Surgical operations in the United States. Then (1983) and now (1994)

I. M. Rutkow
University of Medicine and Dentistry of New Jersey, Newark, USA.

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 Statics. 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 obstetrics-gynecology. 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.