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Then (1983) and Now (1994)

Ira M. Rutkow, MD, MPH, DrPH

Arch Surg. 1997;132(9):983-990.

Abstract
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

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

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