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Surgery Today
Published in: Surgery Today 5/2017

01-05-2017 | Original Article

Association between the participation of board-certified surgeons in gastroenterological surgery and operative mortality after eight gastroenterological procedures

Authors: Hiroyuki Konno, Kinji Kamiya, Hirotoshi Kikuchi, Hiroaki Miyata, Norimichi Hirahara, Mitsukazu Gotoh, Go Wakabayashi, Tetsuo Ohta, Norihiro Kokudo, Masaki Mori, Yasuyuki Seto

Published in: Surgery Today | Issue 5/2017

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Abstract

Purpose

The aim of this study is to evaluate the association between the participation of board-certified surgeons in gastroenterological surgery (BCS-Gs) and the surgical outcomes of gastroenterological surgery.

Methods

Data from the National Clinical Database on patients who underwent eight major gastroenterological procedures were analyzed retrospectively. First, the ratio of cases in which BCS-G were involved to the total cases was calculated for each procedure, and the impact of BCS-G involvement on surgical outcome was assessed by comparing mortality rates in the group with BCS-G involvement vs. the group without BCS-G involvement. Second, the differences in the observed/expected ratio were assessed among four hospital categories according to the available BCS-G number. Finally, the impact of the hospital BCS-G number on mortality was evaluated.

Results

The ratio of BCS-G involvement ranged from 59.0 % for acute diffuse peritonitis to 89.1 % for hepatectomy, and the mortality rate was significantly lower for three procedures when BCS-Gs participated as the operator or assistant. The observed/expected ratio of hospitals with four or more BCS-Gs was less than 1.0 for all the procedures assessed. A multivariable logistic regression model showed that the hospital BCS-G number was a predictor of operative mortality.

Conclusions

BCS-Gs contribute to favorable outcomes of gastroenterological surgery in Japan. The hospital BCS-G number is a surrogate marker of operative mortality.
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Metadata
Title
Association between the participation of board-certified surgeons in gastroenterological surgery and operative mortality after eight gastroenterological procedures
Authors
Hiroyuki Konno
Kinji Kamiya
Hirotoshi Kikuchi
Hiroaki Miyata
Norimichi Hirahara
Mitsukazu Gotoh
Go Wakabayashi
Tetsuo Ohta
Norihiro Kokudo
Masaki Mori
Yasuyuki Seto
Publication date
01-05-2017
Publisher
Springer Japan
Published in
Surgery Today / Issue 5/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-016-1422-5

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