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Study: Overlapping Surgeries Are Safe for Patients

A study of more than 2,000 neurosurgery patients showed no major difference in post-op complications between overlapping and non-overlapping surgeries.

Published: November 8, 2017

EFFICIENCY A JAMA study gives evidence to support the argument that overlapping surgeries don't pose a safety risk for patients.

A study that found that neurosurgery patients didn't suffer serious post-op side effects following overlapping surgeries supports the safety of concurrent surgeries, the increasingly popular and somewhat controversial practice during which the same primary surgeon performs 2 cases in different operating rooms — with the start of one surgery overlapping with the end of another.

The study, the results of which were published today in the Journal of the American Medical Association (JAMA), was conducted on 2,275 neurosurgery patients from the beginning of 2014 through 2015 at Emory University Hospital in Atlanta, Ga.

Researchers compared the health of patients who'd been scheduled for overlapping surgeries with those who were scheduled to remain with their surgeon through the entire procedure, taking into account deaths, complications and patient functional status in the 90 days following their operations. Researchers concluded that patients were not at any more risk of serious side effects following overlapping surgeries than they would be following non-overlapping surgeries.

Researchers also detailed the different types of overlapping surgeries by dividing operations into 3 basic stages — preparation, surgery and emergence. In one scenario, the second patient would be scheduled for preparation during the first patient's emergence phase. In another, the second patient would start preparation during the first patient's surgery — but after the critical portion of that surgery. In the final scenario, the doctor would begin surgery on the second patient immediately following the critical portion of the first patient's surgery.

The findings were published in the midst of debate surrounding the possible safety risks of scheduling overlapping operations. An article published in JAMA in July titled, "The Evolving Story of Overlapping Surgery," argued that the parameters of, "the critical portion," of surgery have not officially been set and that many patients are suspicious of the practice, if they're aware it happens at all.

"[Concurrent surgery] can increase efficiency and allow the expertise of an individual neurosurgeon to be more widely available," writes David Hoyt, MD, FACS, the executive director of the American College of Surgeons, in an accompanying commentary.

Anna Merriman

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