Journal of Gastrointestinal Surgery

, Volume 15, Issue 4, pp 541–550 | Cite as

Elective Resection of Colon Cancer by High-Volume Surgeons Is Associated with Decreased Morbidity and Mortality

  • Sebastien Drolet
  • Anthony R. MacLean
  • Robert P. Myers
  • Abdel Aziz M. Shaheen
  • Elijah Dixon
  • W. Donald Buie
2010 SSAT Poster Presentation

Abstract

Background

The purpose of this study was to determine whether morbidity and mortality in patients undergoing elective resection of colon cancer are associated with surgeon or hospital volume.

Methods

Using the Nationwide Inpatient Sample database, we identified all adult patients who underwent elective resection for colon cancer as their primary procedure between 2003 and 2007. Cases were divided into three groups according to the mean number of resections performed annually by each surgeon: low volume (≤4/year), intermediate volume (5–9/year), or high volume (≥10/year). Annual hospital case-load was also categorized as low volume (≤30/year), intermediate volume (31–60/year), and high volume (≥61/year). Multiple logistic regression models were used to identify differences in morbidity and mortality.

Results

A total of 54,000 patients underwent resection of colon cancer by 7,313 surgeons in 1,398 hospitals. After adjusting for important covariates including hospital volume, colon cancer resection by high-volume surgeons was an independent predictor of decreased morbidity (odds ratio [OR], 0.91; 95% CI, 0.85–0.97) and mortality (OR, 0.75; 95% CI, 0.65–0.86). Mortality was lowest among patients operated on by high-volume surgeons in high-volume hospitals (2.2% vs. 3.9%; OR, 0.56; 95% CI, 0.46–0.68).

Conclusions

In patients undergoing elective resection of colon cancer, procedures done by high-volume surgeons are associated with decreased morbidity and mortality.

Keywords

Colon cancer Hospital volume Surgeon volume 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  • Sebastien Drolet
    • 1
    • 3
  • Anthony R. MacLean
    • 1
  • Robert P. Myers
    • 2
  • Abdel Aziz M. Shaheen
    • 2
  • Elijah Dixon
    • 1
  • W. Donald Buie
    • 1
    • 3
  1. 1.Department of SurgeryUniversity of CalgaryCalgaryCanada
  2. 2.Division of Gastroenterology, Department of MedicineUniversity of CalgaryCalgaryCanada
  3. 3.Foothill Medical CenterCalgaryCanada

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