, surgically treated at a University Hospital in the years 2004–2012. We have developed a methodology that allows disease trajectories of the cancer patients to be estimated from free text in electronic health records (EHRs). By using these disease trajectories, we predict 80% of patient events ahead in time. By control of confounders from 8326 quantified events, we identified 557 events that constitute high subsequent risks (risk>20%), including six events for cancer and seven events for metastasis. We believe that the presented methodology and findings could be used to improve clinical decision support and personalize trajectories, thereby decreasing adverse events and optimizing cancer treatment.

• Brady, Justin T; Ko, Bona; Hohmann, Samuel F; Crawshaw, Benjamin P.; Leinicke, Jennifer A & Steele, Scott R [Show all 8 contributors for this article] (2017). Application of a simple, affordable quality metric tool to colorectal, upper gastrointestinal, hernia, and hepatobiliary surgery patients: the HARM score. Surgical Endoscopy. ISSN 0930-2794. p. 1–8. doi: 10.1007/s00464-017-5998-7. Full text in Research Archive
• Augestad, Knut Magne; Han, H; Paige, J; Ponsky, Todd A.; Schlachta, CM & Dunkin, B [Show all 7 contributors for this article] (2017). Educational implications for surgical telementoring: a current review with recommendations for future practice, policy, and research. Surgical Endoscopy. ISSN 0930-2794. 31(10), p. 3836–3846. doi: 10.1007/s00464-017-5690-y. Full text in Research Archive
• Augestad, Knut Magne; Merok, Marianne Aarstad & Ignjatovic, Dejan (2017). Tailored treatment of colorectal cancer: Surgical, molecular, and genetic considerations. Clinical Medicine Insights: Oncology. 11. doi: 10.1177/1179554917690766. Full text in Research Archive Show summary

  Colorectal cancer (CRC) is a complex cancer disease, and approximately 40% of the surgically cured patients will experience cancer recurrence within 5 years. During recent years, research has shown that CRC treatment should be tailored to the individual patient due to the wide variety of risk factors, genetic factors, and surgical complexity. In this review, we provide an overview of the considerations that are needed to provide an individualized, patient-tailored treatment. We emphasize the need to assess the predictors of CRC, and we summarize the latest research on CRC genetics and immunotherapy. Finally, we provide a summary of the significant variations in the colon and rectal anatomy that is important to consider in an individualized surgical approach. For the individual patient with CRC, a tailored treatment approach is needed in the preoperative, operative, and postoperative phase.

• Soguero-Ruiz, Cristina; Hindberg, Kristian; Mora-Jimenez, Inmaculada; Rojo-Álvarez, José Luis; Skrøvseth, Stein Olav & Godtliebsen, Fred [Show all 11 contributors for this article] (2016). Predicting colorectal surgical complications using heterogeneous clinical data and kernel methods. Journal of Biomedical Informatics. ISSN 1532-0464. 61, p. 87–96. doi: 10.1016/j.jbi.2016.03.008. Full text in Research Archive
• Soguero-Ruiz, Cristina; Hindberg, Kristian; Rojo-Álvarez, José Luis; Skrøvseth, Stein Olav; Godtliebsen, Fred & Mortensen, Kim Erlend [Show all 10 contributors for this article] (2016). Support vector feature selection for early detection of anastomosis leakage from bag-of-words in electronic health records. IEEE Journal of Biomedical and Health Informatics. ISSN 2168-2194. 20(5), p. 1404–1415. doi: 10.1109/JBHI.2014.2361688. Full text in Research Archive
• Crawshaw, Benjamin P.; Augestad, Knut Magne & Delaney, CP (2015). Multivisceral resection for advanced rectal cancer: outcomes and experience at a single institution. American Journal of Surgery. ISSN 0002-9610. 209(3), p. 526–531. doi: 10.1016/j.amjsurg.2014.10.014. Full text in Research Archive
• Crawshaw, Benjamin P.; Chien, Hung-Lun; Augestad, Knut Magne & Delaney, Conor P. (2015). Effect of laparoscopic surgery on health care utilization and costs in patients who undergo colectomy. JAMA Surgery. ISSN 2168-6254. 150(5), p. 410–415. doi: 10.1001/jamasurg.2014.3171. Full text in Research Archive
• Skrøvseth, Stein Olav; Augestad, Knut Magne & Ebadollahi, Shahram (2015). Data-driven approach for assessing utility of medical tests using electronic medical records. Journal of Biomedical Informatics. ISSN 1532-0464. 53, p. 270–276. doi: 10.1016/j.jbi.2014.11.011. Full text in Research Archive
• Warth, Line Lundvoll; Bogen, Etai; Lindsetmo, Rolv-Ole; Patel, Hitendra R.H. & Augestad, Knut Magne (2015). Collaboration in Surgical Training: A Qualitative Study of Mentoring Laparoscopic Surgeons by Using Videoconference in Northern Norway. International Conference on eHealth, Telemedicine, and Social Medicine (eTELEMED). p. 6–9. Full text in Research Archive Show summary

  This paper describes a work in progress, a project studying collaboration among laparoscopic surgeons who are instructed during their education. Access to expert surgeons is a problem at many hospitals. Implementing videoconferencing (VC) as a tool for instruction (telestration) and knowledge-sharing overcomes the distance between mentors and mentees, and has the potential to improve surgical training. Understanding of VC is limited in surgical practice, and the educational and clinical benefits of telementoring should be explored. This project will meet this demand by seeking in-depth understanding of the non-technical aspects or social processes of collaboration in surgical training. Over a three-year period, from 2015 to 2017, this project will examine collaboration in surgical training (CoaST). A hospital in northern Norway at which surgeons collaborate in surgical training to complete their surgical education in general surgery will be investigated. This paper discusses how we will collect the data. When they start to use VC for mentoring in distance surgical training, this will be included. An explorative study will be carried out using video-recorded observations of interactions. The paper is relevant for the conference focusing on the topic of distributed surgery and collaboration between professionals creating new telemedicine practices. This paper outlines the objectives of the study and the qualitative design; the study will explore non-technical aspects or social processes of collaboration in surgical training. The paper concludes by presenting a design for collecting video recordings to explore surgical training.

• Warth, Line Lundvoll; Patel, Hitendra R.H.; Bogen, Etai; Gjessing, Petter Fosse; Augestad, Knut Magne & Ponsky, Todd A. [Show all 7 contributors for this article] (2015). Video-recorded Observations of Surgical Telementoring Approaching collaboration among laparoscopic surgeons using videoconference. International Journal on Advances in Life Sciences. 7(3&4), p. 87–94. Full text in Research Archive Show summary

  In northern Norway, laparoscopic surgeons under training use videoconferencing to access expert surgeons. Videoconferencing as a tool for collaboration and knowledge sharing overcomes the distance between expert mentors and mentees and might improve surgical training. Understanding of videoconferencing in surgical practice is limited, and the educational and clinical benefits of telementoring should be explored. Over a three-year period, from 2015 to 2017, we will undertake an qualitative, explorative study using video-recorded observations of interactions. Our objective is to examine collaboration in surgical training, seeking an in-depth understanding of the non-technical aspects or social processes of collaboration in surgical training. Here we discuss how video-recorded studies may contribute to the understanding of the interactions between mentors and mentees and how to use video for approaching this practice. We discuss the use of video-recorded observations and present a fixed and a flexible design for collecting video recordings. Experiences from 8 real-time cases and one simulation of collaboration using videoconferencing in the operating theatre reflect the optimality of the flexible design, which allows following the dynamic of the surgical team. The results reveal a number of resources that are important both for interactions during surgical (tele)mentoring and for the camera position.

• Augestad, Knut Magne; Bakaki, Paul M.; Rose, Johnie; Crawshaw, Benjamin P.; Lindsetmo, Rolv-Ole & Dørum, Liv Marit [Show all 8 contributors for this article] (2015). Metastatic spread pattern after curative colorectal cancer surgery. A retrospective, longitudinal analysis. Cancer Epidemiology. ISSN 1877-7821. 39(5), p. 734–744. doi: 10.1016/j.canep.2015.07.009. Full text in Research Archive
• Soguero-Ruiz, Cristina; Wang, Fei; Jenssen, Robert; Augestad, Knut Magne; Álvarez, JL & Jiménez, Inmaculada Mora [Show all 8 contributors for this article] (2015). Data-driven Temporal Prediction of Surgical Site Infection. AMIA Annual Symposium Proceedings. ISSN 1559-4076. Full text in Research Archive
• Rose, Johnie; Augestad, Knut Magne & Cooper, Gregory S (2014). Colorectal cancer surveillance: What's new and what's next? World Journal of Gastroenterology (WJG). ISSN 1007-9327. 20(8), p. 1887–1897. doi: 10.3748/wjg.v20.i8.1887. Full text in Research Archive
• Bogen, Moredehi Etai; Augestad, Knut Magne; Patel, Hitendra R.H. & Lindsetmo, Rolv-Ole (2014). Telementoring in education of laparoscopic surgeons: An emerging technology. World Journal of Gastrointestinal Endoscopy (WJGE). 6(5), p. 148–155. doi: 10.4253/wjge.v6.i5.148. Full text in Research Archive
• Skrøvseth, Stein Olav; Augestad, Knut Magne & Ebadollahi, Shahram (2014). Quantifying the Utility of Medical Tests using Longitudinal EHR data. AMIA Annual Symposium Proceedings. ISSN 1559-4076. p. 119–120. Full text in Research Archive
• Augestad, Knut Magne; Norum, Jan; Rose, Johnie & Lindsetmo, Rolv-Ole (2014). A prospective analysis of false positive events in a National Colon Cancer Surveillance Program. BMC Health Services Research. 14:137. doi: 10.1186/1472-6963-14-137. Full text in Research Archive
• Ponsky, Todd A.; Schwachter, Marc; Parry, Jennifer; Rothenberg, Steven & Augestad, Knut Magne (2014). Telementoring: The surgical tool of the future. European journal of pediatric surgery. ISSN 0939-7248. 24(4), p. 287–294. doi: 10.1055/s-0034-1386646. Full text in Research Archive Show summary

  With decreased resident experience during training and the constant evolution of new surgical techniques, surgeons are at risk for complications during the early part of the learning curve. Mentorship by experienced surgeons may mitigate these complications. The availability of such advanced telepresence technology makes it logical that this will be used as part of the model to proctor, mentor, and train practicing surgeons. Here, we review the current state of telementoring.

• Keller, Deborah S; Park, Ki-Jae; Augestad, Knut Magne & Delaney, Conor P. (2014). Integration of open and laparoscopic approaches for rectal cancer resection: oncologic and short-term outcomes. Surgical Endoscopy. ISSN 0930-2794. 28(7), p. 2129–2136. doi: 10.1007/s00464-014-3444-7. Full text in Research Archive
• Rose, Johnie; Augestad, Knut Magne; Kong, Chung Yin; Meropol, Neal J; Kattan, Michael w. & Hong, Qingqing [Show all 8 contributors for this article] (2014). A simulation model of colorectal cancer surveillance and recurrence. BMC Medical Informatics and Decision Making. 14:29. doi: 10.1186/1472-6947-14-29. Full text in Research Archive
• Augestad, Knut Magne; Rose, Johnie; Crawshaw, Benjamin; Cooper, Gregory S & Delaney, Conor P. (2014). Do the benefits outweigh the side effects of colorectal cancer surveillance? A systematic review. World Journal of Gastrointestinal Oncology (WJGO). 6(5), p. 104–111. doi: 10.4251/wjgo.v6.i5.104. Full text in Research Archive
• Augestad, Knut Magne; Revhaug, Arthur; Johnsen, Roar; Skrøvseth, Stein Olav & Lindsetmo, Rolv-Ole (2014). Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach. Journal of Multidisciplinary Healthcare. 7, p. 371–380. doi: 10.2147/JMDH.S66693. Full text in Research Archive Show summary

  Background: Poor coordination between levels of care plays a central role in determining the quality and cost of health care. To improve patient coordination, systematic structures, guidelines, and processes for creating, transferring, and recognizing information are needed to facilitate referral routines. Methods: Prospective observational survey of implementation of electronic medical record (EMR)-supported guidelines for surgical treatment. Results: One university clinic, two local hospitals, 31 municipalities, and three EMR vendors participated in the implementation project. Surgical referral guidelines were developed using the Delphi method; 22 surgeons and seven general practitioners (GPs) needed 109 hours to reach consensus. Based on consensus guidelines, an electronic referral service supported by a clinical decision support system, fully integrated into the GPs’ EMR, was developed. Fifty-five information technology personnel and 563 hours were needed (total cost 67,000 £) to implement a guideline supported system in the EMR for 139 GPs. Economical analyses from a hospital and societal perspective, showed that 504 (range 401–670) and 37 (range 29–49) referred patients, respectively, were needed to provide a cost-effective service. Conclusion: A considerable amount of resources were needed to reach consensus on the surgical referral guidelines. A structured approach by the Delphi method and close collaboration between IT personnel, surgeons and primary care physicians were needed to reach consensus.

• Budrionis, Andrius; Augestad, Knut Magne & Bellika, Johan Gustav (2013). Telementoring as a Service. Linköping Electronic Conference Proceedings. ISSN 1650-3686. 91, p. 11–14. Full text in Research Archive
• Augestad, Knut Magne; Bellika, Johan Gustav; Budrionis, Andrius; Chomutare, Taridzo; Lindsetmo, Rolv-Ole & Patel, Hitendra R.H. [Show all 7 contributors for this article] (2013). Surgical Telementoring in Knowledge Translation--Clinical Outcomes and Educational Benefits: A Comprehensive Review. Surgical Innovation. ISSN 1553-3506. 20(3), p. 273–281. doi: 10.1177/1553350612465793. Full text in Research Archive Show summary

  Background. Surgical telementoring has been reported for decades. However, there exists limited evidence of clinical outcome and educational benefits. Objective. To perform a comprehensive review of surgical telementoring surveys published in the past 2 decades. Results. Of 624 primary identified articles, 34 articles were reviewed. A total of 433 surgical procedures were performed by 180 surgeons. Most common telementored procedures were laparoscopic cholecystectomy (57 cases, 13%), endovascular treatment of aortic aneurysm (48 cases, 11%), laparoscopic colectomy (32 cases, 7%), and nefrectomies (41 cases, 9%). In all, 167 (38%) cases had a laparoscopic approach, and 8 cases (5%) were converted to open surgery. Overall, 20 complications (5%) were reported (liver bleeding, trocar port bleeding, bile collection, postoperative ileus, wound infection, serosa tears, iliac artery rupture, conversion open surgery). Eight surveys (23%) have structured assessment of educational outcomes. Telementoring was combined with simulators (n = 2) and robotics (n = 3). Twelve surveys (35%) were intercontinental. Technology satisfaction was high among 83% of surgeons. Conclusion. Few surveys have a structured assessment of educational outcome. Telementoring has improved impact on surgical education. Reported complication rate was 5%.

• Budrionis, Andrius; Augestad, Knut Magne; Patel, Hitendra R.H. & Bellika, Johan Gustav (2013). An Evaluation Framework for Defining the Contributions of Telestration in Surgical Telementoring. Interactive Journal of Medical Research. 2(2), p. e14–e14. doi: 10.2196/ijmr.2611. Full text in Research Archive Show summary

  Background: An increasing quantity of research in the domain of telemedicine show a growing popularity and acceptance of care over distance systems among both clinicians and patients. We focus on telementoring solutions, developed for providing remote guidance to less experienced surgeons. Telestration is often regarded as an extra functionality of some telementoring systems. However, we advocate that telestration must be viewed as a core feature of telementoring due to its advantages. Objective: To analyze and define concepts, parameters, and measurement procedures to evaluate the impact of using telestration while telementoring. Methods: A systematic review of research dealing with telestration during remote guidance sessions was performed by querying three major online research databases (MEDLINE, Association of Computing Machinery, and Institute of Electrical and Electronics Engineers) using a predefined set of keywords (“laparoscopy”, “annotate”, “telestrate”, “telestration”, “annotation”, “minimally invasive”, and “MIS”). Results: The keyword-based search identified 117 papers. Following the guidelines for performing a systematic review, only 8 publications were considered relevant for the final study. Moreover, a gap in research defining the impacts of telestration during telementoring was identified. To fill this niche, a framework for analyzing, reporting, and measuring the impacts of telestration was proposed. Conclusions: The presented framework lays the basics for the structured analysis and reporting of telestration applied to telementoring systems. It is the first step toward building an evidence knowledge base documenting the advantages of live video content annotation and supporting the presented connections between the concepts.

• Budrionis, Andrius; Augestad, Knut Magne & Bellika, Johan Gustav (2013). Telestration in Mobile Telementoring. In Gemert-Pijnen, Lisette Van & Ossebaard, Hans C. (Ed.), eTELEMED 2013, The Fifth International Conference on eHealth, Telemedicine, and Social Medicine. International Academy, Research and Industry Association (IARIA). ISSN 9781612082523. p. 307–309. Full text in Research Archive
• Augestad, Knut Magne; Norum, Jan; Dehof, Stefan; Aspevik, Ranveig; Ringberg, Unni & Nestvold, Torunn Kristin [Show all 9 contributors for this article] (2013). Cost-effectiveness and quality of life in surgeon versus general practitioner-organised colon cancer surveillance: a randomised controlled trial. BMJ Open. 3(4). doi: 10.1136/bmjopen-2012-002391. Full text in Research Archive Show summary

  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. Participants: Patients surgically treated for colon cancer, hospital surgeons and community GPs. Intervention: 24-month follow-up according to national guidelines at the community GP office. To ensure a high follow-up guideline adherence, a decision support tool for patients and GPs were used. Main outcome measures: Primary outcomes were QoL, measured by the global health scales of the European Organisation for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ C-30) and EuroQol-5D (EQ-5D). Secondary outcomes were cost-effectiveness and time to cancer diagnoses. Results: 110 patients were randomised to intervention (n=55) or control (n=55), and followed by 78 GPs (942 follow-up months) and 70 surgeons (942 follow-up months), respectively. Compared to baseline, there was a significant improvement in postoperative QoL (p=0.003), but no differences between groups were revealed (mean difference at 1, 3, 6, 9, 12, 15, 18, 21 and 24-month follow-up appointments): Global Health; Δ−2.23, p=0.20; EQ-5D index; Δ−0.10, p=0.48, EQ-5D VAS; Δ−1.1, p=0.44. There were no differences in time to recurrent cancer diagnosis (GP 35 days vs surgeon 45 days, p=0.46); 14 recurrences were detected (GP 6 vs surgeon 8) and 7 metastases surgeries performed (GP 3 vs surgeon 4). The follow-up programme initiated 1186 healthcare contacts (GP 678 vs surgeon 508), 1105 diagnostic tests (GP 592 vs surgeon 513) and 778 hospital travels (GP 250 vs surgeon 528). GP organised follow-up was associated with societal cost savings (£8233 vs £9889, p<0.001). Conclusions: GP-organised follow-up was associated with no decline in QoL, no increase in time to recurrent cancer diagnosis and cost savings.

• Bogen, Etai; Aarsæther, Erling Johan; Augestad, Knut Magne; Lindsetmo, Rolv-Ole & Patel, Hitendra R.H. (2013). Telemedical technologies in urological cancer care: past, present and future applications. Expert Review of Anticancer Therapy. ISSN 1473-7140. 13(7), p. 795–809. doi: 10.1586/14737140.2013.811036. Full text in Research Archive Show summary

  Since the initial development of telegraphy by Sir Charles Wheatstone in 1837 and the telephone by Alexander Graham Bell in 1875, doctors have been able to convey medical information across great distances. The exchange and sharing of medical information has evolved and adapted to suit the vast array of today's medicine. Early adopters of telemedicine within clinical practice have gained significant health economic benefits. The arrival of wireless connections has further enhanced the possibilities for all clinical work with focus on diagnosis, treatment and management of urological cancers, as highlighted in this article.

• Augestad, Knut Magne; Lindsetmo, Rolv-Ole; Stulberg, J; Reynolds, H; Champagne, B & Senagore, A [Show all 7 contributors for this article] (2012). System-based factors influencing intraoperative decision-making in rectal cancer by surgeons: an international assessment. Colorectal Disease. ISSN 1462-8910. 14(10), p. E679–E688. doi: 10.1111/j.1463-1318.2012.03093.x. Full text in Research Archive
• Augestad, Knut Magne; Berntsen, Gro; Lassen, Kristoffer; Bellika, Johan Gustav; Wootton, Richard & Lindsetmo, Rolv-Ole (2012). Standards for reporting randomized controlled trials in medical informatics: a systematic review of CONSORT adherence in RCTs on clinical decision support. JAMIA Journal of the American Medical Informatics Association. ISSN 1067-5027. 19(1), p. 13–21. doi: 10.1136/amiajnl-2011-000411. Full text in Research Archive Show summary

  Introduction The Consolidated Standards for Reporting Trials (CONSORT) were published to standardize reporting and improve the quality of clinical trials. The objective of this study is to assess CONSORT adherence in randomized clinical trials (RCT) of disease specific clinical decision support (CDS). Methods A systematic search was conducted of the Medline, EMBASE, and Cochrane databases. RCTs on CDS were assessed against CONSORT guidelines and the Jadad score. Result 32 of 3784 papers identified in the primary search were included in the final review. 181 702 patients and 7315 physicians participated in the selected trials. Most trials were performed in primary care (22), including 897 general practitioner offices. RCTs assessing CDS for asthma (4), diabetes (4), and hyperlipidemia (3) were the most common. Thirteen CDS systems (40%) were implemented in electronic medical records, and 14 (43%) provided automatic alerts. CONSORT and Jadad scores were generally low; the mean CONSORT score was 30.75 (95% CI 27.0 to 34.5), median score 32, range 21–38. Fourteen trials (43%) did not clearly define the study objective, and 11 studies (34%) did not include a sample size calculation. Outcome measures were adequately identified and defined in 23 (71%) trials; adverse events or side effects were not reported in 20 trials (62%). Thirteen trials (40%) were of superior quality according to the Jadad score (≥3 points). Six trials (18%) reported on long-term implementation of CDS. Conclusion The overall quality of reporting RCTs was low. There is a need to develop standards for reporting RCTs in medical informatics.

• Budrionis, Andrius; Augestad, Knut Magne; Patel, Hitendra R.H. & Bellika, Johan Gustav (2012). Towards Requirements for Telementoring Software. Linköping Electronic Conference Proceedings. ISSN 1650-3686. 70, p. 27–34. Full text in Research Archive
• Augestad, Knut Magne; Chomutare, Taridzo; Bellika, Johan Gustav; Budrionis, Andrius; Lindsetmo, Rolv-Ole & Delaney, Conor P. (2012). Clinical and Educational Benefits of Surgical Telementoring. In Patel, Hitendra R.H. & Joseph, Jean V. (Ed.), Simulation Training in Laparoscopy and Robotic Surgery. Springer. ISSN 9781447129295. p. 75–89. doi: 10.1007/978-1-4471-2930-1_9. Full text in Research Archive
• Augestad, Knut Magne; Lindsetmo, Rolv-Ole; Reynolds, H; Stulberg, J; Senagore, A & Champagne, B [Show all 9 contributors for this article] (2011). International trends in surgical treatment of rectal cancer. American Journal of Surgery. ISSN 0002-9610. 201(3), p. 353–358. doi: 10.1016/j.amjsurg.2010.08.030. Full text in Research Archive Show summary

  Background Surgical technique might influence rectal cancer survival, yet international practices for surgical treatment of rectal cancer are poorly described. Methods We performed a cross-sectional survey in a cohort of experienced colorectal surgeons representing 123 centers. Results Seventy-one percent responded, 70% are from departments performing more than 50 proctectomies annually. More than 50% defined the rectum as “15 cm from the verge.” Seventy-two percent perform laparoscopic proctectomy, 80% use oral bowel preparation, 69% perform high ligation of the inferior mesenteric artery, 76% divert stomas as routine for colo-anal anastomosis, and 63% use enhanced recovery protocols. Different practices exist between US and non-US surgeons: 15 cm from the verge to define the rectum (34% vs 59%; P = .03), personally perform laparoscopic resection (82% vs 66%; P = .05), rectal stump washout (36% vs 73%; P = .0001), always drain after surgery (23% vs 42%; P = .03), transanal endoscopic microsurgery for T2N0 in medically unfit patients (39% vs 61%; P = .0001). Conclusions

• Augestad, Knut Magne; Lindsetmo, Rolv-Ole; Stulberg, J; Reynolds, H; Senagore, A & Champagne, B [Show all 9 contributors for this article] (2010). International Preoperative Rectal Cancer Management: Staging, Neoadjuvant Treatment, and Impact of Multidisciplinary Teams. World Journal of Surgery. ISSN 0364-2313. 34(11), p. 2689–2700. doi: 10.1007/s00268-010-0738-3. Full text in Research Archive
• Lindsetmo, Rolv-Ole & Augestad, Knut Magne (2009). Overcoming Distance: Video-Conferencing as a Clinical and Educational Tool Among Surgeons. World Journal of Surgery. ISSN 0364-2313. 33(7), p. 1356–1367. doi: 10.1007/s00268-009-0036-0. Full text in Research Archive
• Augestad, Knut Magne; Revhaug, Arthur; Vonen, Barthold; Johnsen, Roar & Lindsetmo, Rolv-Ole (2009). The one-stop trial: does electronic referral and booking by the general practitioner (GPs) to outpatient day case surgery reduce waiting time and costs? A randomized controlled trial protocol. BMC Surgery. 11, p. 8–14. doi: 10.1186/1471-2482-8-14. Full text in Research Archive
• Augestad, Knut Magne; Vonen, Barthold; Aspevik, Ranveig K; Nestvold, Torunn; Ringberg, Unni & Johnsen, Roar [Show all 8 contributors for this article] (2008). 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. BMC Health Services Research. 8. doi: 10.1186/1472-6963-8-137. Full text in Research Archive Show summary

  This trial has been registered at ClinicalTrials.gov. The trial registration number is: NCT00572143.

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• Kazaryan, Airazat M.; Hagve, Martin Iversen; Augestad, Knut Magne; Nordby, Tom; Edwin, Bjørn von Gohren & Ghanima, Waleed (2025). Academic writing in medicine and healthcare. Frontiers in Medicine. 12. doi: 10.3389/fmed.2025.1617752. Full text in Research Archive Show summary

  The article highlights factors that can motivate doctors to do medical research. Various types of medical publications are presented. In addition, prerequisites that can contribute to successful publication are described. An overview of trends in research publication is given as well as an explanation of the terms discovery and innovation. The role and importance of research and scientific writing for progress in medicine and healthcare are discussed here. The connection between medical practice and research is also highlighted. Not least, the need for support from supervisors and management in the research and publication process is highlighted.

• Kazaryan, Airazat M.; Hagve, Martin Iversen; Mala, Tom; Augestad, Knut Magne; Nordby, Tom & Edwin, Bjørn von Gohren [Show all 7 contributors for this article] (2024). Forskning og vitenskaplig skriving 3. Formidling av forskningen i moderne tid – bedre tilgang, nye medier og fagfellerollen. Kirurgen. ISSN 1504-8888. 4, p. 238–240. Full text in Research Archive Show summary

  Denne artikkelserien som består av tre kronikker belyser faktorer som kan motivere til medisinsk forskning. Ulike typer av medisinske publikasjoner framstilles. I tillegg beskrives forutsetninger som kan bidra til vellykket publisering. Det gis en oversikt over trender i forskningspublisering, samt forklaring av betegnelsene oppdagelse og innovasjon. Her drøftes også forskningen og den vitenskapelige skrivningens rolle og betydning for framgangen innen medisin og helsevesen, og videre belyses sammenhengen mellom medisinsk praksis og forskning. Ikke minst poengteres behov om støtte fra veileder og ledelse i forsknings- og publiseringsprosessen. Kronikk 3 omhandler tema «Formidling av forskningen»

• Kazaryan, Airazat M.; Mala, Tom; Hagve, Martin Iversen; Augestad, Knut Magne; Nordby, Tom & Ghanima, Waleed [Show all 7 contributors for this article] (2024). Forskning og vitenskaplig skriving 2. Fra ide til ferdig artikkel. Kirurgen. ISSN 1504-8888. 4, p. 234–237. Full text in Research Archive Show summary

  Denne artikkelserien, som består av tre kronikker, belyser faktorer som kan motivere til medisinsk forskning. Ulike typer av medisinske publikasjoner framstilles. I tillegg beskrives forutsetninger som kan bidra til vellykket publisering. Det gis en oversikt over trender i forskningspublisering samt forklaring av betegnelsene oppdagelse og innovasjon. Her drøftes også forskningen og den vitenskapelige skrivningens rolle og betydning for framgangen innen medisin og helsevesen, og videre belyses sammenhengen mellom medisinsk praksis og forskning. Ikke minst poengteres behov om støtte fra veileder og ledelse i forsknings- og publiseringsprosessen. Kronikk 2 inkluderer tema «Fra idé til ferdig artikkel»

• Kazarian, Airazat; Mala, Tom; Hagve, Martin Iversen; Augestad, Knut Magne; Nordby, Tom & Edwin, Bjørn von Gohren [Show all 7 contributors for this article] (2024). Forskning og vitenskaplig skriving 1. Hvordan komme igang ? Kirurgen. ISSN 1504-8888. Full text in Research Archive
• Riis, Rolf & Augestad, Knut Magne (2024). Author response to: Comment on: Beyond the transanal total mesorectal excision moratorium: local and distant recurrence among patients operated for low rectal tumours - 5-year follow-up from a Norwegian University Hospital. British Journal of Surgery. ISSN 0007-1323. 111(1). doi: 10.1093/bjs/znad420. Full text in Research Archive
• Butt, Khayam Ashraf; Thomassen, Niels; Christensen, Peter; Consten, Esther C. J.; Rautio, T. & Titu, Vasile-Liviu [Show all 15 contributors for this article] (2023). A Surgical Telementoring Curriculum for Robotic Ventral Mesh Rectopexy. Colorectal Disease. ISSN 1462-8910. 25, p. 147–147. doi: 10.1111/codi.16720. Full text in Research Archive
• Paula, Thais Reif de; Augestad, Knut Magne; Kiran, Ravi P. & Keller, Deborah S. (2023). Erratum to “Management of the positive pathologic circumferential resection margin in rectal cancer: A national cancer database (NCDB) study” [Eur J Surg Oncol 47 (2) (February 2021) 296–303] (European Journal of Surgical Oncology (2021) 47(2) (296–303), (S0748798320306600), (10.1016/j.ejso.2020.07.033)). European Journal of Surgical Oncology. ISSN 0748-7983. 49(10). doi: 10.1016/j.ejso.2023.06.001. Full text in Research Archive
• Schultz, Johannes Kurt; Augestad, Knut Magne & Benth, Jurate Saltyte (2023). Surgical site infections: does one glove fit all? The Lancet. ISSN 0140-6736. 401(10387), p. 1496–1496. doi: 10.1016/S0140-6736(23)00398-7. Full text in Research Archive
• Augestad, Knut Magne (2022). Covidsurg collaborative - et internasjonalt samarbeid. Full text in Research Archive
• Tabiri, Stephen; Kamarajah, Sivesh K.; Nepogodiev, Dmitri; Li, Elizabeth; Sravanam, Sanskrithi & Owusu, Sheila Agyeiwaa [Show all 4,729 contributors for this article] (2021). Impact of Bacillus Calmette-Gue´rin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 infection. BJS Open. 5(6). doi: 10.1093/bjsopen/zrab131. Full text in Research Archive
• Skyrud, Katrine Damgaard; Helgeland, Jon; Lindahl, Anne Karin & Augestad, Knut Magne (2021). Abdominal Surgical Pathways Associated With Failure to Rescue. A Nationwide Analyses. Full text in Research Archive
• Augestad, Knut Magne (2021). High quality education in a high quality environment, the HARM Score and the ”Failure to rescue”- factor. Full text in Research Archive Show summary

  We have developed numerous of quality measurements of surgical care, and we have in our reperch shown that the HARM Score and failure to rescue varies significantly between hospitals, and can be used to discriminate between hospital at a national level. Furthermore, the HARM score and FTR are associated with hospital characteristics. However, although we know that organization and the care provided impacts patients' outcomes, educational outcomes are poorly defined and need to be developed.

• Augestad, Knut Magne; Helgeland, Jon & Lindahl, Anne Karin (2020). Benchmarking av Abdominal Kirurgi ved Hjelp av HARM Score. Full text in Research Archive
• Augestad, Knut Magne; Lindsetmo, Rolv-Ole & Sneve, Anna Mohn (2020). Oppfølging av Stomi Pasienter med Telemedisin. En Randomisert Studie (STOMPA STUDIEN). Full text in Research Archive
• Butt, Khayam & Augestad, Knut Magne (2020). Preliminary experience with telementored robotic ventral mesh rectopexy (T-RVMR) an innovative approach to sages educational recommendations for surgical telementoring. Full text in Research Archive
• Seternes, Arne; Rekstad, Lars Cato; Augestad, Knut Magne; Røkke, Ola & Wasmuth, Hans (2017). CHIMNEYVAC FOR ENTERO-ATMOSPHERIC FISTULAS. EARLY EXPERIENCE WITH A NOVEL VAC SYSTEM FOR OPEN ABDOMEN. Full text in Research Archive
• Warth, Line Lundvoll; Bogen, Etai; Lindsetmo, Rolv-Ole; Hitendra, Patel & Augestad, Knut Magne (2015). Collaboration in Surgical Training: A Qualitative Study of Mentoring Laparoscopic Surgeons by Using Videoconference in Northern Norway. Full text in Research Archive
• Soguero-Ruiz, Cristina; Hindberg, Kristian; Mora-Jimenez, Inmaculada; Rojo-Alvarez, Jose Luis; Skrøvseth, Stein Olav & Godtliebsen, Fred [Show all 11 contributors for this article] (2015). Prediction of Surgical Complications using Heterogeneous Clinical Data and Kernel Methods. Full text in Research Archive
• Jensen, Kasper; Augestad, Knut Magne; Lindsetmo, Rolv-Ole & Skrøvseth, Stein Olav (2015). From unstructured EHR text to data-driven clinical decision support. International Journal of Integrated Care (IJIC). 15. Full text in Research Archive
• Augestad, Knut Magne (2014). Big data in health care, an international paradigm shift. Full text in Research Archive
• Crawshaw, Benjamin; Augestad, Knut Magne & Delaney, Conor P. (2014). Early Discharge In 24 To 48 Hours Following Colectomy. Safe And effective For Selected Patients. Full text in Research Archive
• Augestad, Knut Magne (2014). Integrating colorectal cancer pathways in the electronic medical record. Full text in Research Archive
• Crawshaw, Benjamin; Augestad, Knut Magne & Delaney, Conor P. (2014). Multivisceral resections for advanced rectal cancer. Outcomes and experience at a single institution. Full text in Research Archive
• Augestad, Knut Magne (2014). Long-term readmissions after surgery for colorectal cancer. Full text in Research Archive
• Soguero-Ruiz, Cristina; Skrøvseth, Stein Olav; Augestad, Knut Magne & Jenssen, Robert (2014). Bootstrap resampling feature selection and Support Vector Machine for early detection of Anastomosis Leakage. Full text in Research Archive
• Bogen, Moredehi Etai; Augestad, Knut Magne & Lindsetmo, Rolv-Ole (2014). SAGES 2014 - Emerging Technology: A Low Cost, Plug and Play, PC Tablet For Intrahospital, Interhospital and Intercontinental Surgical Telestration and Telementoring. Bogen EM, MD, Augestad KM, MD, PhD , Norderval S, MD, PhD, Delaney CP, Patel HRH, Lindsetmo RO, MD. Full text in Research Archive
• Soguero-Ruiz, Cristina; Mora-Jimenez, Inmaculada; Rojo-Alvarez, Jose Luis; Hindberg, Kristian; Godtliebsen, Fred & Mortensen, Kim Erlend [Show all 11 contributors for this article] (2014). Feature selection using Kernel Component Analysis For Early Detection Of Anastomosis Leakage. Full text in Research Archive
• Skrøvseth, Stein Olav; Augestad, Knut Magne & Ebadollahi, Shahram (2014). Quantifying the Utility of Medical Tests using Longitudinal EHR data. Full text in Research Archive
• Skrøvseth, Stein Olav; Perer, Adam; Delaney, Conor P.; Revhaug, Arthur; Lindsetmo, Rolv-Ole & Augestad, Knut Magne (2014). Detecting Novel Associations for Surgical Hospital Readmissions in Large Datasets by Interactive Visual Analytics. Full text in Research Archive
• Augestad, Knut Magne (2014). Improving Quality in Colorectal Cancer. The European Perspective. Full text in Research Archive
• Laukli, Randi & Augestad, Knut Magne (2013). Kreftoppfølging like bra hos fastlege. [Internet]. Forskning.no. Full text in Research Archive Show summary

  Pasienter som skal følges opp etter tykktarmskreft får like god oppfølging hos egen fastlege som hos kirurg på poliklinikk.

• Budrionis, Andrius; Augestad, Knut Magne & Bellika, Johan Gustav (2013). Mobile Medical Mentor (M3). Full text in Research Archive
• Budrionis, Andrius; Augestad, Knut Magne; Patel, Hitendra R.H. & Bellika, Johan Gustav (2013). An Evaluation Framework for Defining the Contributions of Telestration in Surgical Telementoring. Full text in Research Archive
• Augestad, Knut Magne; Dehli, Trond; Lu, Thuy Thu Thi & Nygren, Jonas (2012). A Littre bleed. The Lancet. ISSN 0140-6736. 380(9846), p. 1030–1030. doi: 10.1016/S0140-6736(12)60777-6. Full text in Research Archive
• Augestad, Knut Magne; Lindsetmo, Rolv-Ole; Stulberg, J; Reynolds, H; Champagne, B & Leblanc, F [Show all 9 contributors for this article] (2011). Preoperative Rectal Cancer Management: Wide International Practice Makes Outcome Comparison Challenging: Reply. World Journal of Surgery. ISSN 0364-2313. 35, p. 1418–1419. doi: 10.1007/s00268-011-1039-1. Full text in Research Archive Show summary

  In a letter to the editor Dr. Hottenrott provides valuable comments on our survey describing international preoperative rectal cancer management. In our opinion, three key messages are derived from our survey: First, most surgeons agree to neoadjuvant treatment when there is an increased risk of finding histologically positive circumferential margins. In addition, we found more than 40 other indications for neoadjuvant treatment (see our Table 4). This emphasizes the need for an international agreement, as different indications for neoadjuvant treatment will select noncomparable groups of patients in outcome studies. Second, we have shown (see our Table 6) that multidisciplinary team (MDT) meetings significantly influence several important decisions in preoperative rectal cancer management. Interestingly, centers with regular MDT have a higher rate of using magnetic resonance imaging (MRI) (Odds Ratio [OR] = 3.62) and consider a threatened circumferential resection margin (CRM) as indication for neoadjuvant treatment (OR = 5.67). We believe that MDT improves preoperative management of rectal cancer by increasing adherence to national guidelines. Similar discussions in international rectal cancer societies are needed aiming towards an international consensus statement. Finally, our survey revealed sparse use (35% of all cases) of MRI. The goal for the radiologic examination in rectal cancer is to explore the tumor’s relation to nearby anatomical structures. This evaluation will conclude with TNM staging, important for chemoradiotheraphy, surgical treatment, and prognosis. Magnetic resonance imaging has a central role in this evaluation and should be the first choice radiologic modality. Not only is MRI crucial in detection of TNM stage but also plays a central role in determination of the tumor’s distance to the mesorectal fascia and the CRM. Magnetic resonance imaging has moderate sensitivity on T1 and T2 tumors, and should be supplemented with rectal ultrasound.

• Rose, J; Augestad, Knut Magne; Cooper, G & Meropol, NJ (2011). A NEW APPROACH TO MODELING CANCER RECURRENCE AND FOLLOW-UP. Value in Health. ISSN 1098-3015. 14(7), p. A430–A431. Full text in Research Archive
• Augestad, Knut Magne & Delaney, Conor P. (2010). Postoperative ileus: Impact of pharmacological treatment, laparoscopic surgery and enhanced recovery pathways. World Journal of Gastroenterology (WJG). ISSN 1007-9327. 16(17), p. 2067–2074. doi: 10.3748/wjg.v16.i17.2067. Full text in Research Archive

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