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dc.contributor.authorTian, Kevin
dc.contributor.authorBaade, Peter D
dc.contributor.authorAitken, Joanne F
dc.contributor.authorNarendra, Aaditya
dc.contributor.authorSmithers, B Mark
dc.date.accessioned2021-09-06T03:48:14Z
dc.date.available2021-09-06T03:48:14Z
dc.date.issued2021
dc.identifier.issn1445-1433
dc.identifier.doi10.1111/ans.17132
dc.identifier.urihttp://hdl.handle.net/10072/407639
dc.description.abstractBackground: International literature recommends centralising gastric cancer surgery, however, with volumes that define ‘high-volume resection’ being higher than those in most major centres in Australia and New Zealand. These reports rarely focus on the difference between total (TG) and partial gastrectomy (PG). We assessed the impact of resection volume and service capability on operative mortality, morbidity and surgical quality in patients who had a PG and TG. Methods: Patients who had gastrectomy for adenocarcinoma, between 2001 and 2015, were collected from the Queensland Oncology Repository. Hospitals were characterised by cases-per-annum (high-volume [HV] ≥ 5 and low-volume [LV] < 5) and hospital service capability as (high-service [HS] and low-service [LS]), giving three hospital groups: HVHS, LVHS and LVLS. Chi-squared tests were used to compare post-operative mortality, morbidity, failure to rescue (FTR) from complications and surgical quality between these three groups. Results: There were 426 patients who had a TG and 827 having PG. HVHS centres performed 59% of PG with high surgical quality rates of: HVHS = 53%, LVHS = 34% and LVLS = 46% (p < 0.01). Surgical complications were highest in LVLS (LVLS = 19%, LVHS = 11%, HVHS = 11%; p = 0.02). There was no difference in 30-day mortality nor in FTR. For TG, HVHS performed 67% of these procedures, with lower 30-day mortality (2%) and FTR rates (5%) compared with LVHS (7%, 22%) and LVLS (12%, 28%; p < 0.01). There was no difference in operative morbidity and surgical quality between hospital groups. Conclusion: Despite the ‘high-volume’ threshold for gastrectomy being the lowest described in the literature, we have shown that centralisation to HVHS centres was associated with lower operative mortality for TG and improved quality of surgery for PG.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherWiley
dc.relation.ispartofjournalANZ Journal of Surgery
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchcode3202
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsSurgery
dc.subject.keywordsgastric cancer surgery
dc.subject.keywordsupper GI surgery
dc.titleProcedure-specific outcomes following gastrectomy for cancer compared by hospital volume and service capability
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationTian, K; Baade, PD; Aitken, JF; Narendra, A; Smithers, BM, Procedure-specific outcomes following gastrectomy for cancer compared by hospital volume and service capability, ANZ Journal of Surgery, 2021
dcterms.dateAccepted2021-07-29
dc.date.updated2021-09-06T00:43:06Z
gro.description.notepublicThis publication has been entered in Griffith Research Online as an advanced online version.
gro.hasfulltextNo Full Text
gro.griffith.authorBaade, Peter D.


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