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Effect of Centralization on Surgical Outcome of Children Operated for Liver Tumors in Switzerland: A Retrospective Comparative Study

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 a...

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Autores principales: Leoni, Jasmine, Rougemont, Anne-Laure, Calinescu, Ana M., Ansari, Marc, Compagnon, Philippe, Wilde, Jim C. H., Wildhaber, Barbara E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870146/
https://www.ncbi.nlm.nih.gov/pubmed/35204937
http://dx.doi.org/10.3390/children9020217
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author Leoni, Jasmine
Rougemont, Anne-Laure
Calinescu, Ana M.
Ansari, Marc
Compagnon, Philippe
Wilde, Jim C. H.
Wildhaber, Barbara E.
author_facet Leoni, Jasmine
Rougemont, Anne-Laure
Calinescu, Ana M.
Ansari, Marc
Compagnon, Philippe
Wilde, Jim C. H.
Wildhaber, Barbara E.
author_sort Leoni, Jasmine
collection PubMed
description 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: 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 t-test were used to compare groups. 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% (p = 0.01), Clavien > III complications decreased from 50% to 7% (p < 0.01), and hepatic recurrences were also significantly reduced (40% to 5%, p = 0.03). Conclusion: 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.
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spelling pubmed-88701462022-02-25 Effect of Centralization on Surgical Outcome of Children Operated for Liver Tumors in Switzerland: A Retrospective Comparative Study Leoni, Jasmine Rougemont, Anne-Laure Calinescu, Ana M. Ansari, Marc Compagnon, Philippe Wilde, Jim C. H. Wildhaber, Barbara E. Children (Basel) Article 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: 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 t-test were used to compare groups. 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% (p = 0.01), Clavien > III complications decreased from 50% to 7% (p < 0.01), and hepatic recurrences were also significantly reduced (40% to 5%, p = 0.03). Conclusion: 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. MDPI 2022-02-06 /pmc/articles/PMC8870146/ /pubmed/35204937 http://dx.doi.org/10.3390/children9020217 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Leoni, Jasmine
Rougemont, Anne-Laure
Calinescu, Ana M.
Ansari, Marc
Compagnon, Philippe
Wilde, Jim C. H.
Wildhaber, Barbara E.
Effect of Centralization on Surgical Outcome of Children Operated for Liver Tumors in Switzerland: A Retrospective Comparative Study
title Effect of Centralization on Surgical Outcome of Children Operated for Liver Tumors in Switzerland: A Retrospective Comparative Study
title_full Effect of Centralization on Surgical Outcome of Children Operated for Liver Tumors in Switzerland: A Retrospective Comparative Study
title_fullStr Effect of Centralization on Surgical Outcome of Children Operated for Liver Tumors in Switzerland: A Retrospective Comparative Study
title_full_unstemmed Effect of Centralization on Surgical Outcome of Children Operated for Liver Tumors in Switzerland: A Retrospective Comparative Study
title_short Effect of Centralization on Surgical Outcome of Children Operated for Liver Tumors in Switzerland: A Retrospective Comparative Study
title_sort effect of centralization on surgical outcome of children operated for liver tumors in switzerland: a retrospective comparative study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870146/
https://www.ncbi.nlm.nih.gov/pubmed/35204937
http://dx.doi.org/10.3390/children9020217
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