Benchmarks in colorectal surgery: multinational study to define quality thresholds in high and low anterior resection.

Autor:	Staiger RD; Department of Colorectal Surgery, University Hospital Zurich, Zurich, Switzerland., Rössler F; Department of Colorectal Surgery, University Hospital Zurich, Zurich, Switzerland., Kim MJ; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea., Brown C; Department of Surgery, University of British Columbia, St Paul's Hospital, Vancouver, British Columbia, Canada., Trenti L; Bellvitge University Hospital, Department of General and Digestive Surgery, and IDIBELL, University of Barcelona, Barcelona, Spain., Sasaki T; Department of Colorectal Surgery and Surgical Technology, National Cancer Centre Hospital East, Kashiwa, Chiba, Japan., Uluk D; Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany., Campana JP; Section of Colorectal Surgery, Hospital Italiano de Buenos Aires and Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB), Buenos Aires, Argentina., Giacca M; Department of Colorectal Surgery, Beaujon Hospital and University of Paris, Clichy, France., Schiltz B; Department of Colorectal Surgery, Cliniques Universitaires St-Luc - UCL, Brussels, Belgium., Bahadoer RR; Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Lee KY; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, University Surgical Cluster, National University Health System, Singapore., Kupper BEC; A. C. Camargo Cancer Centre, São Paulo, Brazil., Hu KY; Division of Colorectal Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA., Corcione F; Department of General Surgery and Specialty, University Federico II of Naples, Naples, Italy., Paredes SR; Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia., Spampati S; Department of Colorectal Surgery, University Hospital Zurich, Zurich, Switzerland., Ukegjini K; Department of Colorectal Surgery, University Hospital Zurich, Zurich, Switzerland., Jedrzejczak B; Centre for Bowel Diseases, Brzeziny, Poland., Langer D; Surgery Department, Charles University and Central Military Hospital, Prague, Czech Republic., Stakelum A; Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland., Park JW; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea., Phang PT; Department of Surgery, University of British Columbia, St Paul's Hospital, Vancouver, British Columbia, Canada., Biondo S; Bellvitge University Hospital, Department of General and Digestive Surgery, and IDIBELL, University of Barcelona, Barcelona, Spain., Ito M; Department of Colorectal Surgery and Surgical Technology, National Cancer Centre Hospital East, Kashiwa, Chiba, Japan., Aigner F; Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany., Vaccaro CA; Section of Colorectal Surgery, Hospital Italiano de Buenos Aires and Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB), Buenos Aires, Argentina., Panis Y; Department of Colorectal Surgery, Beaujon Hospital and University of Paris, Clichy, France., Kartheuser A; Department of Colorectal Surgery, Cliniques Universitaires St-Luc - UCL, Brussels, Belgium., Peeters KCMJ; Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., Tan KK; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, University Surgical Cluster, National University Health System, Singapore., Aguiar S; A. C. Camargo Cancer Centre, São Paulo, Brazil., Ludwig K; Division of Colorectal Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA., Bracale U; Department of General Surgery and Specialty, University Federico II of Naples, Naples, Italy., Young CJ; Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia., Dziki A; Centre for Bowel Diseases, Brzeziny, Poland.; Department of General and Colorectal Surgery, Medical University, Lodz, Poland., Ryska M; Surgery Department, Charles University and Central Military Hospital, Prague, Czech Republic., Winter DC; Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland., Jenkins JT; Department of Colorectal Surgery, St Mark's Hospital, London, UK., Kennedy RH; Department of Colorectal Surgery, St Mark's Hospital, London, UK., Clavien PA; Department of Colorectal Surgery, University Hospital Zurich, Zurich, Switzerland., Puhan MA; Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland., Turina M; Department of Colorectal Surgery, University Hospital Zurich, Zurich, Switzerland.
Jazyk:	angličtina
Zdroj:	The British journal of surgery [Br J Surg] 2022 Nov 22; Vol. 109 (12), pp. 1274-1281.
DOI:	10.1093/bjs/znac300
Abstrakt:	Background: Benchmark comparisons in surgery allow identification of gaps in the quality of care provided. The aim of this study was to determine quality thresholds for high (HAR) and low (LAR) anterior resections in colorectal cancer surgery by applying the concept of benchmarking. Methods: This 5-year multinational retrospective study included patients who underwent anterior resection for cancer in 19 high-volume centres on five continents. Benchmarks were defined for 11 relevant postoperative variables at discharge, 3 months, and 6 months (for LAR). Benchmarks were calculated for two separate cohorts: patients without (ideal) and those with (non-ideal) outcome-relevant co-morbidities. Benchmark cut-offs were defined as the 75th percentile of each centre's median value. Results: A total of 3903 patients who underwent HAR and 3726 who had LAR for cancer were analysed. After 3 months' follow-up, the mortality benchmark in HAR for ideal and non-ideal patients was 0.0 versus 3.0 per cent, and in LAR it was 0.0 versus 2.2 per cent. Benchmark results for anastomotic leakage were 5.0 versus 6.9 per cent for HAR, and 13.6 versus 11.8 per cent for LAR. The overall morbidity benchmark in HAR was a Comprehensive Complication Index (CCI®) score of 8.6 versus 14.7, and that for LAR was CCI® score 11.9 versus 18.3. Conclusion: Regular comparison of individual-surgeon or -unit outcome data against benchmark thresholds may identify gaps in care quality that can improve patient outcome. (© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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