Oesophagectomy practice and outcomes in England

摘要: Background: The 2001 UK National Health Service guidance on improving outcomes recommended centralization of oesophageal resection. The aim this study was to analyse national trends in resection England determine whether has occurred and its impact outcomes. Methods: The used data from Hospital Episode Statistics for 1997–1998 2003–2004 included patients who had cancer. annual hospital volume grouped into five categories based the recommendation a designated centre. Results: A total 11 838 resections were performed. number hospitals performing decreased, mainly owing fall very low-volume (117 1997 45 2003). proportion performed high-volume increased 17·8 per cent during 1997–1999 21·9 2002–2003 (P < 0·001). overall in-hospital mortality rate 10·1 cent, with significant reduction over time (from 11·7 7·6 cent; P decline may be due numbers undergoing surgery higher-volume hospitals. There an increase new 5672 6230 study, although 31·5 26·0 0·001). Conclusion: Centralization multidisciplinary team expertise partly explain improvement rate, but changes preoperative selection also play part. Copyright © 2007 British Journal Surgery Society Ltd. Published by John Wiley & Sons,