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Threshold volumes for urological cancer surgery: a survey of UK urologists
Author(s) -
Nuttall Martin C.,
Van Der Meulen Jan,
McIntosh Gregor,
Gillatt David,
Emberton Mark
Publication year - 2004
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2004.05095.x
Subject(s) - medicine , volume (thermodynamics) , prostatectomy , cystectomy , surgery , general surgery , cancer , bladder cancer , prostate cancer , physics , quantum mechanics
OBJECTIVE To determine minimum threshold levels of activity set by surgeons for urological cancer surgery, and to relate threshold levels to stated current procedural volume. METHODS In all, 307 consultant urological surgeons were sent a questionnaire asking them to state for four urological cancer operations of different complexity their current procedural volume; whether minimum volume thresholds per surgeon should be implemented; and if so, the level of such thresholds; 212 (69%) replied. RESULTS For all four procedures ≥ 75% of surgeons advocated the setting of a minimum volume threshold. Overall, surgeons set the highest thresholds for radical prostatectomy and the lowest for radical cystectomy with continent diversion. There was no significant association between either the principle of supporting minimum volume thresholds or the level of such a threshold and the number of years worked as a consultant surgeon. The level of surgeon‐derived minimum thresholds increased with increasing surgeon procedural volume. CONCLUSION Most surgeons supported the principle of setting minimum volume thresholds. These thresholds appear to be influenced by current procedural volume and by procedural complexity. By setting thresholds greater than their current volume, some surgeons implicitly indicate that their current volume is insufficient to maintain their surgical competency.