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Low-Volume Hysterectomy Surgeons Tied to Higher Risk

Patient morbidity, mortality higher with these surgeons; minimally invasive surgeries less likely

FRIDAY, Sept. 24 (HealthDay News) -- Morbidity and mortality are higher after hysterectomies performed by surgeons who perform fewer than 10 of these procedures per year, and those who perform at least 10 per year are more likely to perform minimally invasive procedures, according to research published in the October issue of Obstetrics & Gynecology.

Leslie R. Boyd, M.D., of the New York University School of Medicine in New York City, and colleagues conducted a cross-sectional study using 2001 through 2006 data on inpatient hysterectomies from the New York State Department of Health database. The purpose of the study was to estimate the relationship of a surgeon's case volume to route of hysterectomy and short-term morbidity.

During the study period, 146,494 hysterectomies were performed in the state of New York, 26 percent of them by surgeons who performed this procedure fewer than 10 times per year. The researchers found that these lower-volume surgeons tended to perform more abdominal procedures than did higher-volume surgeons (81 versus 67 percent), instead of vaginal and laparoscopic-assisted approaches. Postoperative morbidity and mortality were also higher for lower-volume surgeons (16.5 and 0.21 percent, respectively) compared to higher-volume surgeons (11.7 and 0.06 percent, respectively).

"In summary, performance of an average of 10 hysterectomies per year is associated with improved outcomes and may be a reasonable benchmark for high-volume status," the authors write.

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