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Table of Contents
Vol. 26, No. 5, 2009
Issue release date: December 2009
Section title: Original Paper
Dig Surg 2009;26:422–429
(DOI:10.1159/000236904)

Hospital Volume and Quality of Laparoscopic Gastrectomy in Japan

Kuwabara K. · Matsuda S. · Fushimi K. · Ishikawa K.B. · Horiguchi H. · Fujimori K.
aDepartment of Health Care Administration and Management, Kyushu University, Graduate School of Medical Sciences, Fukuoka, bUniversity of Occupational and Environmental Health, Kitakyushu, cTokyo Medical and Dental University, dNational Cancer Center, eTokyo University Graduate School of Medicine, Tokyo, and fHokkaido University, Sapporo, Japan

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 5/13/2009
Accepted: 8/29/2009
Published online: 11/13/2009

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 3

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU

Abstract

Background: Laparoscopic gastrectomy (LG) has become the prevailing surgery of choice for gastric cancer, but the impact of hospital volume or operating room (OR) time has not been evaluated. An observational study was conducted to assess the quality of LG based on hospital volume and OR time. Methods: 3,054 LG patients were enrolled in 420 hospitals throughout Japan. Analyzed variables included patient demographics, complications, use of stapling devices or chemotherapy, hospital volume, and teaching status. Hospitals were categorized into high- (≥4 LG per month), intermediate- (1–3) and low- (<1) volume hospitals. Multivariate analysis was used to measure hospital volume and OR time impact. Results: 259 laparoscopic total gastrectomies (LTGs) were performed. Complications were observed in 269 cases (8.8%). High-volume hospitals treated less severe cases. OR time, but not hospital volume, was associated with complications. Hospital volume, teaching status and stapling devices explained variations in OR time. Conclusion: OR time was a more significant predictor of complications than hospital volume. OR time was consumed more in the employment of stapling devices and LTG. To promote LG efficiency, training curricula highlighting the applicability of these techniques should be considered by clinical experts.


  

Author Contacts

Kazuaki Kuwabara MD, MPH, DPH
Kyushu University, Graduate School of Medical Sciences
Department of Health Care Administration and Management
3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)
Tel. +81 92 642 6956, Fax +81 92 642 6961, E-Mail kazu228@basil.ocn.ne.jp

  

Article Information

Received: May 13, 2009
Accepted· August 29, 2009
Published online: November 13, 2009
Number of Print Pages : 8
Number of Figures : 1, Number of Tables : 3, Number of References : 24

  

Publication Details

Digestive Surgery

Vol. 26, No. 5, Year 2009 (Cover Date: December 2009)

Journal Editor: Büchler M.W. (Heidelberg), Neoptolemos J.P. (Liverpool)
ISSN: 0253-4886 (Print), eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 5/13/2009
Accepted: 8/29/2009
Published online: 11/13/2009

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 3

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


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