Impact of the hospital volume and setting on postoperative complications of surgery for gastroenterological cancers in a regional area of Western Japan

Susumu Kunisawa, Haku Ishida, Hiroshi Ikai, Hiroaki Nagano, Toshiyoshi Fujiwara, Hideki Ohdan, Yoshiyuki Fujiwara, Yoshitsugu Tajima, Tomio Ueno, Yoshinori Fujiwara, Mitsuo Shimada, Yasuyuki Suzuki, Yuji Watanabe, Kazuhiro Hanazaki, Yoshihiro Kakeji, Hiraku Kumamaru, Arata Takahashi, Hiroaki Miyata, Yuichi Imanaka

研究成果: Article査読

抄録

Purpose: A research subgroup was established by the Japanese Society of Gastroenterological Surgery to improve the health care quality in the Chushikoku area of Western Japan. Methods: The records of four surgical procedures were extracted from the Japanese National Clinical Database and analyzed retrospectively to establish the association between hospital characteristics, defined using a combination of hospital case-volume and patients’ hospital travel distance, and the incidences of perioperative complications of ≥ Grade 3 of the Clavien–Dindo classification after gastroenterological surgery. Results: This study analyzed 11,515 cases of distal gastrectomy for gastric cancer, 4,705 cases of total gastrectomy for gastric cancer, 4,996 cases of right hemicolectomy for colon cancer, and 5,243 cases of lower anterior resection for rectal cancer, with composite outcome incidences of 5.6%, 10.2%, 5.5%, and 10.7%, respectively. After adjusting for patient characteristics and surgical procedures, no association was identified between the hospital category and surgical outcomes. Conclusion: The findings of our study of the Chushikoku region did not provide positive support for the consolidation and centralization of hospitals, based solely on hospital case volume. Our grouping was unique in that we included patient travel distance in the analysis, but further investigations from other perspectives are needed.

本文言語English
ジャーナルSurgery today
DOI
出版ステータスAccepted/In press - 2022

ASJC Scopus subject areas

  • 外科

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