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Langenbeck's Archives of Surgery

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Open Access 01-01-2009 | Original Article

Effect of surgical work volume on postoperative complication: superiority of specialized center in gastric cancer treatment

Authors: Birendra Kumar Sah, Zheng Gang Zhu, Ming Min Chen, Ming Xiang, Jun Chen, Min Yan, Yan Zhen Lin

Published in: Langenbeck's Archives of Surgery | Issue 1/2009

Abstract

Purpose

We investigated the risk factors for early postoperative complications after gastric cancer surgery.

Materials and methods

The data from a total of 273 patients with gastric cancer were analyzed by univariate and multivariate analysis. We applied physiological and operative severity score for the enumeration of morbidity and mortality (POSSUM) to compare risk-adjusted surgical outcomes among different surgical units.

Results

Among the preoperative variables, patient gender, chronic obstructive pulmonary disease, surgical unit, and intraoperative blood loss were independent risk factors for a higher rate of postoperative complications. There were significant differences in complication rates among different surgical units (P = 0.001). The observed-to-expected morbidity ratio (O-to-E ratio) ranged from 0.81 to 1.63. Units with low surgical work volume had higher complication rates. Postoperative length of stay was significantly shorter (P = 0.000) and the rate of moderate and severe complications was significantly lower (P = 0.001) in specialized unit.

Conclusions

POSSUM is a valid system for risk-adjusted evaluation of surgical outcomes. We conclude that surgical experience and work volume greatly influence the outcome, with overall surgical outcome in specialized centers superior to that in other units. Hence, gastric cancer surgery should be performed in specialized centers. Risk factors identified in this study need further confirmation by a prospective study involving a larger cohort.

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Title: Effect of surgical work volume on postoperative complication: superiority of specialized center in gastric cancer treatment
Authors: Birendra Kumar Sah
Zheng Gang Zhu
Ming Min Chen
Ming Xiang
Jun Chen
Min Yan
Yan Zhen Lin
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 1/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-008-0358-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of surgical work volume on postoperative complication: superiority of specialized center in gastric cancer treatment

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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