Abstract：
BACKGROUND: Literature on a potential relationship between surgeon case volume and intra- or postoperative complications after ventral hernia repair remains scarce.
METHODS: Patients who underwent ventral hernia repair between 2011 and 2023 were selected from the prospectively maintained French Hernia-Club Registry. Outcome variables were: intraoperative events, postoperative general complications, surgical site occurrences, surgical site infections, length of intensive care unit (ICU), and patient-reported scar bulging during follow-up. Surgeons\' annual case volume was categorized as 1-5, 6-50, 51-100, 101-125, and > 125 cases, and its association with outcome volume was evaluated using uni- and multivariable analyses.
RESULTS: Over the study period, 199 titular or temporary members registered 15,332 ventral hernia repairs, including 7869 primary, 6173 incisional, and 212 parastomal hernia repairs. In univariate analysis, surgeons\' annual case volume was significantly related with all the postoperative studied outcomes. After multivariate regression analysis, annual case volume remained significantly associated with intra-operative complications, postoperative general complications and length of ICU stay. A primary repair was independently associated with fewer intra- and post-operative complications.
CONCLUSIONS: In the present multivariable analysis of a large registry on ventral hernia repairs, higher surgeon annual case volume was significantly related with fewer postoperative general complications and a shorter length of stay, but not with fewer surgical site occurrences, nor with less patient-reported scar bulging. Factors in the surgeons\' case mix such as the type of hernia have significant impact on complication rates.
METHODS: Patients who underwent ventral hernia repair between 2011 and 2023 were selected from the prospectively maintained French Hernia-Club Registry. Outcome variables were: intraoperative events, postoperative general complications, surgical site occurrences, surgical site infections, length of intensive care unit (ICU), and patient-reported scar bulging during follow-up. Surgeons\' annual case volume was categorized as 1-5, 6-50, 51-100, 101-125, and > 125 cases, and its association with outcome volume was evaluated using uni- and multivariable analyses.
RESULTS: Over the study period, 199 titular or temporary members registered 15,332 ventral hernia repairs, including 7869 primary, 6173 incisional, and 212 parastomal hernia repairs. In univariate analysis, surgeons\' annual case volume was significantly related with all the postoperative studied outcomes. After multivariate regression analysis, annual case volume remained significantly associated with intra-operative complications, postoperative general complications and length of ICU stay. A primary repair was independently associated with fewer intra- and post-operative complications.
CONCLUSIONS: In the present multivariable analysis of a large registry on ventral hernia repairs, higher surgeon annual case volume was significantly related with fewer postoperative general complications and a shorter length of stay, but not with fewer surgical site occurrences, nor with less patient-reported scar bulging. Factors in the surgeons\' case mix such as the type of hernia have significant impact on complication rates.
摘要：
背景：关于外科医生病例体积与腹侧疝修补术后的术中或术后并发症之间潜在关系的文献仍然很少。
方法：从前瞻性维持的法国疝俱乐部登记处选择2011年至2023年接受腹疝修补术的患者。结果变量为：术中事件，术后一般并发症，手术部位的发生，手术部位感染,重症监护病房（ICU）的长度，随访期间患者报告的瘢痕膨出。外科医生的年病例量分为1-5、6-50、51-100、101-125和>125例，并使用单变量和多变量分析评估其与结果体积的关联。
结果：在研究期间，199名名义或临时成员注册了15,332例腹侧疝修复术，包括7869个小学，6173切口，造口旁疝修补术212例.在单变量分析中，外科医生的年病例量与所有术后研究结果显著相关。经过多元回归分析，每年的病例量仍然与术中并发症显著相关，术后一般并发症和ICU住院时间。初次修复与较少的术中和术后并发症独立相关。
结论：在对腹侧疝修补术的大型注册表的当前多变量分析中，较高的外科医生年病例量与较少的术后一般并发症和较短的住院时间显着相关。但手术部位的发生率却更少，患者报告的疤痕凸起也较少。外科医生的病例混合因素如疝气类型对并发症发生率有显著影响。
方法：从前瞻性维持的法国疝俱乐部登记处选择2011年至2023年接受腹疝修补术的患者。结果变量为：术中事件，术后一般并发症，手术部位的发生，手术部位感染,重症监护病房（ICU）的长度，随访期间患者报告的瘢痕膨出。外科医生的年病例量分为1-5、6-50、51-100、101-125和>125例，并使用单变量和多变量分析评估其与结果体积的关联。
结果：在研究期间，199名名义或临时成员注册了15,332例腹侧疝修复术，包括7869个小学，6173切口，造口旁疝修补术212例.在单变量分析中，外科医生的年病例量与所有术后研究结果显著相关。经过多元回归分析，每年的病例量仍然与术中并发症显著相关，术后一般并发症和ICU住院时间。初次修复与较少的术中和术后并发症独立相关。
结论：在对腹侧疝修补术的大型注册表的当前多变量分析中，较高的外科医生年病例量与较少的术后一般并发症和较短的住院时间显着相关。但手术部位的发生率却更少，患者报告的疤痕凸起也较少。外科医生的病例混合因素如疝气类型对并发症发生率有显著影响。
