Esophageal surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it

Paolo Parise, Ugo Elmore, Uberto Fumagalli, Giovanni De Manzoni, Simone Giacopuzzi, Riccardo Rosati

Research output: Contribution to journalArticlepeer-review

Abstract

Esophageal cancer incidence is rapidly increasing in the western countries. Adenocarcinoma has recently become the most frequent subtype because of the changes in lifestyle. As observed for other types of surgery, even for esophageal surgery better results have been observed in centers with high volume of activity. Countries with formal policies of centralization, as Great Britain and The Netherlands, have got lower mortality and longer survival than those obtained before the centralization program introduction and of those countries without centralization programs. However, concerns about accessibility to high volume hospitals for lower level social strata have emerged in different countries. In Italy most of the esophagectomies for cancer are performed in very low volume centers with limited experience. High volume centers with >20 cases/year are few but, even if managing patients with more severe comorbidities have got a lower mortality and a shorter length of stay. The Aim of this paper is to identify the organizational, structural and volume requirements for accreditation of a center as an esophageal surgery center. Special attention must be given to a multidisciplinary approach involving different highly skilled specialists with the creation of a multidisciplinary team and individualized diagnostic and therapeutic pathways.

Original languageEnglish
Pages (from-to)129-133
Number of pages5
JournalUpdates in Surgery
Volume68
Issue number2
DOIs
Publication statusPublished - Jun 1 2016

Keywords

  • Centralization
  • Esophageal cancer
  • Esophagectomy
  • High volume hospitals
  • Volume outcome

ASJC Scopus subject areas

  • Surgery

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