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Terry D Amaral - One of the best experts on this subject based on the ideXlab platform.
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a dual team approach benefits standard volume Surgeons but has minimal impact on outcomes for a high volume surgeon in ais patients
Spine deformity, 2020Co-Authors: Vishal Sarwahi, Jesse M Galina, Stephen Wendolowski, Jonpaul Dimauro, Marina Moguilevich, Chhavi Katyal, Beverly Thornhill, Yungtai Lo, Terry D AmaralAbstract:Retrospective chart review of prospectively collected data. This study seeks to evaluate the effect of number of Surgeons, surgeon experience, and surgeon volume on AIS surgery. Recent literature suggests that utilizing two Surgeons for spine deformity correction surgery can improve perioperative outcomes. However, the surgeon’s experience and surgical volume are likely as important. AIS patients undergoing PSF from 2009 to 2019 were included. Patient demographics, X-ray and perioperative outcomes were collected and collated based on primary surgeon. Analysis was performed for single versus dual Surgeons, surgeon experience (≤ 10 years in practice), and surgical volume (less/greater than 50 cases/year). Median (IQR) values, Wilcoxon Rank Sums test, Kruskal–Wallis test, and Fisher’s exact test were utilized. 519 AIS cases, performed by 4 Surgeons were included. Two Surgeons were highly experienced, 1 of whom was also high volume. Five cohorts were studied: a single senior high volume (S1) (n = 302), dual-junior Surgeons (DJ) (n = 73), dual senior–junior (SJ) (n = 36), dual-senior (DS) (n = 21) and a single senior, standard-volume surgeon alone (S2) (n = 87). Radiographic parameters were similar between the groups (p > 0.05). Preoperative Cobb was significantly higher for DS compared to S1 (p = 0.034) Pre- and post-op kyphosis were similar (p > 0.05). Cobb correction was similar (p > 0.05). Levels fused, fixation points, anesthesia and surgical times were similar (p > 0.05). When the standard-volume surgeon operated with a second surgeon, radiographic parameters were similar (p > 0.05), but anesthesia time, surgical time, and hospital length of stay were significantly shorter (p < 0.05). Additionally, DJ had significantly shorter anesthesia and operative times (p < 0.001) and length of stay (p < 0.001) compared to S2. Standard-volume Surgeons have better outcomes with a dual surgeon approach. Junior Surgeons benefit operating with an experienced surgeon. A high-volume surgeon, however, does not benefit from a dual surgeon approach. Level II.
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p100 a dual team approach benefits standard volume Surgeons but has minimal impact on outcomes for a high volume surgeon in ais patients
The Spine Journal, 2019Co-Authors: Vishal Sarwahi, Jesse M Galina, Aaron M Atlas, Sayyida S Hasan, Yungtai Lo, Terry D AmaralAbstract:BACKGROUND CONTEXT Recent literature suggests that utilizing two Surgeons for spine deformity correction surgery can improve perioperative outcomes. However, the surgeon's experience and surgical volume are likely just as important. PURPOSE This study seeks to evaluate effect of the dual versus single surgeon approach to Adolescent Idiopathic Scoliosis (AIS) correction through posterior spinal fusion (PSF). STUDY DESIGN/SETTING Ambispective chart review. PATIENT SAMPLE AIS patients undergoing PSF from 2012-2018 were included. OUTCOME MEASURES Patient demographics, pre- and postoperative kyphosis, pre- and postoperative Cobb angle, surgery time, anesthesia time, EBL, extubation, transfusion rate, perioperative complication rate, length of hospital stay. METHODS AIS patients undergoing PSF from 2012-2018 were included. Patient demographics, X-ray and perioperative outcomes were collected and collated based on primary surgeon. Analysis was performed for single vs dual Surgeons, surgeon experience ( 10 years in practice), and surgical volume ( 50 cases/year). A sub-analysis was performed for adolescent idiopathic scoliosis patients. Median and IQR values, Wilcoxon Rank Sums test, Kruskal-Wallis test, and Fisher's exact test were utilized. RESULTS A total of 520 AIS cases, performed by 4 Surgeons were included. Two Surgeons were highly experienced, 1 of whom was also high volume. The five cohorts were a single senior high volume (S1) (n=302), dual-junior Surgeons (DJ) (n=73), dual senior-junior (SJ) (n=36), dual-senior (DS) (n=21) and a single senior, standard volume surgeon alone (n =87). Radiographic parameters were similar between the groups (p 0.05). S1 had significantly lower EBL (p 0.05) in EBL, operative time, immediate extubation, transfusion rate, perioperative complication rate, and length of hospital stay between SSHV and DS. A dual junior surgeon approach had significantly shorter anesthesia (p CONCLUSIONS Standard volume Surgeons have better outcomes with dual surgeon approach. Junior Surgeons benefit operating with an experienced surgeon. A high-volume surgeon, however, does not benefit from a dual surgeon approach. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
Vishal Sarwahi - One of the best experts on this subject based on the ideXlab platform.
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a dual team approach benefits standard volume Surgeons but has minimal impact on outcomes for a high volume surgeon in ais patients
Spine deformity, 2020Co-Authors: Vishal Sarwahi, Jesse M Galina, Stephen Wendolowski, Jonpaul Dimauro, Marina Moguilevich, Chhavi Katyal, Beverly Thornhill, Yungtai Lo, Terry D AmaralAbstract:Retrospective chart review of prospectively collected data. This study seeks to evaluate the effect of number of Surgeons, surgeon experience, and surgeon volume on AIS surgery. Recent literature suggests that utilizing two Surgeons for spine deformity correction surgery can improve perioperative outcomes. However, the surgeon’s experience and surgical volume are likely as important. AIS patients undergoing PSF from 2009 to 2019 were included. Patient demographics, X-ray and perioperative outcomes were collected and collated based on primary surgeon. Analysis was performed for single versus dual Surgeons, surgeon experience (≤ 10 years in practice), and surgical volume (less/greater than 50 cases/year). Median (IQR) values, Wilcoxon Rank Sums test, Kruskal–Wallis test, and Fisher’s exact test were utilized. 519 AIS cases, performed by 4 Surgeons were included. Two Surgeons were highly experienced, 1 of whom was also high volume. Five cohorts were studied: a single senior high volume (S1) (n = 302), dual-junior Surgeons (DJ) (n = 73), dual senior–junior (SJ) (n = 36), dual-senior (DS) (n = 21) and a single senior, standard-volume surgeon alone (S2) (n = 87). Radiographic parameters were similar between the groups (p > 0.05). Preoperative Cobb was significantly higher for DS compared to S1 (p = 0.034) Pre- and post-op kyphosis were similar (p > 0.05). Cobb correction was similar (p > 0.05). Levels fused, fixation points, anesthesia and surgical times were similar (p > 0.05). When the standard-volume surgeon operated with a second surgeon, radiographic parameters were similar (p > 0.05), but anesthesia time, surgical time, and hospital length of stay were significantly shorter (p < 0.05). Additionally, DJ had significantly shorter anesthesia and operative times (p < 0.001) and length of stay (p < 0.001) compared to S2. Standard-volume Surgeons have better outcomes with a dual surgeon approach. Junior Surgeons benefit operating with an experienced surgeon. A high-volume surgeon, however, does not benefit from a dual surgeon approach. Level II.
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p100 a dual team approach benefits standard volume Surgeons but has minimal impact on outcomes for a high volume surgeon in ais patients
The Spine Journal, 2019Co-Authors: Vishal Sarwahi, Jesse M Galina, Aaron M Atlas, Sayyida S Hasan, Yungtai Lo, Terry D AmaralAbstract:BACKGROUND CONTEXT Recent literature suggests that utilizing two Surgeons for spine deformity correction surgery can improve perioperative outcomes. However, the surgeon's experience and surgical volume are likely just as important. PURPOSE This study seeks to evaluate effect of the dual versus single surgeon approach to Adolescent Idiopathic Scoliosis (AIS) correction through posterior spinal fusion (PSF). STUDY DESIGN/SETTING Ambispective chart review. PATIENT SAMPLE AIS patients undergoing PSF from 2012-2018 were included. OUTCOME MEASURES Patient demographics, pre- and postoperative kyphosis, pre- and postoperative Cobb angle, surgery time, anesthesia time, EBL, extubation, transfusion rate, perioperative complication rate, length of hospital stay. METHODS AIS patients undergoing PSF from 2012-2018 were included. Patient demographics, X-ray and perioperative outcomes were collected and collated based on primary surgeon. Analysis was performed for single vs dual Surgeons, surgeon experience ( 10 years in practice), and surgical volume ( 50 cases/year). A sub-analysis was performed for adolescent idiopathic scoliosis patients. Median and IQR values, Wilcoxon Rank Sums test, Kruskal-Wallis test, and Fisher's exact test were utilized. RESULTS A total of 520 AIS cases, performed by 4 Surgeons were included. Two Surgeons were highly experienced, 1 of whom was also high volume. The five cohorts were a single senior high volume (S1) (n=302), dual-junior Surgeons (DJ) (n=73), dual senior-junior (SJ) (n=36), dual-senior (DS) (n=21) and a single senior, standard volume surgeon alone (n =87). Radiographic parameters were similar between the groups (p 0.05). S1 had significantly lower EBL (p 0.05) in EBL, operative time, immediate extubation, transfusion rate, perioperative complication rate, and length of hospital stay between SSHV and DS. A dual junior surgeon approach had significantly shorter anesthesia (p CONCLUSIONS Standard volume Surgeons have better outcomes with dual surgeon approach. Junior Surgeons benefit operating with an experienced surgeon. A high-volume surgeon, however, does not benefit from a dual surgeon approach. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
Jesse M Galina - One of the best experts on this subject based on the ideXlab platform.
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a dual team approach benefits standard volume Surgeons but has minimal impact on outcomes for a high volume surgeon in ais patients
Spine deformity, 2020Co-Authors: Vishal Sarwahi, Jesse M Galina, Stephen Wendolowski, Jonpaul Dimauro, Marina Moguilevich, Chhavi Katyal, Beverly Thornhill, Yungtai Lo, Terry D AmaralAbstract:Retrospective chart review of prospectively collected data. This study seeks to evaluate the effect of number of Surgeons, surgeon experience, and surgeon volume on AIS surgery. Recent literature suggests that utilizing two Surgeons for spine deformity correction surgery can improve perioperative outcomes. However, the surgeon’s experience and surgical volume are likely as important. AIS patients undergoing PSF from 2009 to 2019 were included. Patient demographics, X-ray and perioperative outcomes were collected and collated based on primary surgeon. Analysis was performed for single versus dual Surgeons, surgeon experience (≤ 10 years in practice), and surgical volume (less/greater than 50 cases/year). Median (IQR) values, Wilcoxon Rank Sums test, Kruskal–Wallis test, and Fisher’s exact test were utilized. 519 AIS cases, performed by 4 Surgeons were included. Two Surgeons were highly experienced, 1 of whom was also high volume. Five cohorts were studied: a single senior high volume (S1) (n = 302), dual-junior Surgeons (DJ) (n = 73), dual senior–junior (SJ) (n = 36), dual-senior (DS) (n = 21) and a single senior, standard-volume surgeon alone (S2) (n = 87). Radiographic parameters were similar between the groups (p > 0.05). Preoperative Cobb was significantly higher for DS compared to S1 (p = 0.034) Pre- and post-op kyphosis were similar (p > 0.05). Cobb correction was similar (p > 0.05). Levels fused, fixation points, anesthesia and surgical times were similar (p > 0.05). When the standard-volume surgeon operated with a second surgeon, radiographic parameters were similar (p > 0.05), but anesthesia time, surgical time, and hospital length of stay were significantly shorter (p < 0.05). Additionally, DJ had significantly shorter anesthesia and operative times (p < 0.001) and length of stay (p < 0.001) compared to S2. Standard-volume Surgeons have better outcomes with a dual surgeon approach. Junior Surgeons benefit operating with an experienced surgeon. A high-volume surgeon, however, does not benefit from a dual surgeon approach. Level II.
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p100 a dual team approach benefits standard volume Surgeons but has minimal impact on outcomes for a high volume surgeon in ais patients
The Spine Journal, 2019Co-Authors: Vishal Sarwahi, Jesse M Galina, Aaron M Atlas, Sayyida S Hasan, Yungtai Lo, Terry D AmaralAbstract:BACKGROUND CONTEXT Recent literature suggests that utilizing two Surgeons for spine deformity correction surgery can improve perioperative outcomes. However, the surgeon's experience and surgical volume are likely just as important. PURPOSE This study seeks to evaluate effect of the dual versus single surgeon approach to Adolescent Idiopathic Scoliosis (AIS) correction through posterior spinal fusion (PSF). STUDY DESIGN/SETTING Ambispective chart review. PATIENT SAMPLE AIS patients undergoing PSF from 2012-2018 were included. OUTCOME MEASURES Patient demographics, pre- and postoperative kyphosis, pre- and postoperative Cobb angle, surgery time, anesthesia time, EBL, extubation, transfusion rate, perioperative complication rate, length of hospital stay. METHODS AIS patients undergoing PSF from 2012-2018 were included. Patient demographics, X-ray and perioperative outcomes were collected and collated based on primary surgeon. Analysis was performed for single vs dual Surgeons, surgeon experience ( 10 years in practice), and surgical volume ( 50 cases/year). A sub-analysis was performed for adolescent idiopathic scoliosis patients. Median and IQR values, Wilcoxon Rank Sums test, Kruskal-Wallis test, and Fisher's exact test were utilized. RESULTS A total of 520 AIS cases, performed by 4 Surgeons were included. Two Surgeons were highly experienced, 1 of whom was also high volume. The five cohorts were a single senior high volume (S1) (n=302), dual-junior Surgeons (DJ) (n=73), dual senior-junior (SJ) (n=36), dual-senior (DS) (n=21) and a single senior, standard volume surgeon alone (n =87). Radiographic parameters were similar between the groups (p 0.05). S1 had significantly lower EBL (p 0.05) in EBL, operative time, immediate extubation, transfusion rate, perioperative complication rate, and length of hospital stay between SSHV and DS. A dual junior surgeon approach had significantly shorter anesthesia (p CONCLUSIONS Standard volume Surgeons have better outcomes with dual surgeon approach. Junior Surgeons benefit operating with an experienced surgeon. A high-volume surgeon, however, does not benefit from a dual surgeon approach. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
Yungtai Lo - One of the best experts on this subject based on the ideXlab platform.
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a dual team approach benefits standard volume Surgeons but has minimal impact on outcomes for a high volume surgeon in ais patients
Spine deformity, 2020Co-Authors: Vishal Sarwahi, Jesse M Galina, Stephen Wendolowski, Jonpaul Dimauro, Marina Moguilevich, Chhavi Katyal, Beverly Thornhill, Yungtai Lo, Terry D AmaralAbstract:Retrospective chart review of prospectively collected data. This study seeks to evaluate the effect of number of Surgeons, surgeon experience, and surgeon volume on AIS surgery. Recent literature suggests that utilizing two Surgeons for spine deformity correction surgery can improve perioperative outcomes. However, the surgeon’s experience and surgical volume are likely as important. AIS patients undergoing PSF from 2009 to 2019 were included. Patient demographics, X-ray and perioperative outcomes were collected and collated based on primary surgeon. Analysis was performed for single versus dual Surgeons, surgeon experience (≤ 10 years in practice), and surgical volume (less/greater than 50 cases/year). Median (IQR) values, Wilcoxon Rank Sums test, Kruskal–Wallis test, and Fisher’s exact test were utilized. 519 AIS cases, performed by 4 Surgeons were included. Two Surgeons were highly experienced, 1 of whom was also high volume. Five cohorts were studied: a single senior high volume (S1) (n = 302), dual-junior Surgeons (DJ) (n = 73), dual senior–junior (SJ) (n = 36), dual-senior (DS) (n = 21) and a single senior, standard-volume surgeon alone (S2) (n = 87). Radiographic parameters were similar between the groups (p > 0.05). Preoperative Cobb was significantly higher for DS compared to S1 (p = 0.034) Pre- and post-op kyphosis were similar (p > 0.05). Cobb correction was similar (p > 0.05). Levels fused, fixation points, anesthesia and surgical times were similar (p > 0.05). When the standard-volume surgeon operated with a second surgeon, radiographic parameters were similar (p > 0.05), but anesthesia time, surgical time, and hospital length of stay were significantly shorter (p < 0.05). Additionally, DJ had significantly shorter anesthesia and operative times (p < 0.001) and length of stay (p < 0.001) compared to S2. Standard-volume Surgeons have better outcomes with a dual surgeon approach. Junior Surgeons benefit operating with an experienced surgeon. A high-volume surgeon, however, does not benefit from a dual surgeon approach. Level II.
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p100 a dual team approach benefits standard volume Surgeons but has minimal impact on outcomes for a high volume surgeon in ais patients
The Spine Journal, 2019Co-Authors: Vishal Sarwahi, Jesse M Galina, Aaron M Atlas, Sayyida S Hasan, Yungtai Lo, Terry D AmaralAbstract:BACKGROUND CONTEXT Recent literature suggests that utilizing two Surgeons for spine deformity correction surgery can improve perioperative outcomes. However, the surgeon's experience and surgical volume are likely just as important. PURPOSE This study seeks to evaluate effect of the dual versus single surgeon approach to Adolescent Idiopathic Scoliosis (AIS) correction through posterior spinal fusion (PSF). STUDY DESIGN/SETTING Ambispective chart review. PATIENT SAMPLE AIS patients undergoing PSF from 2012-2018 were included. OUTCOME MEASURES Patient demographics, pre- and postoperative kyphosis, pre- and postoperative Cobb angle, surgery time, anesthesia time, EBL, extubation, transfusion rate, perioperative complication rate, length of hospital stay. METHODS AIS patients undergoing PSF from 2012-2018 were included. Patient demographics, X-ray and perioperative outcomes were collected and collated based on primary surgeon. Analysis was performed for single vs dual Surgeons, surgeon experience ( 10 years in practice), and surgical volume ( 50 cases/year). A sub-analysis was performed for adolescent idiopathic scoliosis patients. Median and IQR values, Wilcoxon Rank Sums test, Kruskal-Wallis test, and Fisher's exact test were utilized. RESULTS A total of 520 AIS cases, performed by 4 Surgeons were included. Two Surgeons were highly experienced, 1 of whom was also high volume. The five cohorts were a single senior high volume (S1) (n=302), dual-junior Surgeons (DJ) (n=73), dual senior-junior (SJ) (n=36), dual-senior (DS) (n=21) and a single senior, standard volume surgeon alone (n =87). Radiographic parameters were similar between the groups (p 0.05). S1 had significantly lower EBL (p 0.05) in EBL, operative time, immediate extubation, transfusion rate, perioperative complication rate, and length of hospital stay between SSHV and DS. A dual junior surgeon approach had significantly shorter anesthesia (p CONCLUSIONS Standard volume Surgeons have better outcomes with dual surgeon approach. Junior Surgeons benefit operating with an experienced surgeon. A high-volume surgeon, however, does not benefit from a dual surgeon approach. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
Skjeldestad, Finn Egil - One of the best experts on this subject based on the ideXlab platform.
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Surgeon’s experience and clinical outcome after retropubic tension‐free vaginal tape - A case series
'Wiley', 2020Co-Authors: Holdø Bjørn, Møllersen Kajsa, Verelst Margareta, Milsom Ian, Svenningsen Rune, Skjeldestad, Finn EgilAbstract:Introduction - The retropubic tension‐free vaginal tape procedure has been the preferred method for primary surgical treatment of stress and stress‐dominant mixed urinary incontinence in women for more than 20 years. In this study, we assessed associations between surgeon's experience with the primary tension‐free vaginal tape procedure and both perioperative complications and recurrence rates. Material and methods - Using a consecutive case‐series design, we assessed 596 patients treated with primary retropubic tension‐free vaginal tape surgery performed by 18 Surgeons from 1998 through 2012, with follow up through 2015 (maximum follow‐up time: 10 years per patient). Data on perioperative complications and recurrence of stress urinary incontinence from medical records was transferred to a case report form. Surgeon's experience with the tension‐free vaginal tape procedure was defined as number of such procedures performed as lead surgeon (1‐19 [“beginners”], 20‐49 and ≥50 procedures). All analyses were done with a 5% level of statistical significance. We applied the Chi‐square test in the assessment of perioperative complications. The regression analyses of recurrence rate by number of tension‐free vaginal tape procedures performed were restricted to the three Surgeons who performed ≥50 procedures. Results - We found a significantly higher rate of bladder perforations (P = .03) and a higher rate of urinary retentions among patients whose tension‐free vaginal tape procedures were performed by “beginners” (P = .06). We observed a significant reduction in recurrence rates with increasing number of tension‐free vaginal tape procedures for one surgeon (P = .03). Conclusions - Surgeon's experience with the tension‐free vaginal tape procedure is associated with the risk of bladder perforation and urinary retention, and may be associated with the long‐term effectiveness of the procedure
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Surgeon’s experience and clinical outcome after retropubic tension‐free vaginal tape—A case series
'Wiley', 2020Co-Authors: Holdø Bjørn, Møllersen Kajsa, Verelst Margareta, Milsom Ian, Svenningsen Rune, Skjeldestad, Finn EgilAbstract:Introduction The retropubic tension‐free vaginal tape procedure has been the preferred method for primary surgical treatment of stress and stress‐dominant mixed urinary incontinence in women for more than 20 years. In this study, we assessed associations between surgeon's experience with the primary tension‐free vaginal tape procedure and both perioperative complications and recurrence rates. Material and methods Using a consecutive case‐series design, we assessed 596 patients treated with primary retropubic tension‐free vaginal tape surgery performed by 18 Surgeons from 1998 through 2012, with follow up through 2015 (maximum follow‐up time: 10 years per patient). Data on perioperative complications and recurrence of stress urinary incontinence from medical records was transferred to a case report form. Surgeon's experience with the tension‐free vaginal tape procedure was defined as number of such procedures performed as lead surgeon (1‐19 [“beginners”], 20‐49 and ≥50 procedures). All analyses were done with a 5% level of statistical significance. We applied the Chi‐square test in the assessment of perioperative complications. The regression analyses of recurrence rate by number of tension‐free vaginal tape procedures performed were restricted to the three Surgeons who performed ≥50 procedures. Results We found a significantly higher rate of bladder perforations (P = .03) and a higher rate of urinary retentions among patients whose tension‐free vaginal tape procedures were performed by “beginners” (P = .06). We observed a significant reduction in recurrence rates with increasing number of tension‐free vaginal tape procedures for one surgeon (P = .03). Conclusions Surgeon's experience with the tension‐free vaginal tape procedure is associated with the risk of bladder perforation and urinary retention, and may be associated with the long‐term effectiveness of the procedure
