Aimed at reducing surgical deaths, several initiatives have attempted to establish volume-based referral strategies in high risk surgery.
Dr Metzger and colleagues from Cologne in Germany undertook a detailed analysis of the literature of the last 10 years, comprising 13 papers on esophageal cancer.
The researchers were able to show a clear reduction in postoperative mortality with increasing case volumes per year.
Single papers have analyzed the main reasons for this phenomenon.
|Experience of more than 20 esophagectomies per year can mean a significant reduction of the mortality, down to 4.9%|
|Diseases of the Esophagus|
The researchers noted that previous papers have shown that postoperative complication rates are lower in high-volume hospitals and management of complications is more successful.
The researchers found that further, long-term prognosis is also correlated to case-volume.
The researchers were able to show that only with the experience of more than 20 esophagectomies per year can a significant reduction of the mortality, down to 4.9%, be achieved.
Dr Metzger concluded, "Based on this survey, surgery of esophageal cancer is a task for high-volume hospitals because of decreased postoperative mortality and improved long-term prognosis compared with low volume hospitals."