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National variations in perioperative assessment and surgical management of Crohn’s disease: a multicentre study
Author(s) -
Valerio Celentano,
Gianluca Pellino,
Matteo Rottoli,
Gilberto Poggioli,
Giuseppe Sica,
Mariano Cesare Giglio,
Michela Campanelli,
Claudio Coco,
Gianluca Rizzo,
Francesco Sionne,
Francesco Colombo,
Gianluca Sampietro,
Giulia Lamperti,
Diego Foschi,
Ferdinando Ficari,
Ludovica Vacca,
Marta Cricchio,
Francesco Giudici,
Lucio Selvaggi,
Guido Sciaudone,
Roberto Peltrini,
Andrea Manfreda,
Luigi Bucci,
Raffaele Galleano,
Omar Ghazouani,
Luigi Zorcolo,
Simona Deidda,
Angelo Restivo,
Andrea Braini,
Francesca Di Candido,
Matteo Sacchi,
Michele Carvello,
Stefania Martorana,
Giovanni Bordig,
Imerio Angriman,
Angela Variola,
Mirko Di Ruscio,
Giuliano Barugola,
Andrea Geccherle,
Francesca Paola Tropeano,
Gaetano Luglio,
Marta Tanzanu,
Diego Sasia,
Marco Migliore,
Maria Carmela Giuffrida,
Enrico Marrano,
Gianluigi Moretto,
Harmony Impellizzeri,
Gaetano Gallo,
G Vescio,
Giuseppe Sammarco,
Giovanni Terrosu,
Giacomo Calini,
Andrea Bondurri,
Anna Maffioli,
G Zaffaroni,
Andrea Resegotti,
Massimiliano Mistrangelo,
Marco Ettore Allaix,
F. Botti,
M. Prati,
Luigi Boni,
Serena Perotti,
Michela Mineccia,
Antonio Giuliani,
Lucia Romano,
Giorgio Maria Paolo Graziano,
Luigi Pugliese,
Andrea Pietrabissa,
Gian Gaetano Delaini,
Antonino Spinelli,
Francesco Selvaggi
Publication year - 2021
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.15334
Subject(s) - medicine , laparoscopy , crohn's disease , perioperative , stoma (medicine) , audit , bowel resection , general surgery , colorectal surgery , inflammatory bowel disease , surgery , disease , abdominal surgery , management , economics
Aim Crohn's disease (CD) requires a multidisciplinary approach and surgery should be undertaken by dedicated colorectal surgeons with audited outcomes. We present a national, multicentre study, with the aim to collect benchmark data on key performance indicators in CD surgery, to highlight areas where standards of CD surgery excel and to facilitate targeted quality improvement where indicated. Methods All patients undergoing ileocaecal or redo ileocolic resection in the participating centres for primary and recurrent CD from June 2018 to May 2019 were included. The main objective was to collect national data on hospital volume and practice variations. Postoperative morbidity was the primary outcome. Laparoscopic surgery and stoma rate were the secondary outcomes. Results In all, 715 patients were included: 457 primary CD and 258 recurrent CD with a postoperative morbidity of 21.6% and 34.7%, respectively. Laparoscopy was used in 83.8% of primary CD compared to 31% of recurrent CD. Twenty‐five hospitals participated and the total number of patients per hospital ranged from 2 to 169. Hospitals performing more than 10 primary CD procedures per year showed a higher adoption of laparoscopy and bowel sparing surgery. Conclusions There is significant heterogeneity in the number of CD surgeries performed per year nationally in Italy. Our data suggest that high‐volume hospitals perform more complex procedures, with a higher adoption of bowel sparing surgery. The rate of laparoscopy in high‐volume hospitals is higher for primary CD but not for recurrent CD compared with low‐volume hospitals.