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Impact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer

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Abstract

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.

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Acknowledgments

We are grateful to Ethicon Endo-Surgery for its support of the trial and to J. G. van Duuren–van Pelt for management of the data.

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Authors and Affiliations

  1. Department of Surgery, Erasmus University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands

    COLOR Study Group (COLOR Study Group)

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  1. COLOR Study Group
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Corresponding author

Correspondence to COLOR Study Group.

Appendix. Participants in the COLOR trial

Appendix. Participants in the COLOR trial

Protocol committee: H. J. Bonjer, E. Haglind, J. Jeekel, G. Kazemier, L. Påhlman

Monitoring committee: J. R. T Monson, P. Quircke, M. Trede, T. Stijnen

Writing committee: E. Kuhry, H. J. Bonjer, E. Haglind, W.C. J. Hop, R. Veldkamp, M. A. Cuesta, J. Jeekel, L. Påhlman, M. Morino, A. Lacy, S. Delgado

Trial coordinators: P. Wittich, E. Hazebroek, R. Veldkamp, M. Gholghesaei, E. Kuhry

Mälarsjukhuset, Eskilstuna (Sweden): R. Hellberg; Sahlgrenska University Hospital, Göteborg (Sweden): E. Haglind, S. R Nordgren, P. G. Lindgren, E. Lindholm; Uppsala University Hospital, Uppsala (Sweden): L. Påhlman, M. Dahlberg, Y. Raab; Huddinge Hospital, Huddinge (Sweden): B. Anderberg, S. Ewerth, M. Janson, J. E. Åkerlund; Centrallasarettet, Västerås (Sweden): K. Smedh; University Hospital Malmö, Malmö (Sweden): A. Montgomery; Kärnsjukhuset, Skövde (Sweden): S. Skullman; University Hospital Linköping, Linköping (Sweden): P. O. Nyström, A. Kald, A. Wärnström,; St. Görans Hospital, Stockholm (Sweden): J. Dàlen, I. Svedberg; Östersund Sjukhus, Östersund (Sweden): G. Edlund; University Hospital Uddevalla, Uddevalla (Sweden): U. Kressner; Norrlands University Hospital, Umeå (Sweden): A. Öberg, O. Lundberg; G. E. Lindmark; Oulu Hospital, Oulu (Finland): T. Heikkinen; University Hospital Turin, Turin (Italy): M. Morino, G. Giraudo; Hospital Clinic i Provincial de Barcelona, Barcelona (Spain): A. Lacy, S. Delgado; Fundacio Sanitaria d’lgualada, Igualada (Spain): E. Macarulla Sanz; Hospital Jerez de la Frontera (Spain): J. Medina Díez; University Hospital Lübeck, Lübeck (Germany): O. Schwandner, T. H. Schiedeck, H. Shekarriz; University Hospital Hamburg, Hamburg: C. Bloechle; Zentrallkarankenhaus Bremen Ost, Bremen (Germany): I. Baca, O. Weiss; Louis Mourier Hospital, Colombes (France): S. Msika; Centre Hospital de Montargis, Amilly (France): G. Desvignes; Ninewells Hospitals, Dundee (United Kingdom): K. L. Campbell, A. Cuschieri; Erasmus Medical Center, Rotterdam (The Netherlands): H. J. Bonjer, W. R. Schouten, St. Clara Hospital, Rotterdam (The Netherlands): J. F. Lange, E. v.d. Harst, P. Plaiser, M. J. O. E. Bertleff; University Hospital V.U., Amsterdam (The Netherlands): M. A. Cuesta, W. van der Broek; Leeuwarden Medical Center, Leeuwarden (The Netherlands): J. W. H. J. Meijerink; Catharina Hospital, Eindhoven (The Netherlands): J. J. Jakimowicz, G. Nieuwenhuis, J. Maring, J. Kivit; Rijnstate Hospital, Arnhem (The Netherlands): I. M. C. Janssen, E. J. Spillenaar-Bilgen, F. Berends

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COLOR Study Group Impact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer. Surg Endosc 19, 687–692 (2005). https://doi.org/10.1007/s00464-004-8920-z

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  • DOI: https://doi.org/10.1007/s00464-004-8920-z

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