Surgeon volume and hospital volume in endocrine neck surgery: how many procedures are needed for reaching a safety level and acceptable costs? A systematic narrative review

摘要: The relationship between quality of care and provider's experience is well known in all fields surgery. Even thyroidectomies parathyroidectomies, the emphasis on positive volume-outcome relationships believed. It led us to an evaluation volume activity's impact terms care. A systematic narrative review was performed. According PRISMA criteria, we selected 87 paper and, after study selection performed, 22 studies were finally included this review. All articles unanimous attributing activity surgeons as centers a substantial importance. Some differences outcomes these investigated categories have been found: best results high surgeon evident expecially complications, contrary center are mainly economics, such hospital stay general costs procedures. cut-off 35-40 per year for single surgeon, 90-100 appears reasonable identifying adequate activity. Concerning parathyroidectomy, can consider cut off at 10-12 operations/year. More needed European or more circumscribed perspective.