Impact of surgeon experience on routine prolapse operations
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| Title: | Impact of surgeon experience on routine prolapse operations |
|---|---|
| Authors: | Emil Nüssler, Jacob Kjær Eskildsen, Emil Karl Nüssler, Marie Bixo, Mats Löfgren |
| Source: | Int Urogynecol J Nüssler, E, Eskildsen, J K, Nüssler, E K, Bixo, M & Löfgren, M 2018, 'Impact of surgeon experience on routine prolapse operations', International Urogynecology Journal, vol. 29, no. 2, pp. 297-306. https://doi.org/10.1007/s00192-017-3353-0 |
| Publisher Information: | Springer Science and Business Media LLC, 2017. |
| Publication Year: | 2017 |
| Subject Terms: | Adult, Male, Reoperation, surgical outcome, Gynecologic Surgical Procedures/standards, national register data, patient-reported outcome, Clinical Competence/statistics & numerical data, Pelvic Organ Prolapse, 03 medical and health sciences, Pelvic Organ Prolapse/surgery, Gynecologic Surgical Procedures, 0302 clinical medicine, Humans, quality control, Surgeons/standards, Learning curve, Patient-reported outcome, Aged, Surgeons, Sweden, Surgical outcome, Kirurgi, Quality control, Reoperation/standards, Middle Aged, pelvic organ prolapse, Pelvic organ prolapse, 3. Good health, learning curve, Treatment Outcome, National register data, Patient Satisfaction, 13. Climate action, Surgery, Original Article, Female, Clinical Competence |
| Description: | Surgical work encompasses important aspects of personal and manual skills. In major surgery, there is a positive correlation between surgical experience and results. For pelvic organ prolapse (POP), this relationship has to our knowledge never been examined. In any clinical practice, there is always a certain proportion of inexperienced surgeons. In Sweden, most prolapse surgeons have little experience in performing prolapse operations, 74% conducting the procedure once a month or less. Simultaneously, surgery for POP globally has failure rates of 25-30%. In other words, for most surgeons, the operation is a low-frequency procedure, and outcomes are unsatisfactory. The aim of this study was to clarify the acceptability of having a high proportion of low-volume surgeons in the management of POP.A group of 14,676 exclusively primary anterior or posterior repair patients was assessed. Data were analyzed by logistic regression and as a group analysis.Experienced surgeons had shorter operation times and hospital stays. Surgical experience did not affect surgical or patient-reported complication rates, organ damage, reoperation, rehospitalization, or patient satisfaction, nor did it improve patient-reported failure rates 1 year after surgery. Assistant experience, similarly, had no effect on the outcome of the operation.A management model for isolated anterior or posterior POP surgery that includes a high proportion of low-volume surgeons does not have a negative impact on the quality or outcome of anterior or posterior colporrhaphy. Consequently, the high recurrence rate was not due to insufficient experience of the surgeons performing the operation. |
| Document Type: | Article Other literature type |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 1433-3023 0937-3462 |
| DOI: | 10.1007/s00192-017-3353-0 |
| Access URL: | https://europepmc.org/articles/pmc5780527?pdf=render https://pubmed.ncbi.nlm.nih.gov/28577172 https://link.springer.com/content/pdf/10.1007%2Fs00192-017-3353-0.pdf https://link.springer.com/article/10.1007/s00192-017-3353-0 http://www.diva-portal.org/smash/record.jsf?pid=diva2:1187473 http://umu.diva-portal.org/smash/record.jsf?pid=diva2:1187473 https://link.springer.com/article/10.1007/s00192-017-3353-0/fulltext.html https://www.ncbi.nlm.nih.gov/pubmed/28577172 https://pure.au.dk/portal/en/publications/bacb7619-df71-4ea1-9e8e-a19f2b9c4279 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-144825 https://pure.au.dk/portal/en/publications/bacb7619-df71-4ea1-9e8e-a19f2b9c4279 https://doi.org/10.1007/s00192-017-3353-0 http://www.scopus.com/inward/record.url?scp=85020115972&partnerID=8YFLogxK https://pure.au.dk/ws/files/179656773/N_ssler2018_Article_ImpactOfSurgeonExperienceOnRou.pdf |
| Rights: | CC BY |
| Accession Number: | edsair.doi.dedup.....9970b431fa711eb2cfb4ad73f1db0545 |
| Database: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Surgical work encompasses important aspects of personal and manual skills. In major surgery, there is a positive correlation between surgical experience and results. For pelvic organ prolapse (POP), this relationship has to our knowledge never been examined. In any clinical practice, there is always a certain proportion of inexperienced surgeons. In Sweden, most prolapse surgeons have little experience in performing prolapse operations, 74% conducting the procedure once a month or less. Simultaneously, surgery for POP globally has failure rates of 25-30%. In other words, for most surgeons, the operation is a low-frequency procedure, and outcomes are unsatisfactory. The aim of this study was to clarify the acceptability of having a high proportion of low-volume surgeons in the management of POP.A group of 14,676 exclusively primary anterior or posterior repair patients was assessed. Data were analyzed by logistic regression and as a group analysis.Experienced surgeons had shorter operation times and hospital stays. Surgical experience did not affect surgical or patient-reported complication rates, organ damage, reoperation, rehospitalization, or patient satisfaction, nor did it improve patient-reported failure rates 1 year after surgery. Assistant experience, similarly, had no effect on the outcome of the operation.A management model for isolated anterior or posterior POP surgery that includes a high proportion of low-volume surgeons does not have a negative impact on the quality or outcome of anterior or posterior colporrhaphy. Consequently, the high recurrence rate was not due to insufficient experience of the surgeons performing the operation. |
|---|---|
| ISSN: | 14333023 09373462 |
| DOI: | 10.1007/s00192-017-3353-0 |