Improving clinical outcomes through centralization of rectal cancer surgery and clinical audit: a mixed-methods assessment

Prades, Joan; Manchon-Walsh, P.; Solá, J.; Espinàs, Josep Alfons; Guarga, A; Borràs, Josep M.

doi:10.1093/eurpub/ckv237

Cited by 34 publications

(18 citation statements)

References 21 publications

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“…The subsequent centralization and specialization improved the short-and long-term outcomes of affected patients and narrowed the gap between patients with rectal cancer in the UK and those in continental Europe 19 -21 . Similar observations have been made for several other centralization programmes 22,23 . The proportion of patients in the present study who had a laparoscopic resection was low (29⋅3 per cent) compared with that in the UK, where the rate is over 50 per cent, indicating that centralization and specialization also improves surgical approaches.…”

Section: Discussionsupporting

confidence: 87%

Nationwide in-hospital mortality rate following rectal resection for rectal cancer according to annual hospital volume in Germany

et al. 2020

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Background The impact of hospital volume after rectal cancer surgery is seldom investigated. This study aimed to analyse the impact of annual rectal cancer surgery cases per hospital on postoperative mortality and failure to rescue. Methods All patients diagnosed with rectal cancer and who had a rectal resection procedure code from 2012 to 2015 were identified from nationwide administrative hospital data. Hospitals were grouped into five quintiles according to caseload. The absolute number of patients, postoperative deaths and failure to rescue (defined as in‐hospital mortality after a documented postoperative complication) for severe postoperative complications were determined. Results Some 64 349 patients were identified. The overall in‐house mortality rate was 3·9 per cent. The crude in‐hospital mortality rate ranged from 5·3 per cent in very low‐volume hospitals to 2·6 per cent in very high‐volume centres, with a distinct trend between volume categories (P < 0·001). In multivariable logistic regression analysis using hospital volume as random effect, very high‐volume hospitals (53 interventions/year) had a risk‐adjusted odds ratio of 0·58 (95 per cent c.i. 0·47 to 0·73), compared with the baseline in‐house mortality rate in very low‐volume hospitals (6 interventions per year) (P < 0·001). The overall postoperative complication rate was comparable between different volume quintiles, but failure to rescue decreased significantly with increasing caseload (15·6 per cent after pulmonary embolism in the highest volume quintile versus 38 per cent in the lowest quintile; P = 0·010). Conclusion Patients who had rectal cancer surgery in high‐volume hospitals showed better outcomes and reduced failure to rescue rates for severe complications than those treated in low‐volume hospitals.

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Section: Discussionsupporting

confidence: 87%

Nationwide in-hospital mortality rate following rectal resection for rectal cancer according to annual hospital volume in Germany

et al. 2020

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“…Registration of outcome is common and research with PROMs in cancer patients shows that its use enhances patient-clinician communication, patientsatisfaction and eventually quality of care [6][7][8][9][10][11][12][13][30][31][32][33][34][35]. Partly due to the lack of capacity or funding for traditional follow-up, long-term follow-up is generally not available for high-volume elective treatments such as cholecystectomy, inguinal hernia repair, rubber band ligation of hemorrhoids etc.…”

Section: Discussionmentioning

confidence: 99%

“…Funded by health care companies, it is well-organized, validated and reliable according to (inter-) national guidelines and databases [6][7][8][9][10][11][12][13]. However, for benign pathology, follow-up after treatment is often not available.…”

Section: Introductionmentioning

confidence: 99%

Online collection of Patient Reported Outcome Measures: an effective method for follow-up of benign surgery

Koetje¹,

Dam²,

Dille³

et al. 2018

Clin Res Trial

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“…Just by looking at the first 5 months of the year 2016 through a PubMed search for the keywords ''Centralization'' and ''Surgery'', we can find 17 brand new papers dealing with this issue. Of note, 10 out of 17 are strictly focused to HPB, upper and lower GI tract surgery [1][2][3][4][5][6][7][8][9][10]: we are clearly dealing with a ''burning topic''!…”

mentioning

confidence: 99%

Surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it

Bassi

2016

Updates Surg

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Improving clinical outcomes through centralization of rectal cancer surgery and clinical audit: a mixed-methods assessment

Abstract: The centralization of rectal cancer surgery has been associated with better quality of care and conformity with clinical guidelines. However, a more integrated model of care delivery is needed to strengthen the centralization strategy.

Cited by 34 publications

References 21 publications

Nationwide in-hospital mortality rate following rectal resection for rectal cancer according to annual hospital volume in Germany

Nationwide in-hospital mortality rate following rectal resection for rectal cancer according to annual hospital volume in Germany

Online collection of Patient Reported Outcome Measures: an effective method for follow-up of benign surgery

Surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it

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