Surgical Unit volume and 30-day reoperation rate following primary resection for colorectal cancer in the Veneto Region (Italy)
| Autor: | A. Chiappetta, Nicola Gennaro, Andrea Barina, Donato Nitti, Mario Saugo, Salvatore Pucciarelli, G. Giacomazzo, M. Rebonato |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Adolescent Colorectal cancer Surgical Unit volume Unit volume 030230 surgery 03 medical and health sciences Young Adult 0302 clinical medicine medicine Humans In patient Rectal resection Colectomy Aged Aged 80 and over Reoperation rate Gastroenterology Surgery business.industry Primary resection Middle Aged medicine.disease Comorbidity Colorectal surgery Italy Elective Surgical Procedures 030220 oncology & carcinogenesis Multivariate Analysis Regression Analysis Female Laparoscopy business Colorectal Neoplasms Hospital Units Surgery Department Hospital Abdominal surgery |
| Zdroj: | Techniques in coloproctology. 20(1) |
| ISSN: | 1128-045X |
| Popis: | The aim of this study was to evaluate the impact of Surgical Unit volume on the 30-day reoperation rate in patients with CRC. Data were extracted from the regional Hospital Discharge Dataset and included patients who underwent elective resection for primary CRC in the Veneto Region (2005–2013). The primary outcome measure was any unplanned reoperation performed within 30 days from the index surgery. Independent variables were: age, gender, comorbidity, previous abdominal surgery, site and year of the resection, open/laparoscopic approach and yearly Surgical Unit volume for colorectal resections as a whole, and in detail for colonic, rectal and laparoscopic resections. Multilevel multivariate regression analysis was used to evaluate the impact of variables on the outcome measure. During the study period, 21,797 elective primary colorectal resections were performed. The 30-day reoperation rate was 5.5 % and was not associated with Surgical Unit volume. In multivariate multilevel analysis, a statistically significant association was found between 30-day reoperation rate and rectal resection volume (intermediate-volume group OR 0.75; 95 % CI 0.56–0.99) and laparoscopic approach (high-volume group OR 0.69; 95 % CI 0.51–0.96). While Surgical Unit volume is not a predictor of 30-day reoperation after CRC resection, it is associated with an early return to the operating room for patients operated on for rectal cancer or with a laparoscopic approach. These findings suggest that quality improvement programmes or centralization of surgery may only be required for subgroups of CRC patients. |
| Databáze: | OpenAIRE |
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