Operating lists are created by rational algorithms and use of power. What can a social scientific view offer surgeons?
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.