Hospital volume as a surrogate for laparoscopically assisted colectomy

Abstract

Socioeconomic differences appear to exist between high- and low-volume hospitals in the use of laparoscopy. High hospital volume is associated with an increased likelihood that colectomy will be performed with laparoscopy.

From evidence to a day-to-day laparoscopic colectomy

“…Singla et al [2] concluded that socioeconomic differences appear to exist between high-and low-volume hospitals in the use of laparoscopy in the United States and that laparoscopic colectomy is more often performed in highvolume hospitals. Although the study by Singla et al [2] is limited by its retrospective nature, the proportion of laparoscopic colectomy in the United States still is small even in high-volume hospitals.…”

“…In the study by Singla et al [2], overall, only 8,407 of colon resections (4%) were performed using laparoscopy. The authors found that high-volume hospitals used laparoscopy more often than low-volume hospitals (5.2 vs. 3.4%).…”

“…This question about laparoscopic colectomy in the United States is highlighted by Singla et al [2] in the March issue of Surgical Endoscopy.…”

“…Although Singla et al [2] in their report do not provide precise data on the benign or malignant type of the disease, most colon resections are performed because of colon cancer. Over recent decades, open surgery has been standardized, including adequate resection of the primary tumor and regional lymph nodes, resulting in complete resection with no macroscopic or microscopic evidence of residual tumor (R0 resection).…”

“…Although the study by Singla et al [2] is limited by its retrospective nature, the proportion of laparoscopic colectomy in the United States still is small even in high-volume hospitals. Safe and effective laparoscopic colectomy for cancer requires a R0 for both primary tumor and regional lymph nodes, which is time consuming and requires high-volume surgeons with expertise in laparoscopic technique.…”