Impact of overall major oncologic surgery volume on outcomes in esophagogastrectomies with intrathoracic anastomosis.

IF 2.1 3区 医学 Q2 SURGERY
Guadagni Simone, Comandatore Annalisa, Furbetta Niccolò, Di Franco Gregorio, Bechini Bianca, Vagelli Filippo, Ramacciotti Niccolò, Gaeta Raffaele, Pollina Luca Emanuele, Palmeri Matteo, Di Candio Giulio, Morelli Luca
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引用次数: 0

Abstract

Background: High case volumes for specific surgeries including the treatment of esophagogastric junction and distal esophageal cancer are frequently emphasized in literature to achieve better outcomes. However, recent studies have suggested that a cumulative volume of major oncologic surgeries (MOSs) can positively impact outcomes for single procedures even if below their specific thresholds. This study aimed to report outcomes from esophagogastrectomies with intrathoracic anastomosis (EGs-ITA) from a surgical unit that handles a high volume of other MOSs despite lower volumes for EGs-ITA.

Methods: Data from all patients undergoing EGs-ITA from January 2013 to June 2023 were collected from an institutional database and retrospectively analyzed. Additionally, data on the volume of all MOSs performed in the same 10-year period were retrieved.

Results: This study included 32 patients, averaging three EGs-ITA performed annually. The anastomotic leak rate was 6.2%. The median hospital stay was 12 days, and 30- and 90-day mortality rates were 3.1% and 6.2%, respectively. The mean harvested lymph nodes were 26.3 ± 10.2. Re-admission and locoregional recurrence occurred in 6.2% and 9.3% of patients, respectively. During the study period, the surgical team managed over 400 MOSs annually.

Conclusion: Exposure to high volume and broad range of MOSs appears beneficial for achieving favorable outcomes in esophagogastric junction and distal esophageal cancer surgeries, even in centers with lower volumes of these specific procedures. This finding underscores the potential for excellent surgical results in settings with substantial overall volumes in major oncologic procedures, as an alternative to high-volume specialization in a single surgery type.

总体肿瘤大手术量对食管胃切除术胸内吻合预后的影响。
背景:文献中经常强调特定手术的高病例量,包括治疗食管胃交界处和远端食管癌,以获得更好的结果。然而,最近的研究表明,即使低于特定阈值,大型肿瘤手术(MOSs)的累积量也会对单次手术的结果产生积极影响。本研究旨在报道食管胃切除术胸内吻合术(EGs-ITA)的结果,该手术单元处理大量其他MOSs,尽管EGs-ITA的体积较小。方法:从一个机构数据库中收集2013年1月至2023年6月接受EGs-ITA治疗的所有患者的数据并进行回顾性分析。此外,还检索了同一10年期间所有MOSs的体积数据。结果:本研究纳入32例患者,平均每年进行3次EGs-ITA。吻合口漏率为6.2%。中位住院时间为12天,30天和90天死亡率分别为3.1%和6.2%。平均切除淋巴结26.3±10.2个。再次入院和局部复发的发生率分别为6.2%和9.3%。在研究期间,外科团队每年处理超过400例MOSs。结论:在食管胃交界和远端食管癌手术中,暴露于大容量和大范围的MOSs有利于获得良好的结果,即使在这些特定手术的容量较低的中心也是如此。这一发现强调了在主要肿瘤手术中具有大量总体容量的环境中,作为单一手术类型的高容量专业化的替代方案,具有出色的手术效果的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.30
自引率
8.70%
发文量
342
审稿时长
4-8 weeks
期刊介绍: Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.
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