Oesophagectomy at a New Zealand regional centre: where to now?

Abstract

Oesophagectomy remains a challenging procedure for any institution, although good results can be achieved. Foci for referral are emerging in New Zealand for the surgical management of oesophageal cancer.

Safety and outcomes after oesophagectomy in southern New Zealand: a 25‐year audit of a low volume centre

“…Yuan et al . recently published a 5‐year audit from one of the busier New Zealand centres (Waitemata DHB), 17 with a slightly higher case load than the current study (seven resections per annum ). The mortality (5%) and morbidity outcomes (46%) were similar to those obtained by the current study.…”

“…The Waitemata group concluded that for productive debate around regionalization of oesophagectomy in New Zealand, ‘better regional and institutional outcome data is required and must guide service provision’ 17 . The present audit from the SDHB should address this concern, at least with respect to southern New Zealand.…”

“…The question of regionalization of oesophagectomy in New Zealand to high volume centres has been raised, 17 in line with the international trends towards this 22,23 . The NZ population is sparse and widely dispersed.…”

New Zealand surgeons mimic the All Blacks

“…In the current issue of the ANZ Journal of Surgery , there are five high‐quality reports from New Zealand that provide an insightful perspective into the current state of surgical practice in that country . This collection of manuscripts includes two articles from the North Shore Hospital in Auckland assessing outcomes from pancreatic surgery and an audit of oesophageal resections for adenocarcinoma, a review of surgical treatment of early stage breast cancer in the Auckland and Waikato regions, a review of appendicectomies performed at Wellington Hospital and an exploration of attitudes to bariatric surgery amongst the New Zealand population from the University of Auckland…”

“…First, it is evident that the process of specialization of surgical practice is continuing to occur in New Zealand with regional health services, such as in Auckland, progressing along the pathway of developing centres of excellence and sub‐specializing in key areas of surgical management, such as pancreatic resection surgery and oesophageal resections. In the two manuscripts authored by Koea and co‐authors from the upper gastrointestinal unit in Auckland, it is noted that the North Shore Hospital, which is sited within the Waitemata DHB, performs one‐sixth of New Zealand’s annual volume of pancreatic resections and one‐sixth of New Zealand’s annual volume of oesophagectomies . This would suggest that there has been a considerable centralization of surgical services in this northern district, which is entirely appropriate for these types of very specialized areas of surgical intervention.…”