ArticleBJS open2020
Nationwide in-hospital mortality rate following rectal resection for rectal cancer according to annual hospital volume in Germany.
Article in BJS open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Volume-outcome relationship in corrective surgery for Hirschsprung's disease: a systematic literature review of direct evidence and an overview of indirect evidence.Pediatric surgery international · 2025Pooled it
- Trial
- How aging may impact the failure to rescue after colorectal laparoscopic surgery. Analysis of 1000 patients in a single high-volume center.Updates in surgery · 2025Article
- Impacts of COVID-19 pandemic on short-term outcomes of low anterior resection performed in hospitals with different surgical volumes.Annals of gastroenterological surgery · 2025Article
- The effects of endoscopic vacuum therapy for non-operative treatment of anastomotic leakage on oncological outcomes in rectal cancer patients.Langenbeck's archives of surgery · 2025Article
- The Impact of COVID-19 Pandemic on the Diagnosis, Treatment, and Outcomes of Colorectal Cancer in Singapore.Medicina (Kaunas, Lithuania) · 2025Article
- C-reactive protein-to-albumin ratio as a risk factor for anastomotic leakage after anterior resection for rectal cancer with intraoperative use of indocyanine green fluorescence imaging.Surgical endoscopy · 2024Article
- Availability in ECMO Reduces the Failure to Rescue in Patients With Pulmonary Embolism After Major Surgery: A Nationwide Analysis of 2.4 Million Cases.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Article
- Article
- Rectal cancer surgery: does low volume imply worse outcome-a single surgeon experience.Irish journal of medical science · 2023Article
- [Robot-assisted visceral surgery in Germany : Analysis of the current status and trends of the last 5 years using data from the StuDoQ|Robotics registry].Chirurgie (Heidelberg, Germany) · 2023Article
- Nationwide volume-outcome relationship concerning in-hospital mortality and failure-to-rescue in surgery of sigmoid diverticulitis.International journal of colorectal disease · 2023Article
- Determining the optimal interval between neoadjuvant radiochemotherapy and surgery in rectal cancer: a retrospective cohort study.International journal of colorectal disease · 2023Article
- Endoscopic vacuum-assisted closure therapy for leakage of the lower gastrointestinal tract: multicenter experiences.Endoscopy international open · 2023Article
- [Robot-assisted rectal resections-Scoping review for level 1a evidence and retrospective analysis of in-clinic data].Chirurgie (Heidelberg, Germany) · 2023Article
- Disproportionately high failure to rescue rates after resection for colorectal cancer in the geriatric patient population - A nationwide study.Cancer medicine · 2022Article
- Differences in morbidity and mortality between unilateral adrenalectomy for adrenal Cushing's syndrome and bilateral adrenalectomy for therapy refractory extra-adrenal Cushing's syndrome.Langenbeck's archives of surgery · 2022Article
- Laparoscopic surgery for colorectal cancer in an elderly population with high comorbidity: a single centre experience.International journal of colorectal disease · 2022Article
- What underlies the observed hospital volume-outcome relationship?BMC health services research · 2022Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of hospital volume after rectal cancer surgery is seldom investigated. This study aimed to analyse the impact of annual rectal cancer surgery cases per hospital on postoperative mortality and failure to rescue.
methodsAll patients diagnosed with rectal cancer and who had a rectal resection procedure code from 2012 to 2015 were identified from nationwide administrative hospital data. Hospitals were grouped into five quintiles according to caseload. The absolute number of patients, postoperative deaths and failure to rescue (defined as in-hospital mortality after a documented postoperative complication) for severe postoperative complications were determined.
resultsSome 64 349 patients were identified. The overall in-house mortality rate was 3·9 per cent. The crude in-hospital mortality rate ranged from 5·3 per cent in very low-volume hospitals to 2·6 per cent in very high-volume centres, with a distinct trend between volume categories (P < 0·001). In multivariable logistic regression analysis using hospital volume as random effect, very high-volume hospitals (53 interventions/year) had a risk-adjusted odds ratio of 0·58 (95 per cent c.i. 0·47 to 0·73), compared with the baseline in-house mortality rate in very low-volume hospitals (6 interventions per year) (P < 0·001). The overall postoperative complication rate was comparable between different volume quintiles, but failure to rescue decreased significantly with increasing caseload (15·6 per cent after pulmonary embolism in the highest volume quintile versus 38 per cent in the lowest quintile; P = 0·010).
conclusionPatients who had rectal cancer surgery in high-volume hospitals showed better outcomes and reduced failure to rescue rates for severe complications than those treated in low-volume hospitals.
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