We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The Effects of Hospital Volume on Short-Term Outcomes of Laparoscopic Surgery for Rectal Cancer: A Large-Scale Analysis of 37,821 Cases on a Nationwide Administrative Database.
- Authors
Oba, Takuya; Tomioka, Shinichi; Sato, Norihiro; Otani, Makoto; Sakurai, Akiko; Akiyama, Yasuki; Nagata, Jun; Torigoe, Takayuki; Matsuda, Shinya; Hirata, Keiji
- Abstract
Introduction: Laparoscopic low anterior resection (L-LAR) has become widely accepted for the treatment of rectal cancer. However, little is known about the superiority of L-LAR in a real-world setting (including low-volume hospitals) and the association between the short-term outcomes and hospital volume focusing on L-LAR. Methods: This is a retrospective cohort study. A total of 37,821 patients who underwent LAR for rectal cancer were analyzed using the Diagnosis Procedure Combination (DPC) database from January 2014 to December 2017. The short-term surgical outcomes were analyzed using a multilevel analysis. Hospital volumes were divided into quartiles, including low (1–31), middle (32–55), high (56–91), and very-high volume (92–444 resections per 4 years). The effects of hospital volume on the outcomes were investigated. Results: The study population included 8,335 patients (22%) who underwent open low anterior resection (O-LAR) and 29,486 patients (78%) who underwent L-LAR. The in-hospital mortality and morbidity were consistent with previous reports. In patients who underwent L-LAR, the in-hospital mortality (0.12% vs. 0.41%; OR: 0.33; p = 0.005), the rate of reoperation (3.76% vs. 6.48%; OR: 0.67; p < 0.001), and the perioperative transfusion rate (3.81% vs. 5.90%; OR: 0.66; p < 0.001) were significantly lower in very-high-volume hospitals than in low-volume hospitals. These effects of hospital volume were not observed in O-LAR. Conclusions: Our present study demonstrates that high volume improves outcomes in patients who underwent L-LAR in a real-world setting.
- Subjects
RECTAL cancer; RECTAL surgery; LAPAROSCOPIC surgery; DATABASES; TREATMENT effectiveness; ONCOLOGIC surgery
- Publication
Digestive Surgery, 2023, Vol 40, Issue 1/2, p39
- ISSN
0253-4886
- Publication type
Article
- DOI
10.1159/000529752