ArticleSurgery2018
Each procedure matters: threshold for surgeon volume to minimize complications and decrease cost associated with adrenalectomy.
Article in Surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
26 citing papers in PubMed, 69 citations in OpenAlex.
- Risk factors for early postoperative complications after minimally invasive adrenalectomy: a single-centre retrospective cohort study of more than 800 patients.Surgical endoscopy · 2026Article
- Surgery for adrenal gland disease. Experience of a tertiary center.Surgery open science · 2026Article
- Impact of centre volume on adrenalectomy outcomes: European multicentre study based on EUROCRINE® registry.BJS open · 2025Article
- A Retrospective Study to Assess Survival Post-adrenal Metastasectomy in Our Regional Endocrine Surgery Unit.Cureus · 2025Article
- Current state-of-the-art of adrenal surgery in Italy: the cancer risk in surgical adrenal lesions (CRISAL) survey.Updates in surgery · 2025Article
- Epidemiological trends of adrenalectomies in Brazil: A cohort-based study of the Brazilian public health system.Archives of endocrinology and metabolism · 2025Article
- Perioperative outcomes of adrenal surgery Does surgical specialty matter?Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2025Article
- The role of surgeon and hospital volume in optimizing adrenal surgery outcomes.Gland surgery · 2024Article
- Defining high-volume adrenal surgeons to improve patient outcomes.Gland surgery · 2024Article
- Centralization of adrenal surgeries and improved surgeon volume outcomes.Gland surgery · 2024Article
- Use of computer simulation to identify effects on hospital census with reduction of transfers for non-procedural patients in community hospitals.BMJ open quality · 2024Article
- Adrenalectomy approach and outcomes according to surgeon volume.American journal of surgery · 2024Article
- Effect of ultrasound-guided lumbar square muscle block on stress response in patients undergoing radical gastric cancer surgery.World journal of gastrointestinal oncology · 2023Article
- Retroperitoneoscopic adrenalectomy may be superior to laparoscopic transperitoneal adrenalectomy in terms of costs and profit: a retrospective pair-matched cohort analysis.Surgical endoscopy · 2023Observational
- Risk factors for intraoperative complications, postoperative complications, and prolonged length of stay after laparoscopic adrenalectomy by transperitoneal lateral approach: a retrospective cohort study of 547 procedures.Surgical endoscopy · 2023Article
- National perspective on hospital readmissions following adrenalectomy.Gland surgery · 2022Article
- Optimal surgeon and hospital volume thresholds to reduce mortality and length of stay for CABG.PloS one · 2021Article
- Racial Disparities of Adrenalectomy.Journal of the Endocrine Society · 2020Article
- Impact of Surgeon Volume on Outcomes and Expenditure Among Medicare Beneficiaries Undergoing Liver Resection: the Effect of Minimally Invasive Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
- Update on Pheochromocytoma and Paraganglioma from the SSO Endocrine and Head and Neck Disease Site Working Group, Part 2 of 2: Perioperative Management and Outcomes of Pheochromocytoma and Paraganglioma.Annals of surgical oncology · 2020Review
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn association has been suggested between increasing surgeon volume and improved patient outcomes, but a threshold has not been defined for what constitutes a "high-volume" adrenal surgeon.
methodsAdult patients who underwent adrenalectomy by an identifiable surgeon between 1998-2009 were selected from the Healthcare Cost and Utilization Project National Inpatient Sample. Logistic regression modeling with restricted cubic splines was utilized to estimate the association between annual surgeon volume and complication rates in order to identify a volume threshold.
resultsA total of 3,496 surgeons performed adrenalectomies on 6,712 patients; median annual surgeon volume was 1 case. After adjustment, the likelihood of experiencing a complication decreased with increasing annual surgeon volume up to 5.6 cases (95% confidence interval, 3.27-5.96). After adjustment, patients undergoing resection by low-volume surgeons (<6 cases/year) were more likely to experience complications (odds ratio 1.71, 95% confidence interval, 1.27-2.31, P = .005), have a greater hospital stay (relative risk 1.46, 95% confidence interval, 1.25-1.70, P = .003), and at increased cost (+26.2%, 95% confidence interval, 12.6-39.9, P = .02).
conclusionThis study suggests that an annual threshold of surgeon volume (≥6 cases/year) that is associated with improved patient outcomes and decreased hospital cost. This volume threshold has implications for quality improvement, surgical referral and reimbursement, and surgical training.
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