Uticaj individualnog hirurškog volumena na rane postoperativne ishode posle resekcije rektuma zbog karcinoma

  • Zoran Aleksić University Clinical Center of the Republic of Srpska, Clinic for General and Abdominal Surgery, Banjaluka, Bosnia and Herzegovina
  • Maja Vulović University of Kragujevac, Faculty of Medical Sciences, Department of Anatomy and Forensic Medicine, Kragujevac, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Bojan Milošević Clinical Center Kragujevac, General and Thoracic Surgery Department, Kragujevac, Serbia
  • Aleksandar Cvetković Clinical Center Kragujevac, General and Thoracic Surgery Department, Kragujevac, Serbia
  • Dragan Tomić University Clinical Center of the Republic of Srpska, Clinic for General and Abdominal Surgery, Banjaluka, Bosnia and Herzegovina
  • Nebojša Trkulja University Clinical Center of the Republic of Srpska, Clinic for General and Abdominal Surgery, Banjaluka, Bosnia and Herzegovina
  • Milan Simatović University Clinical Center of the Republic of Srpska, Clinic for General and Abdominal Surgery, Banjaluka, Bosnia and Herzegovina
  • Anđelka Stojković University of Kragujevac, Faculty of Medical Sciences, Department of Pediatrics, Kragujevac, Serbia
  • Anita Ivošević University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
DOI: https://doi.org/10.2298/VSP171020187A
Ključne reči: hemorrhage, length of stay, surgeons, surgical procedures, operative, surgical wound dehiscence, rectal neoplasms, survival, treatment outcome

Sažetak


Abstract

 

Background/Aim. Surgeon-specific experience as meas­ured by procedure volume can have a significant impact on survival of patients with rectal cancer (RC). The aim of this study was to determine whether an individual surgeon-spe­cific volume of procedure influences early postoperative outcomes as well as to determine the strength of different groups of annual surgeon volume (ASV), as a predictor of outcomes in patients after RC resection up to 30 days post­operatively. Methods. This retrospective observational sin­gle center study involved a cohort of 546 patients of both sexes, operated for a 10-year period due to RC. Patients were divided into three groups, according to the annual vol­ume of RC procedures of a surgeon who operated them. Seven outcomes were analyzed: the incidence of colorectal anastomotic dehiscence (CRAD), operative time, intraop­erative blood loss, hospital stay, in-hospital death, the status of the circumferential resection margin (CRM) and the total mesorectal excision (TME) with number of lymph nodes, as well as some risk factors (several independent, dependent and “confusing” variables) of importance for the outcome, to explain the difference. The strength of each group of surgeons and their effect on early outcome of treatment were determined. Results. The majority of surgeons (77.7%) belonged to the low and medium ASV, which per­formed a slightly higher number of surgeries (281) than the high volume group. The high-volume surgeon group was associated with significantly better results in four outcomes (CRAD, operating time, CRM, TME and number of lymph nodes). Conclusion. In our surgical institution, the high volume surgeon remains an important predictor of success of the RC surgery.

Biografija autora

Zoran Aleksić, University Clinical Center of the Republic of Srpska, Clinic for General and Abdominal Surgery, Banjaluka, Bosnia and Herzegovina

NE

Reference

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Objavljeno
2021/04/21
Broj časopisa
Vol. 76 Br. 9 (2019): Vojnosanit Pregl
Rubrika
Originalni članak