Effect of centralization on surgical outcome of children operated for liver tumors in switzerland: a retrospective comparative study

Article Article scientifique Article Effect of centralization on surgical outcome of children operated for liver tumors in switzerland: a retrospective comparative study eng 2022-02-06 2022-02-06 author Leoni Jasmine 753585 author Rougemont-Pidoux Anne-Laure 0000-0002-1785-792X 29140 author Calinescu-Tuleasca Ana Maria 0000-0002-3813-8991 766852 author Ansari Djaberi Marc Georges 0000-0002-9649-6498 61572 author Compagnon Philippe 894594 author Wilde Jimmy 835890 author Wildhaber Barbara 0000-0003-4548-382X 595596 217 10.3390/children9020217 35204937 2227-9067 PMC8870146 Background: Pediatric liver surgery is complex, and complications are not uncommon. Centralization of highly specialized surgery has been shown to improve quality of care. In 2012, pediatric liver surgery was centralized in Switzerland in one national center. This study analyses results before and after centralization. Methods: Retrospective monocentric comparative study. Analysis of medical records of children (0-16 years) operated for any liver tumor between 1 January 2001 and 31 December 2020. Forty-one patients were included: 14 before centralization (before 1 January 2012) and 27 after centralization (after 1 January 2012). Epidemiological, pre-, intra-, and post-operative data were collected. Fischer's exact and t-test were used to compare groups. Results: The two cohorts were homogeneous. Operating time was reduced, although not significantly, from 366 to 277 min. Length of postoperative stay and mortality were not statistically different between groups. Yet, after centralization, overall postoperative complication rate decreased significantly from 57% to 15% (p = 0.01), Clavien > III complications decreased from 50% to 7% (p < 0.01), and hepatic recurrences were also significantly reduced (40% to 5%, p = 0.03). Conclusion: Centralization of the surgical management of liver tumors in Switzerland has improved quality of care in our center by significantly reducing postoperative complications and hepatic recurrence. Centralization Complications Hepatic Oncology Pediatric Relapses Surgery Dewey 616 Dewey 617 Dewey 618 57 Département de chirurgie 222 58 Département de pédiatrie, gynécologie et obstétrique 223 56 Département de médecine 221 false 357 La transplantation d'îlots de Langerhans 623 Children 9 2 e2375a6a-ae27-4790-8f87-410bad569f42 Article (Published version) Public Article-scientifique-from-unpaywall.pdf 640053 application/pdf CC BY-4.0 openAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine clinique / Département de médecine

Title	Published in	Year	Views	Downloads

Les effets de la centralisation sur l’outcome chirurgical des enfants opérés d’une tumeur hépatique en Suisse : une étude comparative rétrospective		2023	139	73
Effect of centralization on surgical outcome of children operated for liver tumors in switzerland: a retrospective comparative study	Children	2022	255	189

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Leoni, Jasmine