Home E-Weekly May 9, 2017

Is It OK to Overlap Neurosurgeries?

Published: May 8, 2017

DOUBLE UP Support for overlapping surgeries is growing as experts debate the risks and rewards of the practice.

The practice of overlapping neurological surgeries is safe and might even improve outcomes, according to research presented at last month's American Association of Neurological Surgeons Annual Scientific Meeting in Los Angeles.

Researchers at the Barrow Neurological Institute in Phoenix, Ariz., compared the outcomes of overlapping and non-overlapping neurosurgical procedures performed at a single facility between July 2013 and June 2016. According to their findings, overlapping surgeries resulted in shorter hospitalizations, fewer returns to the OR and improved patient disposition after surgery. There were no differences in rates of mortality and hospital readmissions. The overlapping cases, which senior surgical residents performed, did take longer to perform than non-overlapping surgeries.

"We found that in every single outcome measure where there was a significant difference between patients who had overlapping surgery and those who didn't, it was in favor of the overlapping surgery group," says study first author, Michael Bohl, MD, a neurosurgery resident at the Barrow Neurological Institute.

The results agree with previous research, which has supported the running of concurrent ORs. Investigators at the University of California San Francisco found no difference in procedural times and complication rates among non-concurrent and concurrent outpatient orthopedic cases. Mayo Clinic researchers also found no differences in rates of post-op complications or death in the month following surgery among more than 10,500 overlapping surgeries and about 16,000 non-overlapping procedures.

Nationwide debate and controversy began to swirl around the fairly common practice of busy surgeons moving between neighboring ORs to perform 2 procedures at once when the Boston Globe ran an in-depth report on the practice at Massachusetts General Hospital.

Daniel Cook

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