Outcome quality standards in pancreatic oncologic surgery.

Autor: Sabater L; Department of Surgery, Hospital Clínico, University of Valencia, Valencia, Spain, luis.sabater@uv.es., García-Granero A, Escrig-Sos J, Gómez-Mateo Mdel C, Sastre J, Ferrández A, Ortega J
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2014 Apr; Vol. 21 (4), pp. 1138-46. Date of Electronic Publication: 2014 Jan 06.
DOI: 10.1245/s10434-013-3451-2
Abstrakt: Purpose: To identify quality indicators and establish acceptable quality limits (AQLs) in pancreatic oncologic surgery using a formal statistical methodology.
Methods: Indicators have been identified through systematic literature reviews and guidelines for pancreatic surgery. AQLs were determined for each indicator with confidence intervals of 99.8 and 95 % above and below the weighted average by sample size from the different series examined.
Results: Several indicators have been identified with the following results as AQLs: resectability rate >59 %; morbidity, mortality, and pancreatic fistula rate in pancreaticoduodenectomy <55, <5, and <16 %, respectively; morbidity, mortality, and fistula rate in distal pancreatectomy <53, <4, and <31 %, respectively; number of lymph nodes retrieved >15; R1 resection <46 %; survival at 1, 3, and 5 years >54, >19, and >8 %, respectively.
Conclusions: A series of different indicators for quality surgical care outcome in pancreatic cancer, as well as their limits, have been determined according to a standard methodology.
Databáze: MEDLINE
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