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首页> 外文期刊>Surgical Endoscopy >With widespread adoption of MIS colectomy for colon cancer, does hospital type matter?
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With widespread adoption of MIS colectomy for colon cancer, does hospital type matter?

机译：随着癌症癌症的广泛采用，医院型是否有疑问？

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BackgroundRecent studies have shown that hospital type impacts patient outcomes, but no studies have examined hospital differences in outcomes for patients undergoing minimally invasive surgery (MIS) for segmental colectomies.MethodsThe 2010-2014 National Cancer Data Base was queried for patients undergoing segmental colectomy for non-metastatic colon adenocarcinoma. Descriptive statistics characterized MIS utilization by hospital type. Multivariable models were used to examine the effect of hospital type on outcomes after MIS. Survival probability was plotted using the Kaplan-Meier method.Results80,922 patients underwent MIS segmental colectomy for colon cancer from 2010 to 2014. From 2010 to 2014, the number of MIS segmental colectomies increased by 157% at academic hospitals, 151% at comprehensive hospitals, and 153% at community hospitals. Compared to academic hospitals, community and comprehensive hospitals had greater adjusted odds of positive margins (Community OR 1.525, 95% Confidence Interval 1.233-1.885; Comprehensive OR 1.216, 95% CI 1.041-1.42), incomplete number of lymph nodes analyzed (12 LNs) from surgery (Community OR 2.15, 95% CI 1.98-2.32; Comprehensive OR 1.42, 95% CI 1.34-1.51), and greater 30-day mortality (Community OR 1.43, 95% CI 1.14-1.78; Comprehensive OR 1.36, 95% CI 1.17-1.59). Patient survival probability was higher at academic hospitals at 5years (Academic 69% vs. Comprehensive 66% vs. Community 63%, p0.001). Community hospitals and comprehensive hospitals had significantly higher risk of adjusted long-term mortality (Community HR 1.28; 95% CI 1.19-1.37; p0.001; Comprehensive HR 1.14; 95% CI 1.09-1.20; p0.001).ConclusionsDespite widespread use of laparoscopic oncologic surgery, short- and long-term outcomes from MIS for segmental colectomy are superior at academic hospitals. This difference may be due to superior perioperative oncologic technique and surgical outcomes at academic hospitals. Our data provide important information for patients, referring physicians, and surgeons about the significance of hospital type in management of colon cancer.
机译：背景技术已经表明，医院类型影响患者结果，但没有研究对经过微创手术（MIS）进行的患者进行了对节段性联合术的患者的医院差异。询问了对未经中间末端联合膜的患者进行全国癌症数据库。 - 促进结肠腺癌。描述性统计数据表征医院类型的MIS利用。多变量模型用于检查MIS后医院类型对结果的影响。生存概率采用Kaplan-Meier生存method.Results80,922患者进行绘制MIS段结肠结肠癌从2010年至2014年从2010年到2014年，MIS节段性结肠切除术的数量在全面的教学医院增加了157％，151％医院，社区医院的153％。与学术界医院相比，社区和综合医院的正距调整了较高的积极边距（社区或1.525,95％，置信区间1.233-1.885;全面或1.216,95％CI 1.041-1.42），分析的不完全淋巴结数（＆来自手术（社区或2.15,95％CI 1.98-2.32;全面或1.42,95％CI 1.34-1.51），且较大30天死亡率（社区或1.43,95％CI 1.14-1.78;全面或1.36 ，95％CI 1.17-1.59）。在5年的学术医院的患者存活概率较高（学术69％与综合66％与社区63％，P <0.001）。社区医院和综合医院的调整后的长期死亡率的风险显着更高（社区HR 1.28; 95％CI 1.19-1.37; P <0.001;综合HR 1.14; 95％CI 1.09-1.20; P <0.001）.ConclusionsDespite广泛使用腹腔镜肿瘤手术的腹腔镜肿瘤手术，短期术术的短期和长期成果在学术医院优越。这种差异可能是由于高级围手术期肿瘤技术和学术医院的手术结果。我们的数据为患者，参考医生和外科医生提供了关于医院类型在结肠癌管理中的重要性的重要信息。

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