National differences in implementation of minimally invasive surgery for colorectal cancer and the influence on short-term outcomes

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National differences in implementation of minimally invasive surgery for colorectal cancer and the influence on short-term outcomes

Warps, A. K. (författare): Department of Surgery, Leiden University Medical Centre, ZA, Leiden, Netherlands; Dutch Institute for Clinical Auditing, Leiden, Netherlands

Saraste, D. (författare): Karolinska Institutet

Westerterp, M. (författare): Department of Surgery, Haagland Medisch Centrum, VA, Den Haag, Netherlands

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Detering, R. (författare): Department of Surgery, Amsterdam University Medical Centres, AZ, Amsterdam, Netherlands

Sjövall, A. (författare): Karolinska Institutet

Martling, A. (författare): Karolinska Institutet

Dekker, J. W. T. (författare): Department of Surgery, Reinier de Graaf Groep, AD, Delft, Netherlands

Tollenaar, R. A. E. M. (författare): Department of Surgery, Leiden University Medical Centre, ZA, Leiden, Netherlands; Dutch Institute for Clinical Auditing, Leiden, Netherlands

Matthiessen, Peter, 1957- (författare): Örebro universitet,Institutionen för medicinska vetenskaper,Department of Surgery, Örebro University Hospital, Örebro, Sweden

Tanis, P. J. (författare): Department of Surgery, Cancer Centre Amsterdam, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands

Dutch ColoRectal Audit and Swedish Colorectal Cancer Registry, - (bidragsgivare)

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2022-03-08
2022
Engelska.
Ingår i: Surgical Endoscopy. - : Springer. - 0930-2794 .- 1432-2218. ; 36:8, s. 5986-6001

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://link.springe...; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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BACKGROUND: The timing and degree of implementation of minimally invasive surgery (MIS) for colorectal cancer vary among countries. Insights in national differences regarding implementation of new surgical techniques and the effect on postoperative outcomes are important for quality assurance, can show potential areas for country-specific improvement, and might be illustrative and supportive for similar implementation programs in other countries. Therefore, this study aimed to evaluate differences in patient selection, applied techniques, and results of minimal invasive surgery for colorectal cancer between the Netherlands and Sweden.METHODS: Patients who underwent elective minimally invasive surgery for T1-3 colon or rectal cancer (2012-2018) registered in the Dutch ColoRectal Audit or Swedish ColoRectal Cancer Registry were included. Time trends in the application of MIS were determined. Outcomes were compared for time periods with a similar level of MIS implementation (Netherlands 2012-2013 versus Sweden 2017-2018). Multilevel analyses were performed to identify factors associated with adverse short-term outcomes.RESULTS: A total of 46,095 Dutch and 8,819 Swedish patients undergoing MIS for colorectal cancer were included. In Sweden, MIS implementation was approximately 5 years later than in the Netherlands, with more robotic surgery and lower volumes per hospital. Although conversion rates were higher in Sweden, oncological and surgical outcomes were comparable. MIS in the Netherlands for the years 2012-2013 resulted in a higher reoperation rate for colon cancer and a higher readmission rate but lower non-surgical complication rates for rectal cancer if compared with MIS in Sweden during 2017-2018.CONCLUSION: This study showed that the implementation of MIS for colorectal cancer occurred later in Sweden than the Netherlands, with comparable outcomes despite lower volumes. Our study demonstrates that new surgical techniques can be implemented at a national level in a controlled and safe way, with thorough quality assurance.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Colorectal cancer
Hospital volume
Laparoscopy
Minimal invasive surgery
Robotic surgery
Short-term outcomes

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Av författaren/redakt...: Warps, A. K.; Saraste, D.; Westerterp, M.; Detering, R.; Sjövall, A.; Martling, A.; visa fler...; Dekker, J. W. T.; Tollenaar, R. A. ...; Matthiessen, Pet ...; Tanis, P. J.; Dutch ColoRectal ...; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

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Av lärosätet: Örebro universitet; Karolinska Institutet

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