Aimed at reducing surgical deaths, several initiatives have attempted to establish volume-based referral strategies in high risk surgery.
Dr Metzger and colleagues conducted a detailed analysis of the literature of the last 10 years, comprising 13 papers on esophageal cancer.
The researchers observed a clear reduction in postoperative mortality with increasing case volumes per year.
|Hospitals with experience of more than 20 esophagectomies per year show 5% reduction in mortality|
|Diseases of the Esophagus|
Single papers analyzed the main reasons for this phenomenon and showed that postoperative complication rates are lower in high-volume hospitals.
The research team also noted that single papers showed the management of complications to be more successful in high-volume hospitals.
Further, long-term prognosis is also correlated to case-volume.
The team found that only with the experience of more than 20 esophagectomies per year can a significant reduction of the mortality, down to 5%, be achieved.
Dr Metzger concludes, “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.”