The impact of surgeon speciality on surgical outcomes following colorectal resection for endometriosis

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Hauptverfasser: Yosef Nasseri, Rachel Ma, Negin Fani, Kristina La, Paola Solis‐Pazmino, Vincent Xu, Matthew T. Siedhoff, Kelly N. Wright, Rebecca Schneyer, Kacey M. Hamilton, Moshe Barnajian, Raanan Meyer
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author Yosef Nasseri
Rachel Ma
Negin Fani
Kristina La
Paola Solis‐Pazmino
Vincent Xu
Matthew T. Siedhoff
Kelly N. Wright
Rebecca Schneyer
Kacey M. Hamilton
Moshe Barnajian
Raanan Meyer
author_facet Yosef Nasseri
Rachel Ma
Negin Fani
Kristina La
Paola Solis‐Pazmino
Vincent Xu
Matthew T. Siedhoff
Kelly N. Wright
Rebecca Schneyer
Kacey M. Hamilton
Moshe Barnajian
Raanan Meyer
Yosef Nasseri
Rachel Ma
Negin Fani
Kristina La
Paola Solis‐Pazmino
Vincent Xu
Matthew T. Siedhoff
Kelly N. Wright
Rebecca Schneyer
Kacey M. Hamilton
Moshe Barnajian
Raanan Meyer
collection Wiley Open Access
contents The impact of surgeon speciality on surgical outcomes following colorectal resection for endometriosis Yosef Nasseri Rachel Ma Negin Fani Kristina La Paola Solis‐Pazmino Vincent Xu Matthew T. Siedhoff Kelly N. Wright Rebecca Schneyer Kacey M. Hamilton Moshe Barnajian Raanan Meyer Colorectal Disease AbstractAimAn estimated 5%–25% of women with endometriosis have colorectal involvement. Colorectal resection is the most suitable surgical management for cases with large bowel infiltration. However, this method is also associated with the highest rate of postoperative complications. Data focusing on surgeon speciality and surgical outcomes are currently limited. The aim of this work was to evaluate the surgical characteristics and short‐term postoperative outcomes following colorectal resection for endometriosis according to surgeon speciality.MethodUsing the National Surgical Quality Improvement Program (NSQIP) database, we included women who underwent colorectal resection for endometriosis between 2012 and 2020. Surgeries by general/colorectal surgeons were compared with those by gynaecological surgeons. The primary outcome was major complications according to the Clavien–Dindo classification.ResultsAmong 745 colorectal resections, 82.3% were performed by general/colorectal surgeons and 17.7% by gynaecologists. Racial and ethnic characteristics differed between groups, but other baseline characteristics were comparable. General/colorectal surgeons performed fewer minimally invasive surgeries (29.9% vs. 58.3%, p < 0.001). General/colorectal surgery cases had lower rates of any postoperative complications and minor complications (14.8% vs. 29.5%, p < 0.001; 10.1% vs. 23.5%, p < 0.001), while major complication rates were similar. Multivariable regression showed no association between major complications and surgical speciality. In a propensity score‐matched analysis, no significant differences were found between the two cohorts.ConclusionMost colorectal resections are performed by general/colorectal surgeons while a minimally invasive approach is more common among gynaecologists. There were no significant differences in outcomes between the two groups after adjusting for confounding variables. This suggests considering a multidisciplinary or dual surgery team approach to deep infiltrative endometriosis requiring bowel resection. 10.1111/codi.70028 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/codi.70028
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publisher Wiley
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spellingShingle The impact of surgeon speciality on surgical outcomes following colorectal resection for endometriosis
Yosef Nasseri
Rachel Ma
Negin Fani
Kristina La
Paola Solis‐Pazmino
Vincent Xu
Matthew T. Siedhoff
Kelly N. Wright
Rebecca Schneyer
Kacey M. Hamilton
Moshe Barnajian
Raanan Meyer
Colorectal Disease
The impact of surgeon speciality on surgical outcomes following colorectal resection for endometriosis Yosef Nasseri Rachel Ma Negin Fani Kristina La Paola Solis‐Pazmino Vincent Xu Matthew T. Siedhoff Kelly N. Wright Rebecca Schneyer Kacey M. Hamilton Moshe Barnajian Raanan Meyer Colorectal Disease AbstractAimAn estimated 5%–25% of women with endometriosis have colorectal involvement. Colorectal resection is the most suitable surgical management for cases with large bowel infiltration. However, this method is also associated with the highest rate of postoperative complications. Data focusing on surgeon speciality and surgical outcomes are currently limited. The aim of this work was to evaluate the surgical characteristics and short‐term postoperative outcomes following colorectal resection for endometriosis according to surgeon speciality.MethodUsing the National Surgical Quality Improvement Program (NSQIP) database, we included women who underwent colorectal resection for endometriosis between 2012 and 2020. Surgeries by general/colorectal surgeons were compared with those by gynaecological surgeons. The primary outcome was major complications according to the Clavien–Dindo classification.ResultsAmong 745 colorectal resections, 82.3% were performed by general/colorectal surgeons and 17.7% by gynaecologists. Racial and ethnic characteristics differed between groups, but other baseline characteristics were comparable. General/colorectal surgeons performed fewer minimally invasive surgeries (29.9% vs. 58.3%, p < 0.001). General/colorectal surgery cases had lower rates of any postoperative complications and minor complications (14.8% vs. 29.5%, p < 0.001; 10.1% vs. 23.5%, p < 0.001), while major complication rates were similar. Multivariable regression showed no association between major complications and surgical speciality. In a propensity score‐matched analysis, no significant differences were found between the two cohorts.ConclusionMost colorectal resections are performed by general/colorectal surgeons while a minimally invasive approach is more common among gynaecologists. There were no significant differences in outcomes between the two groups after adjusting for confounding variables. This suggests considering a multidisciplinary or dual surgery team approach to deep infiltrative endometriosis requiring bowel resection. 10.1111/codi.70028 http://onlinelibrary.wiley.com/termsAndConditions#vor
title The impact of surgeon speciality on surgical outcomes following colorectal resection for endometriosis
topic Colorectal Disease
url https://onlinelibrary.wiley.com/doi/10.1111/codi.70028