OBJECTIVES: Surgeon case volume has been utilized in the credentialing process as a surrogate for surgeon skill. The purpose of this study was to compare objective outcome measures of laparoscopic partial colectomies performed by laparoscopically skilled surgeons with varying annual case census. METHODS: We performed a retrospective cohort review of all patients (n = 255) undergoing elective laparoscopic partial colectomy. Patients were grouped according to surgeon's annual case volume as low annual case volume (LV; n = 48) and high annual case volume (HV; n = 207). HV is defined as performing >20 total cases and >25 cases per year. All demographic and clinical variables were evaluated with univariate logistic regression followed by a multivariate logistic regression model for variables approaching significance. RESULTS: Demographic variables were found to be similar between groups. Only median estimated blood loss (100 vs. 150 mL for HV; p = 0.040) was found to be significantly different between groups. However, this was clinically insignificant, as it did not lead to an increased rate of blood transfusions (0.0 vs. 3.9 % for HV surgeons; p = 0.184). All other variables were similar in both univariate and multivariate logistic regression models. CONCLUSIONS: Among surgeons with advanced laparoscopic training, the data suggest that LV surgeons are able to achieve similar outcomes as those who perform the operation routinely. Annual case volume should not be given undue emphasis when deciding whether to award privileges for laparoscopic partial colectomy.
OBJECTIVES: Surgeon case volume has been utilized in the credentialing process as a surrogate for surgeon skill. The purpose of this study was to compare objective outcome measures of laparoscopic partial colectomies performed by laparoscopically skilled surgeons with varying annual case census. METHODS: We performed a retrospective cohort review of all patients (n = 255) undergoing elective laparoscopic partial colectomy. Patients were grouped according to surgeon's annual case volume as low annual case volume (LV; n = 48) and high annual case volume (HV; n = 207). HV is defined as performing >20 total cases and >25 cases per year. All demographic and clinical variables were evaluated with univariate logistic regression followed by a multivariate logistic regression model for variables approaching significance. RESULTS: Demographic variables were found to be similar between groups. Only median estimated blood loss (100 vs. 150 mL for HV; p = 0.040) was found to be significantly different between groups. However, this was clinically insignificant, as it did not lead to an increased rate of blood transfusions (0.0 vs. 3.9 % for HV surgeons; p = 0.184). All other variables were similar in both univariate and multivariate logistic regression models. CONCLUSIONS: Among surgeons with advanced laparoscopic training, the data suggest that LV surgeons are able to achieve similar outcomes as those who perform the operation routinely. Annual case volume should not be given undue emphasis when deciding whether to award privileges for laparoscopic partial colectomy.
Authors: E Kuhry; H J Bonjer; E Haglind; W C J Hop; R Veldkamp; M A Cuesta; J Jeekel; L Påhlman; M Morino; A Lacy; S Delgado Journal: Surg Endosc Date: 2005-03-30 Impact factor: 4.584
Authors: Daniel J Reichenbach; A Darrel Tackett; James Harris; Diego Camacho; Edward A Graviss; Brendan Dewan; Ashley Vavra; Anquonette Stiles; William E Fisher; F Charles Brunicardi; John F Sweeney Journal: Ann Surg Date: 2006-06 Impact factor: 12.969
Authors: Heidi Nelson; Daniel J Sargent; H Sam Wieand; James Fleshman; Mehran Anvari; Steven J Stryker; Robert W Beart; Michael Hellinger; Richard Flanagan; Walter Peters; David Ota Journal: N Engl J Med Date: 2004-05-13 Impact factor: 91.245
Authors: David W Larson; Peter W Marcello; Sergio W Larach; Steven D Wexner; Adrian Park; John Marks; Anthony J Senagore; Alan G Thorson; Tonia M Young-Fadok; Erin Green; Daniel J Sargent; Heidi Nelson Journal: Ann Surg Date: 2008-11 Impact factor: 12.969