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

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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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Acknowledgments

We thank all data managers and hospitals participating in this National Clinical Database project for their efforts in entering the data. We also thank the working members of the JSGS database committee (Drs Harushi Udagawa, Toshiaki Watanabe, Akira Tangoku, Michiaki Unno, Akinobu Taketomi, Chikara Kunisaki, and Kenichi Sugihara).

Author information

Authors and Affiliations

  1. The Japanese Society of Gastroenterological Surgery, Database Committee, Tokyo, Japan

    Hiroyuki Konno, Hiroaki Miyata, Mitsukazu Gotoh & Go Wakabayashi

  2. Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Higashi-ku, Hamamatsu, 431-3192, Japan

    Hiroyuki Konno, Kinji Kamiya & Hirotoshi Kikuchi

  3. National Clinical Database, Tokyo, Japan

    Hiroaki Miyata, Norimichi Hirahara & Mitsukazu Gotoh

  4. The Japanese Society of Gastroenterological Surgery, Tokyo, Japan

    Tetsuo Ohta, Masaki Mori & Yasuyuki Seto

  5. Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Norihiro Kokudo

Authors
  1. Hiroyuki Konno
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  2. Kinji Kamiya
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  3. Hirotoshi Kikuchi
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  4. Hiroaki Miyata
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  5. Norimichi Hirahara
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  6. Mitsukazu Gotoh
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  7. Go Wakabayashi
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  8. Tetsuo Ohta
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  9. Norihiro Kokudo
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  10. Masaki Mori
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  11. Yasuyuki Seto
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Corresponding author

Correspondence to Hiroyuki Konno.

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Funding/support

This study was partially supported by a research Grant from the Ministry of Health, Labour and Welfare, Japan.

Conflict of interest

Prof. N. Kokudo received research funding from Sumitomo Dainippon Pharma Co., Ltd. The other authors indicated no potential of conflict of interest.

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Konno, H., Kamiya, K., Kikuchi, H. et al. Association between the participation of board-certified surgeons in gastroenterological surgery and operative mortality after eight gastroenterological procedures. Surg Today 47, 611–618 (2017). https://doi.org/10.1007/s00595-016-1422-5

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  • DOI: https://doi.org/10.1007/s00595-016-1422-5

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