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

  • 2010 SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

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.

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Conflicts of interest

No conflicts of interest exist.

Grant support

Dr. Myers is supported by a Clinical Investigator Award from the Alberta Heritage Foundation for Medical Research and a New Investigator Award from the Canadian Institutes of Health Research.

Author information

Authors and Affiliations

  1. Department of Surgery, University of Calgary, Calgary, AB, Canada

    Sebastien Drolet, Anthony R. MacLean, Elijah Dixon & W. Donald Buie

  2. Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada

    Robert P. Myers & Abdel Aziz M. Shaheen

  3. Foothill Medical Center, 1009 North Tower, 1403-29 Street NW, Calgary, AB, T2N 2T9, Canada

    Sebastien Drolet & W. Donald Buie

Authors
  1. Sebastien Drolet
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  2. Anthony R. MacLean
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  3. Robert P. Myers
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  4. Abdel Aziz M. Shaheen
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  5. Elijah Dixon
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  6. W. Donald Buie
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Corresponding authors

Correspondence to Sebastien Drolet or W. Donald Buie.

Additional information

Description of the study

Retrospective database analyses of the impact of surgeon and hospital volume on outcomes in elective colon cancer resection.

Poster presentation

Digestive Disease Week, 1–5 May 2010, New Orleans, LA, USA.

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Drolet, S., MacLean, A.R., Myers, R.P. et al. Elective Resection of Colon Cancer by High-Volume Surgeons Is Associated with Decreased Morbidity and Mortality. J Gastrointest Surg 15, 541–550 (2011). https://doi.org/10.1007/s11605-011-1433-x

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  • DOI: https://doi.org/10.1007/s11605-011-1433-x

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