National Trends of Common Gynecologic Procedures Among Pediatric Hospitals: A National Surgical Quality Improvement Program Pediatric (NSQIP-P) Database Analysis
Tambu Kudze , Elizabeth R. Boskey , Ava Scatoni , Frances W. Grimstad , Jessica Y. Shim
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Abstract
Background
Gynecologic surgeries have in general been performed in pediatric hospitals by both gynecologists and other surgical specialists. This study assessed current practices and outcomes using a national database.
Methods
Procedures performed by gynecologists in the National Surgical Quality Improvement Program Pediatric database (NSQIP-P) from 2012 to 2021 were reviewed and used to identify a set of common gynecologic procedures for which outcomes could be compared across specialties. Categorical data were analyzed using Pearson’s Chi2 or a one-sided Fisher’s exact test where cell sizes were smaller than 5, and continuous data were analyzed using linear regression. This study was exempt from IRB review.
Results
There was a total of 3870 cases performed by gynecologists, of which 2872 were categorized as common gynecology procedures. The median age of patients operated on by gynecologists was 15.0 years (S.D. 2.9) compared to 13.2 years (S.D. 5.0) for other specialties. The proportion of common gynecologic cases performed by gynecologists increased from 19% in 2012 to 30% in 2021 (p < 0.001). Gynecologists were more likely to use only a minimally invasive approach (p < 0.001) and operate with elective case status (p < 0.001) compared to other surgeons performing these procedures. There was no significant difference in the risk of postoperative complications for common gynecology procedures performed by gynecologists vs. other specialties. Gynecologists were less likely to perform an oophorectomy than pediatric surgeons as part of surgeries involving the pelvic adnexa (5% vs 10%, p ≤ 0.002).
Conclusion
Pediatric and adolescent gynecologic surgeries have been increasingly performed by gynecologists over the past decade. These cases have substantiated national databases, which can help in guiding quality improvement efforts.
期刊介绍：
The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.
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