From scratch: developing a hepatic resection service for metastatic colorectal cancer

Wylie, Neil; Hider, Phil; Armstrong, Delwyn; Rajkomar, Kheman; Srinivasa, Sanket; Rodgers, Michael; Brown, Anna; Koea, Jonathan

doi:10.1111/ans.13848

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…Secondly, while it is possible to report total procedural volume, we have not been able to report outcome data, such as procedural related 30-and 90-day mortality at a national or institutional level. Historically, New Zealand surgeons have reported results comparable to highvolume northern hemisphere centers 30,31 in spite of low procedural volumes overall. This may be a result of the culture of a period of overseas training for New Zealand surgeons in high-volume units.…”

Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal and hepatopancreaticobiliary surgery in New Zealand: Balancing the volume‐outcome relationship with accessibility in a surgically low volume country

Koea,

Chao,

Srinivasa

et al. 2024

World j. surg.

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IntroductionNew Zealand has a population of only 5.5 million meaning that for many surgical procedures the country qualifies as a “low‐volume center.” However, the health system is well developed and required to provide complex surgical procedures that benchmark internationally against comparable countries. This investigation was undertaken to review regional variation and volumes of complex resection and palliative upper gastrointestinal (UGI) surgical procedures within New Zealand.MethodsData pertaining to patients undergoing complex resectional UGI procedures (esophagectomy, gastrectomy, pancreatectomy, and hepatectomies) and palliative UGI procedures (esophageal stenting, enteroenterostomy, biliary enteric anastomosis, and liver ablation) in a New Zealand hospital between January 1, 2000 and December 31, 2019 were obtained from the National Minimum Dataset.ResultsNew Zealand is a low‐volume center for UGI surgery (229 hepatectomies, 250 gastrectomies, 126 pancreatectomies, and 74 esophagectomies annually). Over 80% of patients undergoing hepatic resection/ablation, gastrectomy, esophagectomy, and pancreatectomy are treated in one of the six national cancer centers (Auckland, Waikato, Mid‐Central, Capital Coast, Canterbury, or Southern). There is evidence of the decreasing frequency of these procedures in small centers with increasing frequency in large centers suggesting that some regionalization is occurring. Palliative procedures were more widely performed. Indigenous Māori were less likely to be treated in a nationally designated cancer center than non‐Māori.ConclusionsThe challenge for New Zealand and similarly sized countries is to develop and implement a system that optimizes the skills and pathways that come from a frequent performance of complex surgery while maintaining system resilience and ensuring equitable access for all patients.

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Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal and hepatopancreaticobiliary surgery in New Zealand: Balancing the volume‐outcome relationship with accessibility in a surgically low volume country

Koea,

Chao,

Srinivasa

et al. 2024

World j. surg.

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Hidden work in hepatopancreaticobiliary surgery: the contemporary demands of non-operative patient management

Koea

Srinivasa

Leung

et al. 2021

HPB

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From scratch: developing a hepatic resection service for metastatic colorectal cancer

Abstract: A regional hepatic resection centre for colorectal metastases can be established in areas of population need and can provide a high-quality, cost-effective service.

Cited by 2 publications

References 13 publications

Upper gastrointestinal and hepatopancreaticobiliary surgery in New Zealand: Balancing the volume‐outcome relationship with accessibility in a surgically low volume country

Upper gastrointestinal and hepatopancreaticobiliary surgery in New Zealand: Balancing the volume‐outcome relationship with accessibility in a surgically low volume country

Hidden work in hepatopancreaticobiliary surgery: the contemporary demands of non-operative patient management

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