General and Minimally Invasive Surgery, Esophago-gastric Surgery-Humanitas Clinical and Research Center, IRCCS, Via Manzoni, 56, Rozzano, 20089, Milan, Italy,
Updates Surg. 2013 Dec;65(4):271-5. doi: 10.1007/s13304-013-0227-y. Epub 2013 Aug 13.
Surgical procedures for cancer of the esophagus are complex operations, with considerable perioperative morbidity and mortality that require high use of resources. Recent reports indicate better results with centralization of these procedures, referring patients to high-volume dedicated hospitals. The aim of this study was to analyze the results of resective surgery for cancer of the esophagus and cardia performed in hospitals of the Region of Lombardy over the period 2005-2011, in terms of volume of operations, 30-day postoperative mortality, and length of hospitalization. The results showed a significant relation between reduction of mortality rate and number of resections performed in intermediate- and high-volume centers. In the Region of Lombardy there is an inverse relation between volume of esophagectomies in the single hospital, length of postoperative hospital stay, and postoperative 30-day mortality. Centralization of care on a regional level and standardized clinical pathways of diagnosis and care at single healthcare organizations and professionals should be implemented to improve clinical results in patients affected by esophageal and cardia cancer.
食管癌的外科手术是复杂的操作，围手术期发病率和死亡率相当高，需要大量的资源。最近的报告表明，将这些手术集中到高容量的专门医院进行，可以获得更好的结果。本研究旨在分析 2005-2011 年伦巴第大区医院进行的食管癌和贲门癌切除术的结果，包括手术量、30 天术后死亡率和住院时间。结果表明，死亡率的降低与中高容量中心进行的手术数量之间存在显著关系。在伦巴第大区，单个医院的食管癌切除术数量、术后住院时间和 30 天术后死亡率之间存在反比关系。应在区域层面集中治疗，并在单一医疗机构和专业人员中实施标准化的诊断和治疗临床路径，以改善食管癌和贲门癌患者的临床结果。
