scholarly journals Relationship between hospital volume and short-term outcomes: a nationwide population-based study including 75,280 rectal cancer surgical procedures

Oncotarget ◽  
2018 ◽  
Vol 9 (24) ◽  
pp. 17149-17159 ◽  
Author(s):  
Salvatore Pucciarelli ◽  
Manuel Zorzi ◽  
Nicola Gennaro ◽  
Francesco Marchegiani ◽  
Andrea Barina ◽  
...  
2019 ◽  
Vol 45 (4) ◽  
pp. 613-619 ◽  
Author(s):  
J.A.W. Hagemans ◽  
W.J. Alberda ◽  
M. Verstegen ◽  
J.H.W. de Wilt ◽  
C. Verhoef ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253081
Author(s):  
Rebecka Arnsrud Godtman ◽  
Erik Persson ◽  
Walter Cazzaniga ◽  
Fredrik Sandin ◽  
Stefan Carlsson ◽  
...  

Background and objective Few studies have investigated the association between surgical volume and outcome of robot-assisted radical prostatectomy (RARP) in an unselected cohort. We sought to investigate the association between surgical volume with peri-operative and short-term outcomes in a nation-wide, population-based study group. Methods 9,810 RARP’s registered in the National Prostate Cancer Register of Sweden (2015–2018) were included. Associations between outcome and volume were analyzed with multivariable logistic regression including age, PSA-density, number of positive biopsy cores, cT stage, Gleason score, and extent of lymph node dissection. Results Surgeons and hospitals in the highest volume group compared to lowest group had shorter operative time; surgeon (OR 9.20, 95% CI 7.11–11.91), hospital (OR 2.16, 95% CI 1.53–3.06), less blood loss; surgeon (OR 2.58. 95% CI 2.07–3.21) hospital (no difference), more often nerve sparing intention; surgeon (OR 2.89, 95% CI 2.34–3.57), hospital (OR 2.02, 95% CI 1.66–2.44), negative margins; surgeon (OR 1.90, 95% CI 1.54–2.35), hospital (OR 1.28, 95% CI 1.07–1.53). There was wide range in outcome between hospitals and surgeons with similar volume that remained after adjustment. Conclusions High surgeon and hospital volume were associated with better outcomes. The range in outcome was wide in all volume groups, which indicates that factors besides volume are of importance. Registration of surgical performance is essential for quality control and improvement.


2020 ◽  
Vol 26 (3) ◽  
pp. 269-274 ◽  
Author(s):  
Joel Haakon Borgstedt-Bakke ◽  
Thea Overgaard Wichmann ◽  
Gudrun Gudmundsdottir ◽  
Mikkel Mylius Rasmussen

OBJECTIVEThe goal of this study was to establish an incidence and assess the effect of tethered cord release for tethered cord syndrome in patients with myelomeningocele.METHODSThe study population was based on the Western Denmark Myelomeningocele Database, which contains all patients born with myelomeningocele in western Denmark since 1970. The study population was cross-referenced in 2015 with a database for surgical procedures containing all surgical procedures performed in the central Denmark region since 1996. Patients alive between 1996 and 2015 were identified. Incidences was calculated and presented for year of age. File reviews were conducted for all patients who underwent the procedure. Follow-up was divided into short-term and long-term follow-up.RESULTSOne hundred sixty-six patients were alive during various time periods between 1996 and 2015. Of these, 45 patients underwent the procedure. Seven underwent reoperation. The median age for the procedure was 12 years and the highest incidence was found at 15 years of age. Incidence was bimodal with highest incidence in children and adolescents. The most common indications were progressive spine deformity (40%), deteriorating ambulation (38%), and deteriorating neurogenic bladder and/or bowel dysfunction (32%). The mean short-term follow-up was 4.7 months and the mean long-term follow-up was 72.6 months. Postoperatively, the majority had improved (27%) or stabilized (27%) at short-term follow-up. At long-term follow-up, most patients were stable (27%) or had deteriorated (24%). For both follow-up terms there was a loss of approximately one-third of all patients. Complications occurred in 17% of the procedures.CONCLUSIONSIn this population-based study, tethered cord release has the highest incidence in children and adolescents. The beneficial effect of the procedure seems to be short term. Due to the uncertainty of a long-term effect of the procedure in patients with myelomeningocele and the registered complications, the authors suggest that this surgical indication should be reserved for well-selected patients.


2012 ◽  
Vol 24 (1) ◽  
pp. e1-e8 ◽  
Author(s):  
J.J. Jobsen ◽  
M.J. Aarts ◽  
S. Siesling ◽  
J. Klaase ◽  
W.J. Louwman ◽  
...  

2020 ◽  
Vol 18 (9) ◽  
pp. 1230-1237 ◽  
Author(s):  
Seyed M. Qaderi ◽  
Paul W. Dickman ◽  
Johannes H.W. de Wilt ◽  
Rob H.A. Verhoeven

Background: The increasing number of colorectal cancer (CRC) survivors need survival estimates that account for the time already survived. The aim of this population-based study was to determine conditional survival, cure proportions, and time-to-cure (TTC) of patients with colon or rectal cancer. Materials and Methods: All patients with pathologic stage I–III CRC treated with endoscopy or surgery, diagnosed and registered in the Netherlands Cancer Registry between 1995 and 2016, and aged 18 to 99 years were included. Conditional survival was calculated for those diagnosed before and after 2007. Cure proportions were calculated using flexible parametric models. Results: A total of 175,384 patients with pathologic stage I (25%), II (38%), or III disease (37%) were included. Conditional 5-year survival of patients with stage I, II, and III colon cancer having survived 5 years was 98%, 94%, and 92%, respectively. For patients with stage I–III rectal cancer, this was 96%, 89%, and 85%, respectively. Statistical cure in patients with colon cancer was reached directly after diagnosis (stage I) to 6 years (stage III) after diagnosis depending on age, sex, and disease stage. Patients with rectal cancer reached cure 0.5 years after diagnosis (stage I) to 9 years after diagnosis (stage III). In 1995, approximately 42% to 46% of patients with stage III colon or rectal cancer, respectively, were considered cured, whereas in 2016 this percentage increased to 73% to 78%, respectively. Conclusions: The number of patients with CRC reaching cure has increased substantially over the years. This study’s results provide valuable insights into trends of CRC patient survival and are important for patients, clinicians, and policymakers.


2001 ◽  
Vol 88 (9) ◽  
pp. 1221-1227 ◽  
Author(s):  
S. Manfredi ◽  
A. M. Benhamiche ◽  
B. Meny ◽  
N. Cheynel ◽  
P. Rat ◽  
...  

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