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Erschienen in: Digestive Diseases and Sciences 12/2015

01.12.2015 | Review

Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery

verfasst von: Ines Gockel, Constantin Johannes Ahlbrand, Michael Arras, Elke Maria Schreiber, Hauke Lang

Erschienen in: Digestive Diseases and Sciences | Ausgabe 12/2015

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Abstract

Ranking systems and comparisons of quality and performance indicators will be of increasing relevance for complex “high-risk” procedures such as esophageal cancer surgery. The identification of evidence-based standards relevant for key performance indicators in esophageal surgery is essential for establishing monitoring systems and furthermore a requirement to enhance treatment quality. In the course of this review, we analyze the key performance indicators case volume, radicality of resection, and postoperative morbidity and mortality, leading to continuous quality improvement. Ranking systems established on this basis will gain increased relevance in highly complex procedures within the national and international comparison and furthermore improve the treatment of patients with esophageal carcinoma.
Fußnoten
1
R0: microscopic tumor-free resection margin, R1: microscopic positive resection margin, R2: macroscopic positive resection margin.
 
Literatur
3.
Zurück zum Zitat von Zglinicki T. Oxidative stress shortens telomeres. Trends Biochem Sci. 2002;27:339–344.CrossRef von Zglinicki T. Oxidative stress shortens telomeres. Trends Biochem Sci. 2002;27:339–344.CrossRef
4.
Zurück zum Zitat Goldstone J. The role of quality assurance versus continuous quality improvement. J Vasc Surg. 1998;28:378–380.CrossRefPubMed Goldstone J. The role of quality assurance versus continuous quality improvement. J Vasc Surg. 1998;28:378–380.CrossRefPubMed
5.
Zurück zum Zitat Hammermeister KE, Johnson R, Marshall G, Grover FL. Continuous assessment and improvement in quality of care. A model from the Department of Veterans Affairs Cardiac Surgery. Ann Surg. 1994;219:281–290.PubMedCentralCrossRefPubMed Hammermeister KE, Johnson R, Marshall G, Grover FL. Continuous assessment and improvement in quality of care. A model from the Department of Veterans Affairs Cardiac Surgery. Ann Surg. 1994;219:281–290.PubMedCentralCrossRefPubMed
10.
Zurück zum Zitat Markar SR, Karthikesalingam A, Thrumurthy S, Low DE. Volume-outcome relationship in surgery for esophageal malignancy: systematic review and meta-analysis 2000–2011. J Gastrointest Surg. 2012;16:1055–1063. doi:10.1007/s11605-011-1731-3.CrossRefPubMed Markar SR, Karthikesalingam A, Thrumurthy S, Low DE. Volume-outcome relationship in surgery for esophageal malignancy: systematic review and meta-analysis 2000–2011. J Gastrointest Surg. 2012;16:1055–1063. doi:10.​1007/​s11605-011-1731-3.CrossRefPubMed
11.
Zurück zum Zitat Wouters MW, Gooiker GA, van Sandick JW, Tollenaar RA. The volume-outcome relation in the surgical treatment of esophageal cancer: a systematic review and meta-analysis. Cancer. 2012;118:1754–1763. doi:10.1002/cncr.26383.CrossRefPubMed Wouters MW, Gooiker GA, van Sandick JW, Tollenaar RA. The volume-outcome relation in the surgical treatment of esophageal cancer: a systematic review and meta-analysis. Cancer. 2012;118:1754–1763. doi:10.​1002/​cncr.​26383.CrossRefPubMed
13.
Zurück zum Zitat Coupland VH, Lagergren J, Luchtenborg M, et al. Hospital volume, proportion resected and mortality from oesophageal and gastric cancer: a population-based study in England, 2004–2008. Gut. 2013;62:961–966. doi:10.1136/gutjnl-2012-303008.CrossRefPubMed Coupland VH, Lagergren J, Luchtenborg M, et al. Hospital volume, proportion resected and mortality from oesophageal and gastric cancer: a population-based study in England, 2004–2008. Gut. 2013;62:961–966. doi:10.​1136/​gutjnl-2012-303008.CrossRefPubMed
20.
Zurück zum Zitat Milstein A, Galvin RS, Delbanco SF, Salber P, Buck CR Jr. Improving the safety of health care: the leapfrog initiative. Eff Clin Pract. 2000;3:313–316.PubMed Milstein A, Galvin RS, Delbanco SF, Salber P, Buck CR Jr. Improving the safety of health care: the leapfrog initiative. Eff Clin Pract. 2000;3:313–316.PubMed
21.
23.
Zurück zum Zitat Jenkins GJ, Cronin J, Alhamdani A, et al. The bile acid deoxycholic acid has a non-linear dose response for DNA damage and possibly NF-kappaB activation in oesophageal cells, with a mechanism of action involving ROS. Mutagenesis. 2008;23:399–405. doi:10.1093/mutage/gen029.CrossRefPubMed Jenkins GJ, Cronin J, Alhamdani A, et al. The bile acid deoxycholic acid has a non-linear dose response for DNA damage and possibly NF-kappaB activation in oesophageal cells, with a mechanism of action involving ROS. Mutagenesis. 2008;23:399–405. doi:10.​1093/​mutage/​gen029.CrossRefPubMed
28.
Zurück zum Zitat Wouters MW, Krijnen P, Le Cessie S, et al. Volume- or outcome-based referral to improve quality of care for esophageal cancer surgery in The Netherlands. J Surg Oncol. 2009;99:481–487. doi:10.1002/jso.21191.CrossRefPubMed Wouters MW, Krijnen P, Le Cessie S, et al. Volume- or outcome-based referral to improve quality of care for esophageal cancer surgery in The Netherlands. J Surg Oncol. 2009;99:481–487. doi:10.​1002/​jso.​21191.CrossRefPubMed
29.
Zurück zum Zitat Dexter SP, Sue-Ling H, McMahon MJ, Quirke P, Mapstone N, Martin IG. Circumferential resection margin involvement: an independent predictor of survival following surgery for oesophageal cancer. Gut. 2001;48:667–670.PubMedCentralCrossRefPubMed Dexter SP, Sue-Ling H, McMahon MJ, Quirke P, Mapstone N, Martin IG. Circumferential resection margin involvement: an independent predictor of survival following surgery for oesophageal cancer. Gut. 2001;48:667–670.PubMedCentralCrossRefPubMed
32.
Zurück zum Zitat Law S, Arcilla C, Chu KM, Wong J. The significance of histologically infiltrated resection margin after esophagectomy for esophageal cancer. Am J Surg. 1998;176:286–290.CrossRefPubMed Law S, Arcilla C, Chu KM, Wong J. The significance of histologically infiltrated resection margin after esophagectomy for esophageal cancer. Am J Surg. 1998;176:286–290.CrossRefPubMed
33.
Zurück zum Zitat Sagar PM, Johnston D, McMahon MJ, Dixon MF, Quirke P. Significance of circumferential resection margin involvement after oesophagectomy for cancer. Br J Surg. 1993;80:1386–1388.CrossRefPubMed Sagar PM, Johnston D, McMahon MJ, Dixon MF, Quirke P. Significance of circumferential resection margin involvement after oesophagectomy for cancer. Br J Surg. 1993;80:1386–1388.CrossRefPubMed
35.
Zurück zum Zitat Sujendran V, Wheeler J, Baron R, Warren BF, Maynard N. Effect of neoadjuvant chemotherapy on circumferential margin positivity and its impact on prognosis in patients with resectable oesophageal cancer. Br J Surg. 2008;95:191–194. doi:10.1002/bjs.5983.CrossRefPubMed Sujendran V, Wheeler J, Baron R, Warren BF, Maynard N. Effect of neoadjuvant chemotherapy on circumferential margin positivity and its impact on prognosis in patients with resectable oesophageal cancer. Br J Surg. 2008;95:191–194. doi:10.​1002/​bjs.​5983.CrossRefPubMed
39.
40.
Zurück zum Zitat Schwarz RE, Smith DD. Clinical impact of lymphadenectomy extent in resectable esophageal cancer. J Gastrointest Surg. 2007;11:1384–1393; discussion 93–94. doi:10.1007/s11605-007-0264-2. Schwarz RE, Smith DD. Clinical impact of lymphadenectomy extent in resectable esophageal cancer. J Gastrointest Surg. 2007;11:1384–1393; discussion 93–94. doi:10.​1007/​s11605-007-0264-2.
41.
Zurück zum Zitat Courrech Staal EF, Aleman BM, Boot H, van Velthuysen ML, van Tinteren H, van Sandick JW. Systematic review of the benefits and risks of neoadjuvant chemoradiation for oesophageal cancer. Br J Surg. 2010;97:1482–1496. doi:10.1002/bjs.7175.CrossRefPubMed Courrech Staal EF, Aleman BM, Boot H, van Velthuysen ML, van Tinteren H, van Sandick JW. Systematic review of the benefits and risks of neoadjuvant chemoradiation for oesophageal cancer. Br J Surg. 2010;97:1482–1496. doi:10.​1002/​bjs.​7175.CrossRefPubMed
42.
Zurück zum Zitat Siewert JR, Stein HJ. Lymph-node dissection in squamous cell esophageal cancer—who benefits? Langenbecks Arch Surg. 1999;384:141–148.CrossRefPubMed Siewert JR, Stein HJ. Lymph-node dissection in squamous cell esophageal cancer—who benefits? Langenbecks Arch Surg. 1999;384:141–148.CrossRefPubMed
43.
Zurück zum Zitat Siewert JR, Stein HJ, Bottcher K. Lymphadenectomy in tumors of the upper gastrointestinal tract. Chirurg. 1996;67:877–888.CrossRefPubMed Siewert JR, Stein HJ, Bottcher K. Lymphadenectomy in tumors of the upper gastrointestinal tract. Chirurg. 1996;67:877–888.CrossRefPubMed
44.
45.
Zurück zum Zitat Nishihira T, Hirayama K, Mori S. A prospective randomized trial of extended cervical and superior mediastinal lymphadenectomy for carcinoma of the thoracic esophagus. Am J Surg. 1998;175:47–51.CrossRefPubMed Nishihira T, Hirayama K, Mori S. A prospective randomized trial of extended cervical and superior mediastinal lymphadenectomy for carcinoma of the thoracic esophagus. Am J Surg. 1998;175:47–51.CrossRefPubMed
49.
Zurück zum Zitat Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet. 2012;379:1887–1892. doi:10.1016/s0140-6736(12)60516-9.CrossRefPubMed Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet. 2012;379:1887–1892. doi:10.​1016/​s0140-6736(12)60516-9.CrossRefPubMed
50.
Zurück zum Zitat Bolger C, Walsh TN, Tanner WA, Keeling P, Hennessy TP. Chylothorax after oesophagectomy. Br J Surg. 1991;78:587–588.CrossRefPubMed Bolger C, Walsh TN, Tanner WA, Keeling P, Hennessy TP. Chylothorax after oesophagectomy. Br J Surg. 1991;78:587–588.CrossRefPubMed
53.
Zurück zum Zitat Hirai T, Yamashita Y, Mukaida H, Kuwahara M, Inoue H, Toge T. Poor prognosis in esophageal cancer patients with postoperative complications. Surg Today. 1998;28:576–579.CrossRefPubMed Hirai T, Yamashita Y, Mukaida H, Kuwahara M, Inoue H, Toge T. Poor prognosis in esophageal cancer patients with postoperative complications. Surg Today. 1998;28:576–579.CrossRefPubMed
54.
Zurück zum Zitat Kinugasa S, Tachibana M, Yoshimura H, et al. Postoperative pulmonary complications are associated with worse short- and long-term outcomes after extended esophagectomy. J Surg Oncol. 2004;88:71–77. doi:10.1002/jso.20137.CrossRefPubMed Kinugasa S, Tachibana M, Yoshimura H, et al. Postoperative pulmonary complications are associated with worse short- and long-term outcomes after extended esophagectomy. J Surg Oncol. 2004;88:71–77. doi:10.​1002/​jso.​20137.CrossRefPubMed
55.
Zurück zum Zitat Lagarde SM, de Boer JD, ten Kate FJ, Busch OR, Obertop H, van Lanschot JJ. Postoperative complications after esophagectomy for adenocarcinoma of the esophagus are related to timing of death due to recurrence. Ann Surg. 2008;247:71–76. doi:10.1097/SLA.0b013e31815b695e.CrossRefPubMed Lagarde SM, de Boer JD, ten Kate FJ, Busch OR, Obertop H, van Lanschot JJ. Postoperative complications after esophagectomy for adenocarcinoma of the esophagus are related to timing of death due to recurrence. Ann Surg. 2008;247:71–76. doi:10.​1097/​SLA.​0b013e31815b695e​.CrossRefPubMed
58.
Zurück zum Zitat Whooley BP, Law S, Murthy SC, Alexandrou A, Wong J. Analysis of reduced death and complication rates after esophageal resection. Ann Surg. 2001;233:338–344.PubMedCentralCrossRefPubMed Whooley BP, Law S, Murthy SC, Alexandrou A, Wong J. Analysis of reduced death and complication rates after esophageal resection. Ann Surg. 2001;233:338–344.PubMedCentralCrossRefPubMed
62.
64.
Zurück zum Zitat Freiman JA, Chalmers TC, Smith H Jr, Kuebler RR. The importance of beta, the type II error and sample size in the design and interpretation of the randomized control trial. Survey of 71 “negative” trials. N Engl J Med. 1978;299:690–694. doi:10.1056/nejm197809282991304.CrossRefPubMed Freiman JA, Chalmers TC, Smith H Jr, Kuebler RR. The importance of beta, the type II error and sample size in the design and interpretation of the randomized control trial. Survey of 71 “negative” trials. N Engl J Med. 1978;299:690–694. doi:10.​1056/​nejm197809282991​304.CrossRefPubMed
65.
Zurück zum Zitat van Gijn W, Wouters MW, Peeters KC, van de Velde CJ. Nationwide outcome registrations to improve quality of care in rectal surgery. An initiative of the European Society of Surgical Oncology. J Surg Oncol. 2009;99:491–496. doi:10.1002/jso.21203.CrossRefPubMed van Gijn W, Wouters MW, Peeters KC, van de Velde CJ. Nationwide outcome registrations to improve quality of care in rectal surgery. An initiative of the European Society of Surgical Oncology. J Surg Oncol. 2009;99:491–496. doi:10.​1002/​jso.​21203.CrossRefPubMed
66.
Zurück zum Zitat Trayhurn P, Wood IS. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr. 2004;92:347–355.CrossRefPubMed Trayhurn P, Wood IS. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr. 2004;92:347–355.CrossRefPubMed
68.
Zurück zum Zitat Harry M, Schroeder R. Six Sigma. Prozesse optimieren, Null-Fehler-Qualität schaffen, Rendite radikal steigern. Frankfurt am Main: Campus Verlag; 2000. Harry M, Schroeder R. Six Sigma. Prozesse optimieren, Null-Fehler-Qualität schaffen, Rendite radikal steigern. Frankfurt am Main: Campus Verlag; 2000.
70.
Zurück zum Zitat Iannettoni MD, Lynch WR, Parekh KR, McLaughlin KA. Kaizen method for esophagectomy patients: improved quality control, outcomes, and decreased costs. Ann Thorac Surg. 2011;91:1011–1017; discussion 7–8. doi:10.1016/j.athoracsur.2011.01.001. Iannettoni MD, Lynch WR, Parekh KR, McLaughlin KA. Kaizen method for esophagectomy patients: improved quality control, outcomes, and decreased costs. Ann Thorac Surg. 2011;91:1011–1017; discussion 7–8. doi:10.​1016/​j.​athoracsur.​2011.​01.​001.
71.
Zurück zum Zitat Schwarzbach M, Ronellenfitsch U. Klinikpfade in der Chirurgie: Ein Instrument für den Routinebetrieb? Dtsch Arztebl Int. 2008;105:2512. Schwarzbach M, Ronellenfitsch U. Klinikpfade in der Chirurgie: Ein Instrument für den Routinebetrieb? Dtsch Arztebl Int. 2008;105:2512.
72.
Zurück zum Zitat Low DE, Kunz S, Schembre D, et al. Esophagectomy—it’s not just about mortality anymore: standardized perioperative clinical pathways improve outcomes in patients with esophageal cancer. J Gastrointest Surg. 2007;11:1395–1402; discussion 402. doi:10.1007/s11605-007-0265-1. Low DE, Kunz S, Schembre D, et al. Esophagectomy—it’s not just about mortality anymore: standardized perioperative clinical pathways improve outcomes in patients with esophageal cancer. J Gastrointest Surg. 2007;11:1395–1402; discussion 402. doi:10.​1007/​s11605-007-0265-1.
73.
Zurück zum Zitat Munitiz V, Martinez-de-Haro LF, Ortiz A, Ruiz-de-Angulo D, Pastor P, Parrilla P. Effectiveness of a written clinical pathway for enhanced recovery after transthoracic (Ivor Lewis) oesophagectomy. Br J Surg. 2010;97:714–718. doi:10.1002/bjs.6942.CrossRefPubMed Munitiz V, Martinez-de-Haro LF, Ortiz A, Ruiz-de-Angulo D, Pastor P, Parrilla P. Effectiveness of a written clinical pathway for enhanced recovery after transthoracic (Ivor Lewis) oesophagectomy. Br J Surg. 2010;97:714–718. doi:10.​1002/​bjs.​6942.CrossRefPubMed
74.
Zurück zum Zitat Preston SR, Markar SR, Baker CR, Soon Y, Singh S, Low DE. Impact of a multidisciplinary standardized clinical pathway on perioperative outcomes in patients with oesophageal cancer. Br J Surg. 2013;100:105–112. doi:10.1002/bjs.8974.CrossRefPubMed Preston SR, Markar SR, Baker CR, Soon Y, Singh S, Low DE. Impact of a multidisciplinary standardized clinical pathway on perioperative outcomes in patients with oesophageal cancer. Br J Surg. 2013;100:105–112. doi:10.​1002/​bjs.​8974.CrossRefPubMed
75.
Zurück zum Zitat Zehr KJ, Dawson PB, Yang SC, Heitmiller RF. Standardized clinical care pathways for major thoracic cases reduce hospital costs. Ann Thorac Surg. 1998;66:914–919.CrossRefPubMed Zehr KJ, Dawson PB, Yang SC, Heitmiller RF. Standardized clinical care pathways for major thoracic cases reduce hospital costs. Ann Thorac Surg. 1998;66:914–919.CrossRefPubMed
76.
Metadaten
Titel
Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery
verfasst von
Ines Gockel
Constantin Johannes Ahlbrand
Michael Arras
Elke Maria Schreiber
Hauke Lang
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 12/2015
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-015-3790-x

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