The Influence of Surgical Operative Experience on the Duration of First Ventriculoperitoneal Shunt Function and InfectionCochrane D.D. · Kestle J.R.W.
aDepartment of Surgery, University of British Columbia and Children’s and Women’s Health Center of British Columbia, Vancouver, B.C., Canada; bDepartment of Neurosurgery, University of Utah and Primary Children’s Medical Center, Salt Lake City, Utah, USA
The relationship of surgeon experience, measured by operative volume, to the outcomes of ventricular shunt treatment of hydrocephalus in children is not clear. This paper explores this relationship based on first ventriculoperitoneal shunts (VPS) implanted in English-speaking Canada during the period from April 1989 to March 2001. Three thousand seven hundred and ninety-four first VPS insertions, performed by 254 surgeons, were reviewed. Surgical experience was represented by the number of shunt operations performed during the study period by each surgeon prior to the date of the operation. The 6-month shunt failure risk for less experienced surgeons was 38%, compared to 31% for more experienced surgeons. This difference decreased to 4% at 60 months and 3% at 120 months (p = 0.001). The infection rate for initial shunt insertions was 7% for patients treated by more experienced surgeons and 9.4% for those treated by less experienced surgeons (p = 0.006). A relationship between surgeon experience and shunt outcome that appears to be based on the operative experience that a surgeon brings to a procedure is in keeping with clinical experience. This observation has implications for public policy, service planning and surgical mentorship during the earlier years of a surgeon’s career.
D.D. Cochrane, MD, FRCS(C)
Children’s and Women’s Health Center of British Columbia
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Vancouver, BC V5Z 4H4 (Canada)
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Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 2, Number of References : 33
Founded 1985 by E.B. Hendrick and D.H. Reigel; Editor-in-Chief 1992–1996: F.J. Epstein, 1986–1998: D.H. Reigel, 1997–2002: D.G. McLone
Official Journal of the American Society of Pediatric Neurosurgeons (ASPN)
Vol. 38, No. 6, Year 2003 (Cover Date: June 2003)
Journal Editor: W.J. Oakes, Birmingham, Ala.; M.L. Walker, Salt Lake City, Utah
ISSN: 1016–2291 (print), 1423–0305 (Online)
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