ArticlePloS one2024
Association of hospital volume and operative approach with clinical and financial outcomes of elective esophagectomy in the United States.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Association between hospital volume and mortality after elective oesophageal cancer resection in Switzerland: a retrospective national registry study from 2013 to 2022.Langenbeck's archives of surgery · 2026Observational
- The Financial Argument for Centralization of Care for Esophagectomy.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Reproducibility and Consistency of Methods to Define Hospital-Level Procedural Volume Thresholds for Pancreatectomy.Journal of surgical oncology · 2026Article
- Summary of the ROMIO randomized-control trial comparing clinical, economic and patient-reported outcomes between open versus hybrid esophagectomy in the United Kingdom.Journal of thoracic disease · 2025Article
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionLiterature regarding the impact of esophagectomy approach on hospitalizations costs and short-term outcomes is limited. Moreover, few have examined how institutional MIS experience affects costs. We thus examined utilization trends, costs, and short-term outcomes of open and minimally invasive (MIS) esophagectomy as well as assessing the relationship between institutional MIS volume and hospitalization costs.
methodsAll adults undergoing elective esophagectomy were identified from the 2016-2020 Nationwide Readmissions Database. Multiple regression models were used to assess approach with costs, in-hospital mortality, and major complications. Additionally, annual hospital MIS esophagectomy volume was modeled as a restricted cubic spline against costs. Institutions performing > 16 cases/year corresponding with the inflection point were categorized as high-volume hospitals (HVH). We subsequently examined the association of HVH status with costs, in-hospital mortality, and major complications in patients undergoing minimally invasive esophagectomy.
resultsOf an estimated 29,116 patients meeting inclusion, 10,876 (37.4%) underwent MIS esophagectomy. MIS approaches were associated with $10,600 in increased incremental costs (95% CI 8,800-12,500), but lower odds of in-hospital mortality (AOR 0.76; 95% CI 0.61-0.96) or major complications (AOR 0.68; 95% CI 0.60, 0.77). Moreover, HVH status was associated with decreased adjusted costs, as well as lower odds of postoperative complications for patients undergoing MIS operations.
conclusionIn this nationwide study, MIS esophagectomy was associated with increased hospitalization costs, but improved short-term outcomes. In MIS operations, cost differences were mitigated by volume, as HVH status was linked with decreased costs in the setting of decreased odds of complications. Centralization of care to HVH centers should be considered as MIS approaches are increasingly utilized.
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