Annual case volume has no impact on patient outcomes in laparoscopic partial colectomy.
OBJECTIVE
Surgeon case volume has been utilized in the credentialing process as a surrogate for surgeon skill. The purpose of this study was to compare objective outcome measures of laparoscopic partial colectomies performed by laparoscopically skilled surgeons with varying annual case census.


METHODS
We performed a retrospective cohort review of all patients (n = 255) undergoing elective laparoscopic partial colectomy. Patients were grouped according to surgeon's annual case volume as low annual case volume (LV; n = 48) and high annual case volume (HV; n = 207). HV is defined as performing >20 total cases and >25 cases per year. All demographic and clinical variables were evaluated with univariate logistic regression followed by a multivariate logistic regression model for variables approaching significance.


RESULTS
Demographic variables were found to be similar between groups. Only median estimated blood loss (100 vs. 150 mL for HV; p = 0.040) was found to be significantly different between groups. However, this was clinically insignificant, as it did not lead to an increased rate of blood transfusions (0.0 vs. 3.9 % for HV surgeons; p = 0.184). All other variables were similar in both univariate and multivariate logistic regression models.


CONCLUSIONS
Among surgeons with advanced laparoscopic training, the data suggest that LV surgeons are able to achieve similar outcomes as those who perform the operation routinely. Annual case volume should not be given undue emphasis when deciding whether to award privileges for laparoscopic partial colectomy.
Department of General Surgery, Rush University Medical Center, Professional Building Suite 810, 1725 West Harrison Street, Chicago, IL, 60612, USA.
Shaun C
SC
Daly
Matthew M
MM
Klairmont
Amanda B
AB
Francescatti
Jonathan A
JA
Myers
Daniel J
DJ
Deziel
Minh B
MB
Luu
D003082:Colectomy / Q000379:methods* / Q000706:statistics & numerical data; D003108:Colonic Diseases / Q000601:surgery; D003406:Credentialing; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome