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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 7/2017

01-07-2017 | Original Article

The positive impact of surgical quality control on adequate lymph node harvest by standardized laparoscopic surgery and national quality assessment program in colorectal cancer

Authors: Daeyoun David Won, Sung Bong Choi, Yoon Suk Lee, Seong Taek Oh, Jun Gi Kim, In Kyu Lee

Published in: International Journal of Colorectal Disease | Issue 7/2017

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Abstract

Purpose

We aimed to present the factors associated with lymph node harvest (LNH) and seek whether surgical quality control measures can improve LNH.

Methods

From a prospectively collected data at a single institution, 874 CRC patients who underwent curative surgery between 2004 and 2013 were included. Factor and survival analyses were performed regarding LNH. Subgroup analysis was performed according to LNH group (LNH ≥ 12 vs LNH < 12) and year of surgery (2004–2008, 2009–2011, and 2012–2013 group).

Results

In the multivariate analysis, tumor location (OR 0.6, p < 0.001), stage (OR 1.95, p < 0.001), and year of surgery (OR 3.86, p < 0.001) showed an association with adequate LNH. In the subgroup analysis categorized by the year of surgery, surgical quality control measures by standardized laparoscopic surgery (OR 52.91, p < 0.001) showed notable association with adequate LNH. Comparing the 2009–2011 and 2012–2013 group, the national quality assessment program additionally improved adequate LNH percentage (83.9 vs 94.3%). In the survival analysis, disease-free survival (DFS) differed according to year of surgery, standardized laparoscopic surgery with high vascular ligation, and adequate LNH by stage. In the overall survival (OS) analysis, the LNH-related factors did not show significant difference.

Conclusions

Through standardized laparoscopic surgery with high vascular ligation and national quality assessment program, surgical quality control had a positive impact on the increase of adequate LNH. Improving the modifiable LNH factors resulted in the enhancement of adequate LNH and related DFS.
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Metadata
Title
The positive impact of surgical quality control on adequate lymph node harvest by standardized laparoscopic surgery and national quality assessment program in colorectal cancer
Authors
Daeyoun David Won
Sung Bong Choi
Yoon Suk Lee
Seong Taek Oh
Jun Gi Kim
In Kyu Lee
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 7/2017
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-017-2771-2

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