論文

査読有り
2020年1月

Impact of certification status of the institute and surgeon on short-term outcomes after surgery for thoracic esophageal cancer: evaluation using data on 16,752 patients from the National Clinical Database in Japan.

Esophagus : official journal of the Japan Esophageal Society
  • Satoru Motoyama
  • Hiroyuki Yamamoto
  • Hiroaki Miyata
  • Masahiko Yano
  • Takushi Yasuda
  • Masaichi Ohira
  • Yoshiaki Kajiyama
  • Yasushi Toh
  • Masayuki Watanabe
  • Yoshihiro Kakeji
  • Yasuyuki Seto
  • Yuichiro Doki
  • Hisahiro Matsubara
  • 全て表示

17
1
開始ページ
41
終了ページ
49
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s10388-019-00694-9

BACKGROUND: In 2009, the Japan Esophageal Society (JES) established a system for certification of qualified surgeons as "Board Certified Esophageal Surgeons" (BCESs) or institutes as "Authorized Institutes for Board Certified Esophageal Surgeons" (AIBCESs). We examined the short-term outcomes after esophagectomy, taking into consideration the certifications statuses of the institutes and surgeons. METHODS: This study investigated patients who underwent esophagectomy for thoracic esophageal cancer and who were registered in the Japanese National Clinical Database (NCD) between 2015 and 2017. Using hierarchical multivariable logistic regression analysis adjusted for patient-level risk factors, we determined whether the institute's or surgeon's certification status had greater influence on surgery-related mortality or postoperative complications. RESULTS: Enrolled were 16,752 patients operated on at 854 institutes by 1879 surgeons. There were significant differences in the backgrounds and incidences of postoperative complications and surgery-related mortality rates between the 11,162 patients treated at AIBCESs and the 5590 treated at Non-AIBCESs (surgery-related mortality rates: 1.6% vs 2.8%). There were also differences between the 6854 patients operated on by a BCES and the 9898 treated by a Non-BCES (1.7% vs 2.2%). Hierarchical logistic regression analysis revealed that surgery-related mortality was significantly lower among patients treated at AIBCESs. The institute's certification had greater influence on short-term surgical outcomes than the operating surgeon's certification. CONCLUSIONS: The certification system for surgeons and institutes established by the JES appears to be appropriate, as indicated by the improved surgery-related mortality rate. It also appears that the JES certification system contributes to a more appropriate medical delivery system for thoracic esophageal cancer in Japan.

リンク情報
DOI
https://doi.org/10.1007/s10388-019-00694-9
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31583502
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6976551
ID情報
  • DOI : 10.1007/s10388-019-00694-9
  • ISSN : 1612-9059
  • PubMed ID : 31583502
  • PubMed Central 記事ID : PMC6976551

エクスポート
BibTeX RIS