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2019 STS: Impact of Regionalization of Lung Cancer Surgery on Outcomes

By: Susan Reckling
Posted: Friday, February 8, 2019

Not only is regionalization of thoracic surgery for lung cancer feasible in an American integrated health-care system, it also may lead to improvements in the use of video-assisted thoracoscopic surgery, shorter hospital stays, and fewer complications, according to a study recently presented at the 2019 Society of Thoracic Surgeons (STS) Annual Meeting in San Diego (J. Maxwell Chamberlain Memorial Paper for General Thoracic Surgery).

“We found that regionalization resulted in improvements in quality of care throughout surgical treatment,” stated Jeffrey B. Velotta, MD, of Kaiser Permanente Oakland Medical Center and the University of California San Francisco School of Medicine, in an STS press release.

Dr. Velotta and colleagues at Kaiser Permanente retrospectively reviewed more than 1,600 patients who underwent pulmonary resection within their managed-care network in the 3 years before (2011–2013) and after (2015–2017) regionalization of thoracic surgery care to 5 designated Centers of Excellence. The surgical treatment consisted of lobectomy, bilobectomy, or pneumonectomy.

The investigators reported that regionalization successfully shifted cases from 16 preregionalization sites to 5 Centers of Excellence; 100% were performed by 2015 to 2016. In fact, at the Centers of Excellence, the average facility volume increased from 16 to 56 cases per year. In addition, regionalization appeared to be associated with increased use of video-assisted thoracoscopic surgery (from 57% to 86%); it also was linked to decreased use of the intensive care unit and hospital length of stay as well as fewer total and major complications.

“Our results are promising and could even instigate regionalization attempts in other U.S. health-care systems,” shared Dr. Velotta.

Disclosure: The study authors’ disclosure information can be found at www.sts.org.



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