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Higher hospital volume more important than surgeon experience in outcome of prostate cancer surgery
Date:5/15/2012

05. Then, looking at the outcome for each patient within 30 days after surgery, they analyzed the effect of both hospital volume (HV) and surgeon volume (SV) in predicting complications, including blood transfusion, anastomotic stricture (scarring and narrowing of incision lines), long-term incontinence, and erectile dysfunction.

In each case, the results were adjusted for the patient's age, race, the presence of other disease or disorders, and marital and socioeconomic status, as well the hospital's surrounding population density, the surgical approach, and the seriousness of the cancer.

The study found:

  • Both higher HV and higher SV led to lower rates of overall complications.
  • HV and SV were each related to fewer respiratory and vascular complications.
  • Higher SV led to less need for blood transfusion.
  • Both HV and SV were associated with lower rates of anastomotic stricture, urinary incontinence, and erectile dysfunction.

Based on these findings and others, the researchers concluded "hospital volume matters more where it's about general delivery of care for example, preventing complications and mortality," Dr. Trinh says. "That probably depends on the quality of the hospital's intensive care unit, the nursing staff, and other factors such as those, rather than on a specific surgeon's skill.

"But risk of recurrence probably depends on the skill of the surgeon to remove the cancer properly, not on how good the hospital is."

Overall, Dr. Trinh adds, "the main finding is that hospital volume matters more than surgeon volume with regard to 30-day complication rates, especially for older, sicker patients, those at higher risk of complications."


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Contact: Krista Hopson
khopson1@hfhs.org
313-874-7207
Henry Ford Health System
Source:Eurekalert

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