Bentrem David J, Brennan Murray F
Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
World J Surg. 2005 Oct;29(10):1210-6. doi: 10.1007/s00268-005-7991-x.
Commonly performed elective surgical procedures on the alimentary tract are carried out with low morbidity and low mortality in most hospitals in the United States. There are some procedures on the alimentary tract that are performed with a relatively low frequency and are associated with higher mortality. Volume is a surrogate marker associated with improved outcome, with relative differences being dependent on the complexity of the procedure and the frequency with which it is done. Both surgeon and institutional volume matters, but it seems that improved operative mortality can be reached with lower surgeon volume in high-volume institutions. It appears that volume can be substituted in part for by specialization and training, with improved outcomes based on specialist credentials and fellowship training.
在美国的大多数医院里，常见的消化道择期手术的发病率和死亡率都很低。消化道的一些手术实施频率相对较低，且死亡率较高。手术量是与改善预后相关的一个替代指标，相对差异取决于手术的复杂性及其实施频率。外科医生的手术量和机构的手术量都很重要，但在手术量大的机构中，似乎较低的外科医生手术量也能实现手术死亡率的改善。似乎手术量可以部分地被专业化和培训所替代，基于专科资质和进修培训可改善预后。
