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Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma

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Each procedure matters: threshold for surgeon volume to minimize complications and decrease cost associated with

Kevin L Anderson¹, Samantha M Thomas², Mohamed A Adam³

¹Duke University School of Medicine, Durham, NC.

|November 11, 2017

Summary

This summary is machine-generated.

Defining a high-volume adrenal surgeon is crucial for patient outcomes. This study identifies an annual surgeon volume of at least 6 adrenalectomy cases as a threshold for improved results and reduced costs.

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Area of Science:

Surgical Outcomes Research
Health Services Research

Background:

Surgeon volume is linked to patient outcomes, but a clear threshold for high-volume adrenal surgeons is undefined.
Adrenalectomy is a complex procedure where surgeon experience may significantly impact results.

Purpose of the Study:

To define a volume threshold for "high-volume" adrenal surgeons.
To investigate the association between annual surgeon volume and patient outcomes after adrenalectomy.

Main Methods:

Analysis of adult patients undergoing adrenalectomy from 1998-2009 using the Healthcare Cost and Utilization Project National Inpatient Sample.
Logistic regression modeling with restricted cubic splines to assess the relationship between surgeon volume and complication rates.

Main Results:

A total of 3,496 surgeons performed 6,712 adrenalectomies; median annual volume was 1 case.
Complication rates decreased with increasing annual surgeon volume up to approximately 5.6 cases.
Low-volume surgeons (<6 cases/year) were associated with higher complication rates, longer hospital stays, and increased costs.

Conclusions:

An annual surgeon volume threshold of at least 6 adrenalectomy cases is associated with improved patient outcomes.
This identified volume threshold has significant implications for surgical quality improvement, referral practices, reimbursement policies, and surgical training programs.