Abstract
Background
Population-based data on the early postoperative outcome after surgery for gastric
cancer are very sparse. We examined the development in the quality of surgery and
early postoperative outcomes in Denmark following centralization of gastric cancer
surgery and implementation of national clinical guidelines.
Methods
All patients in Denmark who underwent resection with curative intent for gastric cancer
between 1st July 2003 and 31st December 2008 in one of five university hospitals were
registered in a national database. Data on surgical quality and mortality were obtained
from the database and compared with the results from the period before centralization
(1999–2003).
Results
A total of 416 patients underwent resection in the study period. The risk of anastomotic
leakages for the whole period was 5.0% (95%CI; 3.2–7.7) compared to 6.1% (95%CI; 4.3–8.6)
before centralization, whereas the 30-days hospital mortality was 2.4% (95%CI; 1.2–4.4)
compared to 8.2% (95%CI; 6.0–10.4) before centralization. In addition, the percentage
of patients with at least 15 lymph nodes removed increased during the study period
from 19 in 2003 to 76 in 2008.
Conclusions
Centralization of gastric cancer surgery in Denmark and implementation of national
clinical guidelines monitored by a national database was associated with improvements
in surgical quality and substantially lower in-hospital mortality.
Keywords
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Article info
Publication history
Accepted:
June 9,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
