Objective: To examine the relationship between the number of procedures performed per hospital or per surgeon and health care outcomes.
Design: Literature review.
Method: Relevant literature was identified using recent systematic reviews from Germany, England, France and the United States. The Cochrane Library, Medline and Embase were also searched for recent studies (2000-2005) published in German, English, French, or Dutch using the combined search terms 'surgery' and 'volume'; included studies reported mortality or morbidity as measures of health care quality.
Results: 5 systematic reviews were found, which described the results of a total of 41 relevant articles. 8 original articles of sufficient quality published since 2000 were also identified. Most of these articles were also included in the reviews. Relationships between volume per hospital and per surgeon and case fatality (or survival) and morbidity were found for a number of surgical procedures. The strongest associations between volume and case fatality were found for pancreatic and oesophageal resection and, to a lesser degree, elective repair ofabdominal aortic aneurysm. For other procedures the relationship was relatively weak, absent, or not studied.
Conclusion: Volume appears to be related to quality for some surgical procedures. The magnitude of the relationship differs depending on the procedure. For technically less complex procedures, organisation within the hospital appears to have a greater influence on the differences between hospitals than the performing surgeon.
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Clin Oral Investig
January 2025
Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein 10, Nijmegen, 6525, GA, the Netherlands.
Objectives: To assess the effect of patient positioning and general anesthesia on the condylar position in orthognathic surgery.
Materials And Methods: This prospective study included patients undergoing orthognathic surgery between 2019 and 2020. Four weeks prior to surgery (T0) cone-beam computed tomography (CBCT) scans and intra-oral scans (IOS) were acquired in an upright position.
Langenbecks Arch Surg
January 2025
Stockholm University, Stockholm, Sweden.
Introduction: Imposter syndrome (IS) refers to the psychological experience of imagining that one's achievements do not originate from one's own authentic competence. Surgeons are constantly faced with life-threatening decisions and can easily feel inadequate or insecure despite their years of training and experience. Imposter syndrome can distress surgeons at all career stages and has profound psychological and professional consequences.
View Article and Find Full Text PDFAliment Pharmacol Ther
January 2025
Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada.
Background: Novel colorectal cancer endoscopic surveillance techniques for inflammatory bowel disease (IBD) have recently been developed.
Aims: Compare the efficacy of currently available techniques for dysplasia detection in colonic IBD.
Methods: We conducted a systematic literature search from inception to March 2024 for randomized controlled trials (RCTs) or prospective cohort studies enrolling adults with IBD and having surveillance colonoscopy for dysplasia screening.
Orthop Surg
January 2025
Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
Objective: The incidence of anterior cruciate ligament (ACL) ruptures has been increasing annually. However, clinical surgeons have overlooked the impaction fractures of the posterolateral tibial plateau and lateral femoral condyle in patients with ACL ruptures. The purpose of the present study was to report the detection rate of the posterolateral tibial plateau impaction fractures in patients with ACL ruptures, and to evaluate the functional outcomes of patients following ACL reconstruction (ACLR) without treatment of the tibial fractures at a 2-year postoperative follow-up.
View Article and Find Full Text PDFJ Biophotonics
January 2025
Department of Electrical Engineering, Columbia University, New York, New York, USA.
Epicardial catheter ablation is necessary to address ventricular tachycardia targets located far from the endocardium, but epicardial adipose tissue and coronary blood vessels can complicate ablation. We demonstrate that catheter-based near-infrared spectroscopy (NIRS) can identify these obstacles to guide ablation. Eighteen human ventricles were mapped ex vivo using NIRS catheters with optical source-detector separations (SDSs) of 0.
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