title: Establishing a complex surgical oncology program with low morbidity and mortality at a community hospital.
abstract: BACKGROUND
  We report our experience with a large volume of complex oncologic resections and describe the framework necessary to develop a program with low morbidity and mortality in a community hospital.
  
  
  METHODS
  From August 2010 to May 2014, 224 consecutive patients underwent abdominal oncological resection, at a community hospital by a single surgeon (R.N.B.). Cases included pancreatic, gastric, hepatobiliary, colorectal, hyperthermic intraperitoneal chemotherapy with cytoreduction, splenic, and sarcoma resections. We retrospectively reviewed our prospectively maintained database and evaluated postoperative complications.
  
  
  RESULTS
  There was no 0, 30-, 60-, or 90-day mortality. The complication rate was 44%, including 5% grade I, 28% grade II, 9% grade III, and 1% grade IV complications. The median length of stay was 8 days. Mean follow-up for the entire group was 643 days.
  
  
  CONCLUSIONS
  Our study demonstrates that complex oncologic resections can be safely performed in the community setting if a well-organized, surgeon-led multidisciplinary team is assembled.
authors.affiliation: Section of Surgical Oncology, Department of Surgery, St John Hospital and Medical Center, Van Elslander Cancer Center, Detroit, MI, USA.
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Van Dorp
authors.affiliation: Section of Surgical Oncology, Department of Surgery, St John Hospital and Medical Center, Van Elslander Cancer Center, Detroit, MI, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Boston
authors.affiliation: Section of Surgical Oncology, Department of Surgery, St John Hospital and Medical Center, Van Elslander Cancer Center, Detroit, MI, USA. Electronic address: richard.berri@stjohn.org.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Berri
mesh_terms: D004067:Digestive System Neoplasms / Q000401:mortality / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009017:Morbidity / Q000639:trends; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D015397:Program Evaluation / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Community hospital; Morbidity; Mortality; Multidisciplinary team; Oncologic resection