Affiliation
Department of Surgery, Cork University Hospital and University College Cork,, Cork, Ireland.Issue Date
2012-02-03T15:07:23ZMeSH
Health Facility SizeHospitals/*statistics & numerical data
Humans
Neoplasms/mortality/*surgery
Surgical Procedures, Operative/*statistics & numerical data
Treatment Outcome
Workload/*statistics & numerical data
Metadata
Show full item recordCitation
Br J Surg. 2005 Apr;92(4):389-402.Journal
The British journal of surgeryDOI
10.1002/bjs.4954PubMed ID
15786424Abstract
BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.Language
engISSN
0007-1323 (Print)0007-1323 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1002/bjs.4954