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September 1997

Surgical Operations in the United States: Then (1983) and Now (1994)

Author Affiliations

From the University of Medicine and Dentistry of New Jersey, Newark, and The Hernia Center, Freehold, NJ.

Arch Surg. 1997;132(9):983-990. doi:10.1001/archsurg.1997.01430330049007

Objective:  To study the hypothesis that numbers of surgical operations in the United States have increased from 1983 and 1994.

Design:  Analysis of data from the National Center for Health Statistics.

Setting:  Short-stay general and specialty noninstitutional hospitals, and freestanding ambulatory surgical facilities, exclusive of federal, military, and Veterans Affairs hospitals.

Patients:  Five-percent national sample.

Main Outcome Measure:  Ten most frequent surgical operations or classes of surgical procedures within neurosurgery, ophthalmology, otorhinolaryngology, cardiothoracic surgery, general surgery, urology, obstetrics and gynecology, and orthopedics.

Results:  In 1994, the 10 most frequently performed surgical operations in the United States totaled 7 929 000 cases. This contrasted with 5 731 000 top 10 procedures in 1983, or an increase of 38%. The most common surgical operation in 1994 was cataract extraction, totaling 2 049 000 cases. Groin herniorrhaphy (689 000 procedures) remained the most common operation performed by a general surgeon. Cesarean section was the most frequently completed obstetrical-gynecological operation (858 000 procedures) and the country's second most common surgical procedure in 1994. Arthroscopy of the knee (632 000 procedures) demonstrated enormous growth (153%) and was the country's seventh most frequent operation in 1994. Transurethral prostatectomy (229 000 procedures) underwent the most precipitous decline (29%) of any No. 1—ranked specialty procedure.

Conclusions:  Numbers of top 10 surgical operations have increased in every surgical specialty except obstetricsgynecology. Explanations may be the presence of new technologies, willingness of a preexisting reservoir of patients to undergo now less anxiety-provoking procedures, or less stringent indications.Arch Surg. 1997;132:983-990

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