Abstract
inverse relationship between intervention volume and complications of esophagectomy and pancreatectomy. a review background: The prevalence of pancreatic cancer increased in Chile in the last decade, while that of esophageal cancer is decreasing. Both diseases are a surgical challenge due to their high mortality and rate of complications. aim: To analyze the relationship between intervention volume and surgical complications. material and methods : We reviewed 19 papers analyzing the relationship between the number of interventions performed in a determinate hospital (yearly hospital volume), the number of interventions performed by each surgeon (yearly surgical volume) and the rates of mortality and complications of both conditions. results: There is a clear inverse relationship between volumes and complications. There is also a higher five years survival in high volume hospitals. conclusions: Intervention volume is inversely associated with rates
Highlights
The prevalence of pancreatic cancer increased in Chile in the last decade, while that of esophageal cancer is decreasing
Material and Methods: We reviewed 19 papers analyzing the relationship between the number of interventions performed in a determinate hospital (yearly hospital volume), the number of interventions performed by each surgeon (yearly surgical volume) and the rates of mortality and complications of both conditions
Long-term survival is superior after resection for cancer in high-volume centers
Summary
The prevalence of pancreatic cancer increased in Chile in the last decade, while that of esophageal cancer is decreasing. Dos entidades que representan este problema son, por un lado el cáncer esofágico, el que se encuentra entre las 10 principales causas de mortalidad por cáncer a nivel mundial, con un pronóstico extremadamente ominoso, constituyendo la esofaguectomía una parte del tratamiento multimodal de esta patología[2], siendo realizada comúnmente en pacientes de alto riesgo y añosos, con múltiples comorbilidades cardiopulmonares y nutricionales; el éxito de la esofaguectomía depende de la presencia de un equipo quirúrgico experimentado que trabaje en el contexto de un programa multidisciplinario bien estructurado. Estudios poblacionales de gran volumen sugieren una mortalidad considerablemente más alta, particularmente en hospitales con baja experiencia en este procedimiento[3], demostrando de esta manera la relación inversamente proporcional entre la mortalidad operatoria y el volumen de casos por hospital. El objetivo de esta revisión es analizar la relación entre el volumen quirúrgico y los resultados operatorios en la esofaguectomía y la pancreato duodenectomía, dando una visión crítica al estado actual de esta situación en nuestro país
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