Table 3. Surgeon procedure volume low vs. high: mortality, survival, recurrence, complications, 12 nodes examined, operating time, hospital stay, hospital expenses.
| Surgeon volume- outcomes | Overall | Rectal only | Colon only | Colorectal | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Study N [patient N] | HRa | (95% CI) | Study N [patient N] | HRa | (95% CI) | Study N [patient N] | HRa | (95% CI) | Study N [patient N] | HRa | (95% CI) | ||||
| Mortality | |||||||||||||||
| 30-day | 15 [131,320] | 0.84 | (0.80–0.89)*** | 5 [7,246] | 0.89 | (0.75–1.04) | 3 [60,258] | 0.62 | (0.53–0.72)*** | 7 [63,816] | 0.88 | (0.82–0.94)*** | |||
| In-hospital | 3 [256,181] | 0.98 | (0.96–0.99)*** | 1 [58,568] | 0.87 | (0.81–0.93)*** | 2 [197,613] | 0.98 | (0.97–0.99)** | – | – | – | |||
| Intra-operative | 2 [69,947] | 0.50 | (0.40–0.62)*** | – | – | – | – | – | – | 2 [69,947] | 0.50 | (0.40–0.62)*** | |||
| Survival | |||||||||||||||
| 5-year | 4 [81,366] | 0.79 | (0.75–0.83)*** | 1 [8,219] | 0.85 | (0.73–0.83)*** | 1 [8,219] | 0.84 | (0.76–0.93)*** | 2 [64,928] | 0.77 | (0.72–0.82)*** | |||
| Recurrence | |||||||||||||||
| Local | 6 [6,845] | 0.71 | (0.62–0.82)*** | 5 [4,139] | 0.72 | (0.62–0.83)*** | – | – | – | 1 [2,706] | 0.64 | (0.41–1.00) | |||
| Complications | |||||||||||||||
| Post-operative | 3 [4,896] | 0.85 | (0.70–1.08) | 2 [3,684] | 0.80 | (0.62–1.03) | 1 [1,212] | 1.69 | (0.73–3.93) | – | – | – | |||
| Anastomotic leak | 1 [8,219] | 0.59 | (0.37–0.94)** | 1 [8,219] | 0.59 | (0.37–0.94)** | – | – | – | – | – | – | |||
| Other | |||||||||||||||
| Hospital stay | 1 [61,728] | 0.67 | (0.46–0.99)* | – | – | – | – | – | – | 1 [61,728] | 0.67 | (0.46–0.99)* | |||
| Operating time | 1 [1,212] | 0.17 | (0.10–0.29)*** | – | – | – | – | – | – | – | – | – | |||
| Hospital expenses | 1 [61,728] | 0.29 | (0.18–0.44)*** | – | – | – | – | – | – | 1 [61,728] | 0.29 | (0.18–0.44)*** | |||
| 12 Nodes examined | 1 [377] | 3.66 | (2.36–5.7)** | 1 [377] | 3.66 | (2.36–5.7)** | – | – | – | – | – | – | |||
*, P value <0.05; **, P value <0.01; ***, P value <0.001. HR, hazard ratio; N, number; 95% CI, 95% confidence interval; a, low (reference) vs. high hospital procedure volume.