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[Minimum quantities from a thoracic surgical standpoint].

D Kaiser1

  • 1HELIOS Klinikum Emil von Behring, Klinik für Thoraxchirurgie, Lungenklinik Heckeshorn, Walterhöferstrasse 11, Berlin, Germany. dirk.kaiser@helios-kliniken.de

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|October 13, 2007
PubMed
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Establishing minimum thoracic surgery volumes improves patient outcomes. Higher surgical case numbers enhance complication management and reduce mortality rates, ensuring quality care in specialized centers.

Area of Science:

  • Thoracic Surgery
  • Health Services Research
  • Patient Safety

Background:

  • The relationship between hospital volume and surgical outcomes is critical for quality assessment.
  • Thoracic surgery outcomes are influenced by procedural complexity and surgeon experience.

Purpose of the Study:

  • To determine the impact of hospital volume on thoracic surgery lethality.
  • To establish minimum procedural volumes for specialized thoracic surgery centers.
  • To inform healthcare policy regarding the concentration of thoracic surgical services.

Main Methods:

  • Analysis of operational lethality in relation to hospital surgical volume for thoracic procedures.
  • Identification of key performance indicators including resectional operations, mediastinoscopy, heart-lung machine use, and thoracic drainage.

Related Experiment Videos

  • Benchmarking against established minimum quantity requirements for specialized centers.

    • Main Results:

    • Minimum volumes for specialized thoracic surgery centers are defined: 300 resectional operations (excluding mediastinoscopy), plus procedures involving heart-lung machines and thoracic drainage.
    • These minimums are essential for effective complication management and reducing operation lethality.
    • Adequate staffing, including at least two full-time thoracic surgeons, is linked to these volume requirements.

    Conclusions:

    • Concentrating thoracic surgical services in high-volume main hospitals (≥300 operations/year) and organ centers (≥500 resectional operations/year) is a rational approach.
    • Meeting minimum volume requirements is crucial for maintaining surgical quality and patient safety in Germany.
    • Volume-outcome relationships provide a basis for structuring and financing specialized thoracic surgical care.