Filed at 5:23 p.m. ET

Whether it's high-risk surgery or a more ordinary operation, experience counts.

Two studies in Thursday's New England Journal of Medicine looked at how patients fared after various operations, and the findings add to the growing body of evidence that says people should look for experienced surgeons and hospital staffs.

One study looked at 14 high-risk cardiovascular or cancer operations on 2.5 million patients between 1994 and 1999. The other studied 11,522 men whose prostates were removed between 1992 and 1996 because of cancer. Both studies used Medicare data on patients at least 65 years old.

Prostate removal has a very low risk of death but can have life-threatening complications and can leave men with bladder obstructions, incontinence and other urinary problems, or impotence.

The study did not look at impotence. But Dr. Peter Scardino of Memorial Sloan-Kettering Cancer Center's urology department in New York city found that the other dangers are less likely if the operation is done either at a hospital where many prostatectomies are performed, or by a surgeon who often does the operation.

Experience can avert post-operative complications for about five of every 100 patients and urinary side effects for eight out of every 100, Scardino said.

``Nearly 100,000 men who undergo prostatectomies each year,'' he said. ``While it may seem like common sense, having data that shows a measurable reduction in side effects like urinary incontinence is very important to both surgeons and patients.''

The larger study, led by Dr. John D. Birkmeyer of Dartmouth Medical School's surgery department, found that patients were more likely to survive a specific operation at hospitals where that operation was often performed.

The biggest differences were for surgery for cancer of the pancreas and esophagus.

The death rate among the pancreatic cancer patients was 4 percent at the highest-volume hospitals and 16 percent at those that did the fewest such operations. Surgery for cancer of the esophagus also had a spread of 12 percentage points in the death rate -- from 8 percent to 20 percent.

The difference was less than 2 percentage points for patients undergoing surgery for colon or kidney cancer, a heart bypass or carotid endarterectomy, in which a partial blockage is scraped out of the main artery to the brain to prevent a stroke.

The difference in death rates between high- and low-volume hospitals was 2 to 5 percentage points for five other operations: heart valve replacement, abdominal aneurysm repair, and surgery for lung, stomach or bladder cancer.

Each year in the United States more than 20,000 elderly patients die undergoing one of these 14 high-risk operations.

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On the Net:

http://www.nejm.org

Memorial Sloan-Kettering: http://www.mskcc.org/mskcc/html/44.cfm

Dartmouth Medical School: http://www.dartmouth.edu/dms/