{"title":"Impact of overall major oncologic surgery volume on outcomes in esophagogastrectomies with intrathoracic anastomosis.","authors":"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","doi":"10.1007/s00423-025-03684-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"115"},"PeriodicalIF":2.1000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Langenbeck's Archives of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00423-025-03684-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
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.
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.