Annals of Surgical Oncology

, Volume 24, Issue 4, pp 1010–1017

Surgeon’s Experience Overrides the Effect of Hospital Volume for Postoperative Outcomes of Laparoscopic Surgery in Gastric Cancer: Multi-institutional Study

  • Han Hong Lee
  • Sang-Yong Son
  • Ju Hee Lee
  • Min Gyu Kim
  • Hoon Hur
  • Do Joong Park
Gastrointestinal Oncology

DOI: 10.1245/s10434-016-5672-7

Cite this article as:
Lee, H.H., Son, SY., Lee, J.H. et al. Ann Surg Oncol (2017) 24: 1010. doi:10.1245/s10434-016-5672-7
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Abstract

Background

Hospital volume is known to be a crucial factor in reducing postoperative morbidity and mortality in laparoscopic gastrectomy for gastric cancer. However, it is unclear whether surgeon’s individual experience can overcome the effect of hospital volume.

Methods

Clinicopathologic data of initial 50 laparoscopic gastrectomy cases were collected from six gastric cancer surgeons. Half of the six surgeons worked in high-volume centers, and the other half worked in low-volume hospitals. Perioperative outcomes were compared between the high-volume centers and the low-volume hospitals.

Results

Three low-volume hospitals in this study contained significantly more male and older patients with a higher American Society of Anesthesiologists score than high-volume centers. Although high- and low-volume hospitals mainly used laparoscopy-assisted and totally laparoscopic approach, respectively, there were no differences between the two groups in the extent of resection, operating time, estimated blood loss, and number of collected lymph nodes. Postoperative recovery such as duration to soft diet and hospital stay did not differ between the high- and the low-volume hospitals. No significant difference was found in postoperative morbidities by Clavien–Dindo classification. There was no mortality reported in both groups of the enrolled hospitals.

Conclusions

Hospital volume is not a decisive factor in affecting postoperative morbidity and mortality for well-trained beginners in laparoscopic surgery for gastric cancer.

Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Han Hong Lee
    • 1
  • Sang-Yong Son
    • 2
  • Ju Hee Lee
    • 3
  • Min Gyu Kim
    • 4
  • Hoon Hur
    • 2
  • Do Joong Park
    • 5
  1. 1.Department of Surgery, Uijeongbu St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulKorea
  2. 2.Department of SurgeryAjou University School of MedicineSuwonKorea
  3. 3.Department of SurgeryHanyang University Hospital, Hanyang University School of MedicineSeoulKorea
  4. 4.Department of SurgeryHanyang University Guri Hospital, Hanyang University School of MedicineSeoulKorea
  5. 5.Department of SurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineSeoulKorea