{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T14:54:48Z","timestamp":1773327288667,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,12,30]],"date-time":"2017-12-30T00:00:00Z","timestamp":1514592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,12,30]],"date-time":"2017-12-30T00:00:00Z","timestamp":1514592000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Few studies have analyzed the relationship between surgical volume and outcomes after antireflux procedures. The aim of this study was to determine the effect of surgical volume on postoperative results and costs for patients undergoing surgery for gastroesophageal reflux disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed the National Inpatient Sample (period 2000\u20132013). Adult patients (\u226518 years old) with gastroesophageal reflux disease who underwent fundoplication were included. Hospital surgical volume was determined using the 30th and 60th percentile cut points using weighted discharges and categorized as low (&lt;10 operations\/year), intermediate (10\u201325 operations\/year), or high (&gt;25 operations\/year). We performed multivariable logistic regression models to assess the effect of surgical volume on patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The studied cohort comprised 75,544 patients who had antireflux surgery. When operations performed at low\u2010volume hospitals, postoperative bleeding, cardiac failure, renal failure, respiratory failure, and inpatient mortality were more common. In intermediate\u2010volume hospitals, patients were more likely to have postoperative infection, esophageal perforation, bleeding, cardiac failure, renal failure, and respiratory failure. The length of hospital stay was longer at low\u2010 and intermediate\u2010volume hospitals (1.08 and 0.55\u00a0days longer, respectively). There was an increase in charges of 5120 dollars per patient at low\u2010volume centers, and 4010 dollars per patient at intermediate\u2010volume centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When antireflux surgery is performed at high\u2010volume hospitals, morbidity is lower, length of hospital stay is shorter, and costs for the healthcare system are decreased.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4429-1","type":"journal-article","created":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T23:04:55Z","timestamp":1514588695000},"page":"2183-2189","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Antireflux Surgery in the USA: Influence of Surgical Volume on Perioperative Outcomes and Costs\u2014Time for Centralization?"],"prefix":"10.1002","volume":"42","author":[{"given":"Francisco","family":"Schlottmann","sequence":"first","affiliation":[{"name":"Department of Surgery University of North Carolina at Chapel Hill 4030 Burnett Womack Building, 101 Manning Drive, CB 7081 27599\u20107081 Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula D.","family":"Strassle","sequence":"additional","affiliation":[{"name":"Department of Surgery University of North Carolina at Chapel Hill 4030 Burnett Womack Building, 101 Manning Drive, CB 7081 27599\u20107081 Chapel Hill NC USA"},{"name":"Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco G.","family":"Patti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of North Carolina at Chapel Hill Chapel Hill NC 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