Why the study?
Anastomotic leakage is a major concern following esophagectomy, and current trends in anastomotic leakage and associated failure-to-rescue relative to hospital volume needed analysis using real-world German data.
Does hospital case volume impact anastomotic leakage rates and failure-to-rescue mortality in patients undergoing esophagectomy?
Population
32 335 cases undergoing esophagectomy from 2013 to 2021 in German acute care hospitals
Comparison
Hospital case volume categories and endoscopic treatment modalities
Design
Retrospective secondary data analysis of the G-DRG database
Key result
High hospital volume (>25 procedures/year) did not significantly differ in anastomotic leakage rates compared to lower volumes (17.6% vs 16.8%, OR 1.06, P=0.07), but had lower failure-to-rescue mortality.
Authors
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High-volume hospitals have significantly lower failure-to-rescue mortality rates following anastomotic leakage after esophagectomy, supporting the centralization of these procedures.
Cohort (n=32,335)
Yes
Does hospital case volume impact anastomotic leakage rates and failure-to-rescue mortality in patients undergoing esophagectomy?
Odds Ratio: 1.06
Absolute Event Rate: 17.6% vs 16.8%
p-value: p=0.07
High-volume hospitals have significantly lower failure-to-rescue mortality rates following anastomotic leakage after esophagectomy, supporting the centralization of these procedures.
Weber et al. (2025) conducted a cohort in Esophagectomy (n=32,335). High hospital volume (>25 procedures/year) vs. Hospital volume ≤25 procedures/year was evaluated on Anastomotic leakage rate (OR 1.06, p=0.07). High hospital volume (>25 procedures/year) did not significantly differ in anastomotic leakage rates compared to lower volumes (17.6% vs 16.8%, OR 1.06, P=0.07), but had lower failure-to-rescue mortality.