Influence of surgeon's volume on early outcome after total gastrectomy.

Objective: To examine correlation between number of total gastrectomies done by each of 21 surgeons and the early outcome of these operations.

Design: Retrospective case series.

Setting: University hospital, Japan.

Patients: 136 patients treated by total gastrectomy for gastric cancer during a 4-year period.

Intervention: Univariate and multivariate analyses of the effect of each surgeon's volume on the early outcome of total gastrectomy.

Main outcome measures: Differences in the morbidity and mortality after total gastrectomy between high-volume and low-volume surgeons.

Results: There was a significant difference in the incidence of major complications of total gastrectomy between high-volume (7/66, 11%) and low-volume (17/70, 24%) surgeons (p = 0.04).

Conclusion: Possible reasons for differences in outcome between high-volume and low-volume surgeons should be investigated in an attempt to define and describe the methods that are associated with the best outcome.