Jorge Sancho-Muriel1, Matteo Frasson2, David Hervás3, Blas Flor-Lorente2, José Luis Ramos Rodriguez4, Manuel Romero Simó5, Jordi Escoll Rufino6, Marta Santamaría Olabarrieta7, José Viñas Martinez8, Manolo López Bañeres9, Eduardo García-Granero2. 1. Unidad de Cirugía Digestiva, Hospital Universitario y Politécnico La Fe, Universidad de Valencia, Valencia, España. Electronic address: jsanchomuriel@gmail.com. 2. Unidad de Cirugía Digestiva, Hospital Universitario y Politécnico La Fe, Universidad de Valencia, Valencia, España. 3. Unidad de Bioestadística, Instituto de Investigación Sanitaria La Fe, Valencia, España. 4. Servicio de Cirugía General, Hospital Universitario de Getafe, Madrid, España. 5. Hospital General Universitario de Alicante, Alicante, España. 6. Hospital Universitari Arnau de Vilanova, Lleida, España. 7. Hospital de Cruces, Bilbao, España. 8. Hospital Arquitecto Marcide, Ferrol, España. 9. Hospital Arnau de Vilanova, Valencia, España.
Abstract
INTRODUCTION: Lately there has been an increasing interest in identifying quality standards in different pathologies, among them colon cancer due to its great prevalence. The main goal of this study is to define the quality standards of colon cancer surgery based on a large prospective national study dataset. METHODS: Data from the prospective national study ANACO were used. This study included a consecutive series of patients operated on for colon cancer in 52 Spanish hospitals (2011-2012). Centers with less than 30 patients were excluded. The present analysis finally included 42 centers (2975 patients). Based on the results obtained in 4main indicators from each hospital (anastomotic leak, lymph-nodes found in the specimen, mortality and length of stay), a nomogram that allows the evaluation of the performance of each center was designed. Standard results for further 5 intraoperative and 5 postoperative quality indicators were also reported. RESULTS: Median of anastomotic leak and mortality rate was 8.5% (25th-75th percentiles 6.1%-12.4%) and 2.5% (25th-75th percentiles 0.6%-4.7%), respectively. Median number of nodes found in the surgical specimen was 15,1 (25th-75th percentiles 18-14 nodes). Median length of postoperative stay was 7.7 days (25th-75th percentiles 6.9-9.2 days). Based on these data, a nomogram for hospital audit was created. CONCLUSIONS: Standard surgical results after colon cancer surgery were defined, creating a tool for auto-evaluation and allowing each center to identify areas for improvement in the surgical treatment of colon cancer.
INTRODUCTION: Lately there has been an increasing interest in identifying quality standards in different pathologies, among them colon cancer due to its great prevalence. The main goal of this study is to define the quality standards of colon cancer surgery based on a large prospective national study dataset. METHODS: Data from the prospective national study ANACO were used. This study included a consecutive series of patients operated on for colon cancer in 52 Spanish hospitals (2011-2012). Centers with less than 30 patients were excluded. The present analysis finally included 42 centers (2975 patients). Based on the results obtained in 4main indicators from each hospital (anastomotic leak, lymph-nodes found in the specimen, mortality and length of stay), a nomogram that allows the evaluation of the performance of each center was designed. Standard results for further 5 intraoperative and 5 postoperative quality indicators were also reported. RESULTS: Median of anastomotic leak and mortality rate was 8.5% (25th-75th percentiles 6.1%-12.4%) and 2.5% (25th-75th percentiles 0.6%-4.7%), respectively. Median number of nodes found in the surgical specimen was 15,1 (25th-75th percentiles 18-14 nodes). Median length of postoperative stay was 7.7 days (25th-75th percentiles 6.9-9.2 days). Based on these data, a nomogram for hospital audit was created. CONCLUSIONS: Standard surgical results after colon cancer surgery were defined, creating a tool for auto-evaluation and allowing each center to identify areas for improvement in the surgical treatment of colon cancer.
Authors: L Sánchez-Guillén; M Frasson; Á García-Granero; G Pellino; B Flor-Lorente; E Álvarez-Sarrado; E García-Granero Journal: Ann R Coll Surg Engl Date: 2019-09-06 Impact factor: 1.891