Evidence map›Paper›PMID 35257214›Full record

ArticleSurgical endoscopy2022

Association of individual surgeon volume and postoperative outcome in esophagomyotomy for achalasia.

Anthony J DeSantis, Haroon M Janjua, Daniela Moiño, Graham Davis, Victoria Sands, McWayne Weche, Paul C Kuo, Joseph Sujka, Christopher DuCoin

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Anthony J DeSantisDepartment of Surgery, University of South Florida, Harborside Medical Tower, 5 Tampa General Circle, Suite 410, Tampa, FL, 33606, USA. adesanti@usf.edu.ORCID http://orcid.org/0000-0002-0746-8605
Haroon M JanjuaOnetoMap Analytics, University of South Florida, Tampa, FL, USA.
Daniela MoiñoDepartment of Surgery, University of South Florida, Harborside Medical Tower, 5 Tampa General Circle, Suite 410, Tampa, FL, 33606, USA.
Graham DavisDepartment of Surgery, University of South Florida, Harborside Medical Tower, 5 Tampa General Circle, Suite 410, Tampa, FL, 33606, USA.
Victoria SandsDepartment of Surgery, University of South Florida, Harborside Medical Tower, 5 Tampa General Circle, Suite 410, Tampa, FL, 33606, USA.
McWayne WecheDepartment of Surgery, University of South Florida, Harborside Medical Tower, 5 Tampa General Circle, Suite 410, Tampa, FL, 33606, USA.
Paul C KuoOnetoMap Analytics, University of South Florida, Tampa, FL, USA.
Joseph SujkaDepartment of Surgery, University of South Florida, Harborside Medical Tower, 5 Tampa General Circle, Suite 410, Tampa, FL, 33606, USA.
Christopher DuCoinDepartment of Surgery, University of South Florida, Harborside Medical Tower, 5 Tampa General Circle, Suite 410, Tampa, FL, 33606, USA.
University of South Florida · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany surgical disciplines have demonstrated superior outcomes when procedures are performed at "high-volume". Esophagomyotomy is commonly performed for achalasia, however it's unclear what constitutes "high-volume" for this procedure, and if individual procedure volume and outcome are related. We identified physicians performing esophagomyotomy, stratified them by individual case volume, and examined their outcomes with the hypothesis that high-volume surgeons will be associated with improved outcomes as compared to low-volume surgeons.

methodsThe 2015-2019 Florida Agency for Health Care Administration (AHCA) inpatient dataset was queried for esophagomyotomy. Surgeons who performed ≥ 10 procedures during the study period were placed into the high-volume cohort, and those performing < 10 into the low-volume cohort. Groups were compared by length of stay, discharge disposition, and postoperative complications. Patient demographics were evaluated using student's t test and chi square test, p < 0.05 considered significant.

resultsSix hundred and sixty-two procedures performed by 135 surgeons were identified. The mean number of esophagomyotomies per surgeon was 4.9 (Range 1-147). The high-volume group (n = 12) performed 362 of the 662 procedures (55%), while the low-volume group (n = 123) performed the remaining 300 (45%). Patients of high-volume physicians had decreased length of stay (1.4 ± 0.8 days vs 4.9 ± 6.7 days, p = 0.01) and were more likely to be discharged to home following surgery (92.8% vs 86.0, p = 0.04). High volume physicians also had statistically significant differences in rates of urinary tract infection (1.4% vs 4.0%, p = 0.034), postoperative malnutrition (5.8% vs 11.0%, p = 0.015), and postoperative fluid and electrolyte disorders (5.5% vs 13.3%, p < 0.0001).

conclusionSurgeons who perform higher volumes of esophagomyotomies are associated with decreased length of stay, higher likelihood of patient discharge to home, and decreased rates of some postoperative complications. This research should prompt further inquiry into defining what constitutes a high-volume center in foregut surgery and their role in improving patient outcomes.

Indexed as

Esophageal AchalasiaSurgeonsHumansLength of StayPostoperative ComplicationsRetrospective StudiesTreatment OutcomeAchalasiaEsophagomyotomyForegut surgeryHellerOutcomesPOEMSurgeon volume

Identifiers

PMID35257214
OpenAlexW4220832931

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.