ArticleThe British journal of surgery2024
Impact of adrenal surgeon volume on outcome: analysis of 4464 operations from the United Kingdom Registry of Endocrine and Thyroid Surgery (UKRETS).
Article in The British journal of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 8 citations in OpenAlex.
- A two-centre experience with hand-assisted laparoscopic, transperitoneal laparoscopic and retroperitoneoscopic adrenalectomy.Surgical endoscopy · 2026Article
- [Diagnostics and surgery of mild autonomous cortisol secretion (MACS)].Chirurgie (Heidelberg, Germany) · 2026Article
- Surgery for adrenal gland disease. Experience of a tertiary center.Surgery open science · 2026Article
- Article
- Impact of centre volume on adrenalectomy outcomes: European multicentre study based on EUROCRINE® registry.BJS open · 2025Article
- Standardizing the reporting of postoperative hypoparathyroidism following thyroidectomy: consensus statement from the European Society of Endocrine Surgeons, the American Association of Endocrine Surgeons, and the International Association of Endocrine Surgeons.The British journal of surgery · 2025Article
- Risk factors for recurrent laryngeal nerve injury following thyroid surgery: a systematic review and meta-analysis.Frontiers in surgery · 2025Review
- 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
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is a surgeon volume-outcome effect in adrenal surgery but the threshold for high-volume surgeon remains controversial. This study aimed to determine predictors of high-risk adrenal operations and to explore whether these should be restricted to high-volume surgeons.
methodsPatients undergoing adrenal surgery and registered in the United Kingdom Registry of Endocrine and Thyroid Surgery between 2004 and 2021 were analysed. Outcomes included postoperative complications, duration of hospital stay, and mortality. Factors included in multivariable analysis were age, sex, diagnosis, surgical approach, laterality, and surgeon volume. Patients with missing data were excluded.
resultsA total of 4464 of 6174 patients (72.3%) were analysed. Postoperative complications occurred in 418 patients (9.4%) and 14 (0.3%) died. Median duration of hospital stay was 3 (i.q.r. 2-5) days. Co-variables significantly associated with an increase or decrease in postoperative complications (P < 0.050) were age (OR 1.02, 95% c.i. 1.01 to 1.03), adrenal cancer (OR 1.64, 1.14 to 2.36), minimally invasive approach (OR 0.317, 0.248 to 0.405), bilateral surgery (OR 1.66, 1.03 to 2.69), and surgeon volume (OR 0.98, 0.96 to 0.99). An increase or decrease in mortality was associated with patient age (OR 1.08, 1.03 to 1.13), minimally invasive approach (OR 0.08, 0.02 to 0.27), and bilateral surgery (OR 6.93, 1.40 to 34.34). The incidence of postoperative complications was significantly lower above a threshold of 12 operations per year (P = 0.034) and 20 per year (P < 0.001), but not six per year (P = 0.540). Median duration of hospital stay was 2 days for surgeons doing over 20 operations per year, compared with 3 days for those undertaking fewer than 20, fewer than 12 or fewer than 6 operations per year.
conclusionIncreasing surgical volume is associated with shorter hospital stay and fewer complications. This analysis supports the case for centralization of surgery for adrenal cancer and bilateral tumours to higher-volume surgeons performing a minimum of 12 operations per year.
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