Lobectomy for Lung Cancer at Veterans Administration Medical Center Versus Academic Medical Center

Abstract

Keeping surgeon experience constant, and after adjusting for patient factors, the rate of major complication after lobectomy is higher at VAMC. The difference is largely attributable to a higher rate of postoperative pneumonia at VAMC. Complications after pulmonary resection at VAMC could be reduced by implementing quality improvement initiatives aimed at reducing the rate of postoperative pneumonia.

Reintervention and Survival After Limited Lung Resection for Lung Cancer Treatment in Australia

“…The inverse association between hospital volume and reintervention observed in our study was consistent with previous reports showing better survival outcomes and lower rate of postoperative complications among patients undergoing resection at high-volume compared with low-volume hospitals [9]. The rationale for this observed association could be the availability of multidisciplinary teams in high-volume hospitals, and the high surgical volume could be a surrogate measure for surgeon specialization [22]. Reintervention could be related to a number of factors.…”

“…However, this study has some limitations. The hospital data do not capture all possible factors associated with reintervention, including preoperative and perioperative care and surgeon volumes [22]. In addition, the lack of longitudinal data on patient's health status as well as tumor type and cancer staging further limited comparisons between individual patients as well as between hospitals.…”

Uptake of Video-Assisted Thoracoscopic Lung Resections Within the Veterans Affairs for Known or Suspected Lung Cancer

“…Veterans are more likely to develop lung cancer than the general public . Population-based studies from Pennsylvania and the Pacific Northwest and other preliminary reports suggest that lung cancer–specific mortality is also higher in veterans. Overall survival after curative-intent therapy for lung cancer among veterans has improved since 2001; however, to our knowledge, the reasons for this have yet to be explored and are likely multifactorial …”

Balancing the Benefits and Harms of Lung Cancer Screening

“…Comparing lobectomy by muscle-sparing thoracotomy performed at an academic medical center vs a Veterans Affairs Medical Center by the same surgeon revealed a complication rate of 30.9% vs 44.4%, respectively. 9 The difference was attributed to differences in perioperative care and rates of postoperative pneumonia.…”