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Practice Makes Perfect for Surgeons

http://www.wate.com/global/story.asp?s=1488616&ClientType=Printable

Practice Makes Perfect for Surgeons


(Ivanhoe Newswire) -- If you need surgery to repair the largest blood vessel in your body, a new study says your risk of surviving the surgery is much higher if your surgeon has operated on many other patients with the same condition.


The study compared the mortality rates of nearly 4,000 patients who underwent surgery to repair an intact abdominal aortic aneurysm. An AAA is a weak spot in the aorta, the body's main blood vessel. When the vessel wall gets too thin and weak it can burst and cause a stroke.



Patients in the study were operated on by either a vascular, cardiac or general surgeon. Researchers found 2.2 percent of patients operated on by vascular surgeons died, compared to 4 percent of patients operated on by cardiac surgeons and 5.5 percent of patients operated on by general surgeons. The analysis shows the risk of death was 76-percent higher if a general surgeon performed the operation than if a vascular surgeon or cardiac surgeon did it.


The researchers also looked at how many AAA repairs all three types of surgeons performed each year. They qualified any surgeon, no matter what their specialty, as "high-volume" if they repaired more than 10 AAAs in a year. The study found patients operated on by "high-volume" surgeons were 40-percent less likely to die in the hospital than those operated on by "low-volume" surgeons.


Senior author Gilbert R. Upchurch, Jr., M.D., says, "The bottom line is that with a complex operation like this, experience counts."


The study's authors conclude patients have the best chance of survival if a vascular surgeon -- a surgeon who specializes in operating on blood vessels -- repairs their abdominal aortic aneurysms, or AAAs. The authors say if a vascular surgeon is not available, patients should at least try to go to a surgeon or a hospital with a high level of experience performing the tricky procedure.


Researchers also found that if patients had the surgery in a hospital that performed at least 35 AAA operations a year, they had a 30 percent lower chance of dying in the hospital.


This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.


SOURCE: Journal of Vascular Surgery, 2003;38:739-744
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