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• W1964300443 abstract "To estimate the effect of operator surgical volume on key perioperative outcomes following all modes of hysterectomy. Retrospective review of 1914 hysterectomies during 3 year study period. Large academic tertiary care hospital in Boston, Massachusetts. Women who underwent an abdominal, laparoscopic, vaginal or robotic hysterectomy for benign, non-obstetric indication in 2006, 2009 and 2010. Gynecologic surgeons were categorized according their average annual case volume - low volume (<11 cases per year), intermediate volume (11-50 cases per year) and high volume (> 50 cases per year). The low/intermediate surgical volume operators principally operated on cases involving uterine fibroids. The operative findings of endometriosis, adhesions or urogynecological issues (predominantly prolapse) did not differ significantly in the three groups under study. The low and high volume group performed more abdominal hysterectomies compared to the intermediate volume group (42.64% and 40.81% vs. 19.65%, p=<0.001). Surgeries performed by high surgical volume surgeons required less operative time (203.35 minutes vs. 199.19 minutes vs. 155.11 minutes, p<0.001) and resulted in less estimated blood loss compared to low and intermediate surgeons (237.96 ml vs. 205.58 ml vs. 161.09 ml, p<0.001). The three surgical volume groups did not differ from each other significantly in the conversion rates to laparotomy or incidence of intraoperative and postoperative complications.Tabled 1Perioperative Characteristics/OutcomesLow Volume (n = 394)Intermediate Volume (n = 682)High Volume (n = 838)P valueMean; SD/%Mean and SD/%Mean and SD/%Operating Time203.35; 64.34199.19; 69.41155.11; 53.98<0.001Length of Hospital Stay1.80; 1.321.35; 1.392.06; 1.67<0.001Uterine weight305.39; 346.88312.12; 398.75300.95; 469.990.877EBL237.96; 254.29205.58; 238.90161.09; 255.46<0.001Conversion (n = 1270)9; 3.9815; 2.7410; 2.020.314Readmission113; 28.68181; 26.54270; 32.220.05Intraop Complications14; 3.5523; 3.3715; 1.790.087Postop Complications44; 11.1773; 10.70104; 12.410.565We used the one-way Analysis of Variance (oneway ANOVA) test for comparing continuous variables and the Chi squared test or the Fischer's exact test, as may be applicable, for comparing categorical variables. All comparisons were considered to have reached statistical significance at a P value of </= 0.05. We also applied the Bonferroni correction for multiple comparisons, as may be applicable. Open table in a new tab We used the one-way Analysis of Variance (oneway ANOVA) test for comparing continuous variables and the Chi squared test or the Fischer's exact test, as may be applicable, for comparing categorical variables. All comparisons were considered to have reached statistical significance at a P value of </= 0.05. We also applied the Bonferroni correction for multiple comparisons, as may be applicable. Hysterectomies performed by high volume surgeons at our institution during the three-year study period were associated with shorter operative times and less estimated blood loss. However, there were no significant differences in complication rates." @default.
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• W1964300443 date "2011-11-01" @default.
• W1964300443 modified "2023-09-27" @default.
• W1964300443 title "The Impact of Surgeon Volume on Perioperative Outcomes in Hysterectomy" @default.
• W1964300443 doi "https://doi.org/10.1016/j.jmig.2011.08.241" @default.
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