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A SYSTEMATIC REVIEW AND CRITIQUE OF THE LITERATURE RELATING HOSPITAL OR SURGEON VOLUME TO HEALTH OUTCOMES FOR 3 UROLOGICAL CANCER PROCEDURES

2004; Lippincott Williams & Wilkins; Volume: 172; Issue: 6 Part 1 Linguagem: Inglês

10.1097/01.ju.0000140257.05714.45

1527-3792

Martin Nuttall, Jan van der Meulen, N. R. Phillips, Carlos Sharpin, David Gillatt, Gregor McIntosh, Mark Emberton,

Colorectal Cancer Surgical Treatments

No AccessJournal of UrologyReview Articles1 Dec 2004A SYSTEMATIC REVIEW AND CRITIQUE OF THE LITERATURE RELATING HOSPITAL OR SURGEON VOLUME TO HEALTH OUTCOMES FOR 3 UROLOGICAL CANCER PROCEDURES MARTIN NUTTALL, JAN van der MEULEN, NIRREE PHILLIPS, CARLOS SHARPIN, DAVID GILLATT, GREGOR McINTOSH, and MARK EMBERTON MARTIN NUTTALLMARTIN NUTTALL , JAN van der MEULENJAN van der MEULEN , NIRREE PHILLIPSNIRREE PHILLIPS , CARLOS SHARPINCARLOS SHARPIN , DAVID GILLATTDAVID GILLATT , GREGOR McINTOSHGREGOR McINTOSH , and MARK EMBERTONMARK EMBERTON View All Author Informationhttps://doi.org/10.1097/01.ju.0000140257.05714.45AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We performed a systematic review and critique of the literature of the relationship between hospital or surgeon volume and health outcomes in patients undergoing radical surgery for cancer of the bladder, kidney or prostate. Materials and Methods: Four electronic databases were searched to identify studies that describe the relationship between hospital or surgeon volume and health outcomes. Results: All included studies were performed in North America. A total of 12 studies were found that related hospital volume to outcomes. For radical prostatectomy and cystectomy all 8 included studies showed improvement in at least 1 outcome measure with increasing volume and never deterioration. For nephrectomy the 4 included studies produced conflicting results. Four studies were found that related surgeon volume to outcomes. All radical prostatectomy and cystectomy studies showed that some outcomes were better with higher surgeon volume and never deterioration. We did not find any studies of the effect of surgeon volume on outcomes after nephrectomy. The 3 studies of the combined effect of hospital and surgeon volume on outcomes after radical prostatectomy or cystectomy suggest that high volume hospitals have better outcomes, in part because of the effect of surgeon volume and vice versa. Conclusions: Outcomes after radical prostatectomy and cystectomy are on average likely to be better if these procedures are performed by and at high volume providers. For radical nephrectomy the evidence is unclear. The impact of volume based policies (increasing volume to improve outcomes) depends on the extent to which “practice makes perfect” explains the observed results. Further studies should explicitly address selective referral and confounding as alternative explanations. Longitudinal studies should be performed to evaluate the impact of volume based policies References 1 : Is volume related to outcome in health care? A systematic review and methodologic critique of the literature. Ann Intern Med2002; 137: 511. 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Google Scholar From the Clinical Effectiveness Unit (MN, JvdM, NP, CS, ME) and Volume and Outcome Study Group in Urological Cancer Surgery (MN, JvdM, NP, CS, DG, GM, ME), Royal College of Surgeons of England, London School of Hygiene and Tropical Medicine (JvdM, NP) and Institute of Urology and Nephrology, University College London (ME), London, United Kingdom© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byFlum A, Oberlin D, Bachrach L, Jovanovic B, Helenowski I, Flury S and Meeks J (2015) Characteristics of Certifying Urologists Performing Cystectomies in the United StatesUrology Practice, VOL. 2, NO. 6, (367-372), Online publication date: 1-Nov-2015.Wang H, Tejwani R, Zhang H, Wiener J and Routh J (2015) Hospital Surgical Volume and Associated Postoperative Complications of Pediatric Urological Surgery in the United StatesJournal of Urology, VOL. 194, NO. 2, (506-511), Online publication date: 1-Aug-2015.Schlomer B, Saperston K and Baskin L (2013) National Trends in Augmentation Cystoplasty in the 2000s and Factors Associated with Patient OutcomesJournal of Urology, VOL. 190, NO. 4, (1352-1358), Online publication date: 1-Oct-2013.Elliott D (2012) Can We Better Predict and Treat Urinary Incontinence After Prostatectomy?Journal of Urology, VOL. 187, NO. 3, (789-790), Online publication date: 1-Mar-2012.Sugihara T, Yasunaga H, Horiguchi H, Nishimatsu H, Kume H, Matsuda S and Homma Y (2011) Impact of Hospital Volume and Laser Use on Postoperative Complications and In-Hospital Mortality in Cases of Benign Prostate HyperplasiaJournal of Urology, VOL. 185, NO. 6, (2248-2253), Online publication date: 1-Jun-2011.Fradet V, Allareddy V, Aaronson D and Konety B (2009) Is the Complication Rate of Radical Cystectomy Predictive of the Complication Rate of Other Urological Procedures?Journal of Urology, VOL. 181, NO. 3, (1054-1060), Online publication date: 1-Mar-2009.Wilt T, Shamliyan T, Taylor B, MacDonald R and Kane R (2008) Association Between Hospital and Surgeon Radical Prostatectomy Volume and Patient Outcomes: A Systematic ReviewJournal of Urology, VOL. 180, NO. 3, (820-829), Online publication date: 1-Sep-2008.Lowrance W, Cookson M, Clark P, Smith J and Chang S (2007) Assessing Retroperitoneal Lymphadenectomy Experience in United States Urological Residency ProgramsJournal of Urology, VOL. 178, NO. 2, (500-503), Online publication date: 1-Aug-2007.NELSON C, DUNN R, WEI J and GEARHART J (2018) SURGICAL REPAIR OF BLADDER EXSTROPHY IN THE MODERN ERA: CONTEMPORARY PRACTICE PATTERNS AND THE ROLE OF HOSPITAL CASE VOLUMEJournal of Urology, VOL. 174, NO. 3, (1099-1102), Online publication date: 1-Sep-2005. Volume 172Issue 6 Part 1December 2004Page: 2145-2152 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsurogenital neoplasmshealth care evaluation mechanismsbladderkidneyprostateMetricsAuthor Information MARTIN NUTTALL More articles by this author JAN van der MEULEN More articles by this author NIRREE PHILLIPS More articles by this author CARLOS SHARPIN More articles by this author DAVID GILLATT More articles by this author GREGOR McINTOSH More articles by this author MARK EMBERTON More articles by this author Expand All Advertisement PDF downloadLoading ...