Defining Benchmark Outcomes for Distal Pancreatectomy: Results of a French Multicentric Study. - Université de Picardie Jules Verne Accéder directement au contenu
Article Dans Une Revue Annals of Surgery Année : 2022

Defining Benchmark Outcomes for Distal Pancreatectomy: Results of a French Multicentric Study.

1 CHRU Lille - Centre Hospitalier Régional Universitaire [Lille]
2 Institut Paoli-Calmettes
3 Service de chirurgie hepato-pancreato-biliaire
4 Hôpital Beaujon [AP-HP]
5 IVH - Institut de Recherche sur les Maladies Virales et Hépatiques
6 CHU Strasbourg
7 UPCité - Université Paris Cité
8 CHU Bordeaux [Bordeaux]
9 OENO - Unité de Recherche Œnologie [Villenave d'Ornon]
10 ISVV - Institut des Sciences de la Vigne et du Vin [Villenave d'Ornon]
11 MHCS - Moët Hennessy Champagne Services
12 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
13 Faculté de Médecine [Nancy]
14 AMU SMPM MED - Aix-Marseille Université - École de médecine
15 CRCM - Centre de Recherche en Cancérologie de Marseille
16 OSS - Oncogenesis, Stress, Signaling
17 CHU Pontchaillou [Rennes]
18 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
19 Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi]
20 CHB - Centre hépato-biliaire
21 Hôpital de la Croix-Rousse [CHU - HCL]
22 APHM - Assistance Publique - Hôpitaux de Marseille
23 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
24 CIC 1405 - Centre d'Investigation Clinique [CHU Clermont-Ferrand]
25 M2iSH - Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte
26 Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière]
27 Hôpital Charles Nicolle [Rouen]
28 Service de chirurgie digestive [CHU Rouen]
29 GPMCND - Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques
30 CHU Trousseau [Tours]
31 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
32 CHU Nantes - Centre hospitalier universitaire de Nantes
33 C3M - Centre méditerranéen de médecine moléculaire
34 Hôpital l'Archet
35 Chirurgie digestive [CHU Amiens]
36 SSPC - Simplification des soins chez les patients complexes - UR UPJV 7518
Piettro Addeo
  • Fonction : Auteur
Ecoline Tribillon
  • Fonction : Auteur

Résumé

OBJECTIVE: Defining robust and standardized outcome references for distal pancreatectomy (DP) by using Benchmark analysis. BACKGROUND: Outcomes after DP are recorded in medium or small-sized studies without standardized analysis. Therefore, the best results remain uncertain. METHODS: This multicenter study included all patients undergoing DP for resectable benign or malignant tumors in 21 French expert centers in pancreas surgery from 2014 to 2018. A low-risk cohort defined by no significant comorbidities was analyzed to establish 18 outcome benchmarks for DP. These values were tested in high-risk, minimally invasive and benign tumor cohorts. RESULTS: 1188 patients were identified and 749 low-risk patients were screened to establish Benchmark cut-offs. Therefore, Benchmark rate for mini-invasive approach was ≥q36.8%. Benchmark cut-offs for postoperative mortality, major morbidity grade ≥q3a and clinically significant pancreatic fistula rates were 0%, ≤q27% and ≤q28%, respectively. The benchmark rate for readmission was ≤q 16%. For patients with pancreatic adenocarcinoma, cut-offs were ≥q75%, ≥q69.5% and ≥q66% for free resection margins (R0), 1-year disease free-survival and 3-year overall survival, respectively. The rate of mini-invasive approach in high-risk cohort was lower than the Benchmark cut-off (34.1% vs. ≥q36.8%). All Benchmark cut-offs were respected for benign tumor group. The proportion of benchmark cases was correlated to outcomes of DP. Centers with a majority of low-risk patients had worse results than those operating complex cases. CONCLUSION: This large-scale study is the first benchmark analysis of DP outcomes and provides robust and standardized data. This may allow for comparisons between surgeons, centers, studies, and surgical techniques.
Fichier non déposé

Dates et versions

hal-03711172 , version 1 (01-07-2022)

Identifiants

Citer

Thibault Durin, Ugo Marchese, Alain Sauvanet, Safi Dokmak, Zineb Cherkaoui, et al.. Defining Benchmark Outcomes for Distal Pancreatectomy: Results of a French Multicentric Study.. Annals of Surgery, 2022, Publish Ahead of Print, ⟨10.1097/SLA.0000000000005539⟩. ⟨hal-03711172⟩
88 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook Twitter LinkedIn More