Impact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer.
BACKGROUND
High hospital case volume has been associated with improved outcome after open operation for colorectal malignancies.


METHODS
To assess the impact of hospital case volume on short-term outcome after laparoscopic operation for colon cancer, we conducted an analysis of patients who underwent laparoscopic colon resection within the COlon Cancer Laparoscopic or Open Resection (COLOR) trial.


RESULTS
A total of 536 patients with adenocarcinoma of the colon were included in the analysis. Median operating time was 240, 210 and 188 min in centers with low, medium, and high case volumes, respectively (p < 0.001). A significant difference in conversion rate was observed among low, medium, and high case volume hospitals (24% vs 24% vs 9%; p < 0.001). A higher number of lymph nodes were harvested at high case volume hospitals (p < 0.001). After operation, fewer complications (p = 0.006) and a shorter hospital stay (p < 0.001) were observed in patients treated at hospitals with high caseloads.


CONCLUSIONS
Laparoscopic operation for colon cancer at hospitals with high caseloads appears to be associated with improved short-term results.
Kuhry
E
E
e.kuhrij@erasmusmc.nl <e.kuhrij@erasmusmc.nl>
Bonjer
H J
HJ
Haglind
E
E
Hop
W C J
WC
Veldkamp
R
R
Cuesta
M A
MA
Jeekel
J
J
Påhlman
L
L
Morino
M
M
Lacy
A
A
Delgado
S
S
D000368:Aged; D016063:Blood Loss, Surgical; D003082:Colectomy / Q000379:methods* / Q000706:statistics & numerical data; D003110:Colonic Neoplasms / Q000601:surgery*; D005060:Europe; D005260:Female; D017052:Hospital Mortality; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome