Does surgical volume influence short-term outcomes of laparoscopic hysterectomy?

作者：Tunitsky Elena^*; Citil Ayse; Ayaz Reyhan; Esin Sertac; Knee Alexander; Harmanli Oz

来源：American Journal of Obstetrics and Gynecology, 2010, 203(1): 24.e1.

DOI：10.1016/j.ajog.2010.01.070

• complications
• conversion
• hysterectomy
• laparoscopic hysterectomy
• learning curve
• surgical volume

OBJECTIVE: To evaluate whether surgical volume has an impact on short-term outcomes of laparoscopic hysterectomy.
STUDY DESIGN: This is a retrospective analysis of 1016 laparoscopic hysterectomies.
RESULTS: The surgeons were divided into 2 groups based on a cutoff of 30 cases. Patient characteristics, the rates of laparotomy (4.5% vs 6.7%), and serious complications (3.6% vs 5.5%) were similar between 9 "high" and the remaining 39 "low volume" gynecologists, respectively (P < .05). Mean operating time was longer in the "low volume" group. Compared with their first 29 hysterectomies, the "high volume" surgeons decreased their operating time significantly in their subsequent cases. The "high volume" surgeons improved their conversion rate (9.2% vs 2.4%; P < .0001) over time but not their serious complications.
CONCLUSION: In laparoscopic hysterectomy, increasing the surgical volume can reduce the operating time and the risk for conversion to laparotomy but not the rate of serious complications.

• 出版日期2010-7