Hospital volume and quality of laparoscopic gastrectomy in Japan

Digestive Surgery
Kazuaki KuwabaraKenji Fujimori

Abstract

Laparoscopic gastrectomy (LG) has become the prevailing surgery of choice for gastric cancer, but the impact of hospital volume or operating room (OR) time has not been evaluated. An observational study was conducted to assess the quality of LG based on hospital volume and OR time. 3,054 LG patients were enrolled in 420 hospitals throughout Japan. Analyzed variables included patient demographics, complications, use of stapling devices or chemotherapy, hospital volume, and teaching status. Hospitals were categorized into high- (>or=4 LG per month), intermediate- (1-3) and low- (<1) volume hospitals. Multivariate analysis was used to measure hospital volume and OR time impact. 259 laparoscopic total gastrectomies (LTGs) were performed. Complications were observed in 269 cases (8.8%). High-volume hospitals treated less severe cases. OR time, but not hospital volume, was associated with complications. Hospital volume, teaching status and stapling devices explained variations in OR time. OR time was a more significant predictor of complications than hospital volume. OR time was consumed more in the employment of stapling devices and LTG. To promote LG efficiency, training curricula highlighting the applicability of these techniques ...Continue Reading

Citations

Oct 12, 2012·Annals of Surgical Oncology·Johan L DikkenJohanna W van Sandick
Nov 20, 2012·Surgical Oncology Clinics of North America·Joseph D PhillipsNathaniel J Soper
Aug 17, 2010·Health Policy·Ravishankar JayadevappaStanley Bruce Malkowicz
Apr 11, 2012·Journal of Surgical Oncology·Johan L DikkenCornelis J H van de Velde
Nov 28, 2012·The British Journal of Surgery·J L DikkenM Verheij
Sep 28, 2010·Journal of the American College of Surgeons·Yasuhiro KoderaAkimasa Nakao
Aug 13, 2010·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Maria R Mascarenhas, Meena Thayu
Jun 5, 2018·Annals of Gastroenterological Surgery·Yosuke MukaiYuichiro Doki

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