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 23 January 2018

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News

Hospital caseload impacts on laparoscopy for diverticular disease

High-volume surgeons and hospitals are more likely to perform laparoscopic surgery for diverticular disease, shows April's issue of Archives of Surgery.

News image

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There is a hypothesis that high-volume surgeons and hospitals are more likely to perform laparoscopic than open procedures for diverticular disease.

Dr Walter Weber and colleagues from Switzerland undertook a real-world analysis at United States community hospitals.

In high-volume hospitals, patients were 3 times more likely to have laparoscopy
Archives of Surgery

The team included 55,949 patients with diverticulosis or diverticulitis.

The researchers assessed the 1992 to 2001 Nationwide Inpatient Samples commercially available databases from the USA.

The patients were predominantly white with a mean age of 61 years.

The research team's main outcome variable was the likelihood of performing laparoscopic vs open sigmoid resection.

The primary predictor variable was the annual caseload of sigmoid resections per surgeon and hospital.

The team found that unadjusted and risk-adjusted odds ratios of laparoscopic sigmoidectomy were higher for high-volume surgeons and high-volume hospitals.

The researchers found that high-volume surgeons were 9 times more likely to perform a laparoscopic sigmoid resection compared with low-volume surgeons.

In high-volume hospitals, patients were 3 times more likely to undergo a laparoscopic sigmoid resection compared with patients in low-volume hospitals.

The team observed that the differences remained statistically significant in subset analyses stratified by age, and time of surgery.

Dr Weber's team concluded, “The findings of the present investigation is based on data from large nationwide databases.”

“It provides compelling evidence that high-volume surgeons and hospitals are more likely to perform laparoscopic surgery for diverticular disease compared with low-volume surgeons and hospitals.”

“Based on studies showing advantages of the laparoscopic technique over the open counterpart, our results should be considered by both patients and physicians.”

Arch Surg 2007: 142(3): 253-9
29 March 2007

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