Defining Benchmark Outcomes for Distal ...
Document type :
Article dans une revue scientifique
Title :
Defining Benchmark Outcomes for Distal Pancreatectomy: Results of a French Multicentric Study.
Author(s) :
Durin, Thibault [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Marchese, Ugo [Auteur]
Institut Paoli-Calmettes [IPC]
Sauvanet, Alain [Auteur]
Service de chirurgie hepato-pancreato-biliaire
Dokmak, Safi [Auteur]
Hôpital Beaujon [AP-HP]
Cherkaoui, Zineb [Auteur]
Institut de Recherche sur les Maladies Virales et Hépatiques [IVH]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Fuks, David [Auteur]
Université Paris Cité [UPCité]
Laurent, Christophe [Auteur]
Institut des Sciences de la Terre [ISTerre]
André, Marie [Auteur]
Unité de Recherche Œnologie [Villenave d'Ornon] [OENO]
Institut des Sciences de la Vigne et du Vin [Villenave d'Ornon] [ISVV]
Ayav, Ahmet [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Magallon, Cloe [Auteur]
Turrini, Olivier [Auteur]
Centre de Recherche en Cancérologie de Marseille [CRCM]
Institut Paoli-Calmettes [IPC]
Sulpice, Laurent [Auteur]
Oncogenesis, Stress, Signaling [OSS]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Robin, Fabien [Auteur]
Oncogenesis, Stress, Signaling [OSS]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Bachellier, Philippe [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Addeo, Piettro [Auteur]
Souche, François-Régis [Auteur]
Bardol, Thomas [Auteur]
Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi]
Perinel, Julie [Auteur]
Centre hépato-biliaire [CHB]
Adham, Mustapha [Auteur]
Hôpital de la Croix-Rousse [CHU - HCL]
Tzedakis, Stylianos [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Birnbaum, David Jérémie [Auteur]
Facy, Olivier [Auteur]
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand [CHU Dijon]
Gagniere, Johan [Auteur]
Centre d'Investigation Clinique [CHU Clermont-Ferrand] [CIC 1405]
Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte [M2iSH]
Gaujoux, Sébastien [Auteur]
Tribillon, Ecoline [Auteur]
Roussel, Edouard [Auteur]
Hôpital Charles Nicolle [Rouen]
Schwarz, Lilian [Auteur]
Service de Chirurgie Digestive [CHU Rouen]
Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques [GPMCND]
Barbier, Louise [Auteur]
CHU Trousseau [Tours]
Doussot, Alexandre [Auteur]
Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon]
Regenet, Nicolas [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Iannelli, Antonio [Auteur]
Centre méditerranéen de médecine moléculaire [C3M]
Hôpital l'Archet
Regimbeau, Jean-Marc [Auteur]
Chirurgie digestive [CHU Amiens]
Simplification des soins chez les patients complexes - UR UPJV 7518 [SSPC]
Piessen, Guillaume [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lenne, Xavier [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Truant, Stéphanie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
El Amrani, Mehdi [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Marchese, Ugo [Auteur]
Institut Paoli-Calmettes [IPC]
Sauvanet, Alain [Auteur]
Service de chirurgie hepato-pancreato-biliaire
Dokmak, Safi [Auteur]
Hôpital Beaujon [AP-HP]
Cherkaoui, Zineb [Auteur]
Institut de Recherche sur les Maladies Virales et Hépatiques [IVH]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Fuks, David [Auteur]
Université Paris Cité [UPCité]
Laurent, Christophe [Auteur]
Institut des Sciences de la Terre [ISTerre]
André, Marie [Auteur]
Unité de Recherche Œnologie [Villenave d'Ornon] [OENO]
Institut des Sciences de la Vigne et du Vin [Villenave d'Ornon] [ISVV]
Ayav, Ahmet [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Magallon, Cloe [Auteur]
Turrini, Olivier [Auteur]
Centre de Recherche en Cancérologie de Marseille [CRCM]
Institut Paoli-Calmettes [IPC]
Sulpice, Laurent [Auteur]
Oncogenesis, Stress, Signaling [OSS]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Robin, Fabien [Auteur]
Oncogenesis, Stress, Signaling [OSS]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Bachellier, Philippe [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Addeo, Piettro [Auteur]
Souche, François-Régis [Auteur]
Bardol, Thomas [Auteur]
Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi]
Perinel, Julie [Auteur]
Centre hépato-biliaire [CHB]
Adham, Mustapha [Auteur]
Hôpital de la Croix-Rousse [CHU - HCL]
Tzedakis, Stylianos [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Birnbaum, David Jérémie [Auteur]
Facy, Olivier [Auteur]
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand [CHU Dijon]
Gagniere, Johan [Auteur]
Centre d'Investigation Clinique [CHU Clermont-Ferrand] [CIC 1405]
Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte [M2iSH]
Gaujoux, Sébastien [Auteur]
Tribillon, Ecoline [Auteur]
Roussel, Edouard [Auteur]
Hôpital Charles Nicolle [Rouen]
Schwarz, Lilian [Auteur]
Service de Chirurgie Digestive [CHU Rouen]
Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques [GPMCND]
Barbier, Louise [Auteur]
CHU Trousseau [Tours]
Doussot, Alexandre [Auteur]
Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon]
Regenet, Nicolas [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Iannelli, Antonio [Auteur]
Centre méditerranéen de médecine moléculaire [C3M]
Hôpital l'Archet
Regimbeau, Jean-Marc [Auteur]
Chirurgie digestive [CHU Amiens]
Simplification des soins chez les patients complexes - UR UPJV 7518 [SSPC]
Piessen, Guillaume [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lenne, Xavier [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Truant, Stéphanie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
El Amrani, Mehdi [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Journal title :
Annals of Surgery
Publisher :
Lippincott, Williams & Wilkins
Publication date :
2022
ISSN :
0003-4932
HAL domain(s) :
Sciences du Vivant [q-bio]/Médecine humaine et pathologie
English abstract : [en]
OBJECTIVE: Defining robust and standardized outcome references for distal pancreatectomy (DP) by using Benchmark analysis. BACKGROUND: Outcomes after DP are recorded in medium or small-sized studies without standardized ...
Show more >OBJECTIVE: Defining robust and standardized outcome references for distal pancreatectomy (DP) by using Benchmark analysis. BACKGROUND: Outcomes after DP are recorded in medium or small-sized studies without standardized analysis. Therefore, the best results remain uncertain. METHODS: This multicenter study included all patients undergoing DP for resectable benign or malignant tumors in 21 French expert centers in pancreas surgery from 2014 to 2018. A low-risk cohort defined by no significant comorbidities was analyzed to establish 18 outcome benchmarks for DP. These values were tested in high-risk, minimally invasive and benign tumor cohorts. RESULTS: 1188 patients were identified and 749 low-risk patients were screened to establish Benchmark cut-offs. Therefore, Benchmark rate for mini-invasive approach was ≥q36.8%. Benchmark cut-offs for postoperative mortality, major morbidity grade ≥q3a and clinically significant pancreatic fistula rates were 0%, ≤q27% and ≤q28%, respectively. The benchmark rate for readmission was ≤q 16%. For patients with pancreatic adenocarcinoma, cut-offs were ≥q75%, ≥q69.5% and ≥q66% for free resection margins (R0), 1-year disease free-survival and 3-year overall survival, respectively. The rate of mini-invasive approach in high-risk cohort was lower than the Benchmark cut-off (34.1% vs. ≥q36.8%). All Benchmark cut-offs were respected for benign tumor group. The proportion of benchmark cases was correlated to outcomes of DP. Centers with a majority of low-risk patients had worse results than those operating complex cases. CONCLUSION: This large-scale study is the first benchmark analysis of DP outcomes and provides robust and standardized data. This may allow for comparisons between surgeons, centers, studies, and surgical techniques.Show less >
Show more >OBJECTIVE: Defining robust and standardized outcome references for distal pancreatectomy (DP) by using Benchmark analysis. BACKGROUND: Outcomes after DP are recorded in medium or small-sized studies without standardized analysis. Therefore, the best results remain uncertain. METHODS: This multicenter study included all patients undergoing DP for resectable benign or malignant tumors in 21 French expert centers in pancreas surgery from 2014 to 2018. A low-risk cohort defined by no significant comorbidities was analyzed to establish 18 outcome benchmarks for DP. These values were tested in high-risk, minimally invasive and benign tumor cohorts. RESULTS: 1188 patients were identified and 749 low-risk patients were screened to establish Benchmark cut-offs. Therefore, Benchmark rate for mini-invasive approach was ≥q36.8%. Benchmark cut-offs for postoperative mortality, major morbidity grade ≥q3a and clinically significant pancreatic fistula rates were 0%, ≤q27% and ≤q28%, respectively. The benchmark rate for readmission was ≤q 16%. For patients with pancreatic adenocarcinoma, cut-offs were ≥q75%, ≥q69.5% and ≥q66% for free resection margins (R0), 1-year disease free-survival and 3-year overall survival, respectively. The rate of mini-invasive approach in high-risk cohort was lower than the Benchmark cut-off (34.1% vs. ≥q36.8%). All Benchmark cut-offs were respected for benign tumor group. The proportion of benchmark cases was correlated to outcomes of DP. Centers with a majority of low-risk patients had worse results than those operating complex cases. CONCLUSION: This large-scale study is the first benchmark analysis of DP outcomes and provides robust and standardized data. This may allow for comparisons between surgeons, centers, studies, and surgical techniques.Show less >
Language :
Anglais
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Collections :
Source :