Effect of Centralization on Surgical Outcome of Children Operated for Liver Tumors in Switzerland: A Retrospective Comparative Study.
centralization
complications
hepatic
oncology
pediatric
relapses
surgery
Journal
Children (Basel, Switzerland)
ISSN: 2227-9067
Titre abrégé: Children (Basel)
Pays: Switzerland
ID NLM: 101648936
Informations de publication
Date de publication:
06 Feb 2022
06 Feb 2022
Historique:
received:
26
12
2021
revised:
18
01
2022
accepted:
01
02
2022
entrez:
25
2
2022
pubmed:
26
2
2022
medline:
26
2
2022
Statut:
epublish
Résumé
Pediatric liver surgery is complex, and complications are not uncommon. Centralization of highly specialized surgery has been shown to improve quality of care. In 2012, pediatric liver surgery was centralized in Switzerland in one national center. This study analyses results before and after centralization. Retrospective monocentric comparative study. Analysis of medical records of children (0-16 years) operated for any liver tumor between 1 January 2001 and 31 December 2020. Forty-one patients were included: 14 before centralization (before 1 January 2012) and 27 after centralization (after 1 January 2012). Epidemiological, pre-, intra-, and post-operative data were collected. Fischer's exact and The two cohorts were homogeneous. Operating time was reduced, although not significantly, from 366 to 277 min. Length of postoperative stay and mortality were not statistically different between groups. Yet, after centralization, overall postoperative complication rate decreased significantly from 57% to 15% ( Centralization of the surgical management of liver tumors in Switzerland has improved quality of care in our center by significantly reducing postoperative complications and hepatic recurrence.
Sections du résumé
BACKGROUND
BACKGROUND
Pediatric liver surgery is complex, and complications are not uncommon. Centralization of highly specialized surgery has been shown to improve quality of care. In 2012, pediatric liver surgery was centralized in Switzerland in one national center. This study analyses results before and after centralization.
METHODS
METHODS
Retrospective monocentric comparative study. Analysis of medical records of children (0-16 years) operated for any liver tumor between 1 January 2001 and 31 December 2020. Forty-one patients were included: 14 before centralization (before 1 January 2012) and 27 after centralization (after 1 January 2012). Epidemiological, pre-, intra-, and post-operative data were collected. Fischer's exact and
RESULTS
RESULTS
The two cohorts were homogeneous. Operating time was reduced, although not significantly, from 366 to 277 min. Length of postoperative stay and mortality were not statistically different between groups. Yet, after centralization, overall postoperative complication rate decreased significantly from 57% to 15% (
CONCLUSION
CONCLUSIONS
Centralization of the surgical management of liver tumors in Switzerland has improved quality of care in our center by significantly reducing postoperative complications and hepatic recurrence.
Identifiants
pubmed: 35204937
pii: children9020217
doi: 10.3390/children9020217
pmc: PMC8870146
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Cancer Imaging. 2009 Oct 02;9 Spec No A:S98-S103
pubmed: 19965302
PLoS One. 2016 Mar 07;11(3):e0150782
pubmed: 26950852
Scand J Gastroenterol. 2012 Jan;47(1):99-107
pubmed: 22171974
Pediatr Cardiol. 2000 Jul-Aug;21(4):353-7
pubmed: 10865012
Eur J Surg Oncol. 2010 Sep;36 Suppl 1:S55-63
pubmed: 20615649
PLoS One. 2022 Jan 13;17(1):e0261729
pubmed: 35025887
J Pediatr Surg. 2022 Feb;57(2):178-181
pubmed: 34836641
J Pediatr Surg. 2011 Sep;46(9):1689-94
pubmed: 21929975
Ann Surg. 2018 Nov;268(5):712-724
pubmed: 30169394
Cochrane Database Syst Rev. 2012 Mar 14;(3):CD005391
pubmed: 22419309
Med Pediatr Oncol. 1990;18(2):103-9
pubmed: 2154662
J Am Coll Surg. 1998 May;186(5):501-6
pubmed: 9583689
Surgery. 2022 Jan 13;:
pubmed: 35034796
Front Surg. 2021 Jul 21;8:708351
pubmed: 34368218
Eur J Pediatr Surg. 2017 Oct;27(5):416-421
pubmed: 28946167
Clin Liver Dis. 2018 Nov;22(4):753-772
pubmed: 30266161
J Gastrointest Surg. 2019 Oct;23(10):2081-2092
pubmed: 31037503
Hepatology. 2003 Sep;38(3):560-6
pubmed: 12939582
Dig Surg. 2012;29(5):374-83
pubmed: 23128369
J Pediatr Gastroenterol Nutr. 2008 Mar;46(3):299-307
pubmed: 18376248
Surg Oncol. 2007 Nov;16(3):195-203
pubmed: 17714939
J Pediatr Surg. 2007 Nov;42(11):1797-803
pubmed: 18022426
Eur J Pediatr Surg. 2017 Oct;27(5):407-409
pubmed: 28958097
Liver Transpl. 2008 Nov;14(11):1545-56
pubmed: 18975283
Can Urol Assoc J. 2020 Apr;14(4):91-96
pubmed: 31702550
J Clin Oncol. 2019 Dec 1;37(34):3234-3242
pubmed: 31251691
Eur J Pediatr Surg. 2017 Oct;27(5):429-430
pubmed: 28910832