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

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Colorectal Disease Pub Date : 2025-02-13 DOI:10.1111/codi.70028

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

{"title":"The impact of surgeon speciality on surgical outcomes following colorectal resection for endometriosis","authors":"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","doi":"10.1111/codi.70028","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>An 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.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>Using 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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 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%, <i>p</i> < 0.001). General/colorectal surgery cases had lower rates of any postoperative complications and minor complications (14.8% vs. 29.5%, <i>p</i> < 0.001; 10.1% vs. 23.5%, <i>p</i> < 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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Most 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.</p>\n </section>\n </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Colorectal Disease","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/codi.70028","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

An 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.

Method

Using 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.

Results

Among 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.

Conclusion

Most 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.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

外科医生专业对子宫内膜异位症结直肠切除术后手术结果的影响

目的估计5%-25%的子宫内膜异位症患者会累及结肠直肠。结直肠切除术是大肠浸润最合适的手术治疗方法。然而，这种方法也与术后并发症的发生率最高有关。目前关于外科医生专业和手术结果的数据有限。这项工作的目的是根据外科医生的专业评估子宫内膜异位症结直肠切除术后的手术特点和短期术后结果。方法采用国家手术质量改进计划（NSQIP）数据库，纳入2012年至2020年间因子宫内膜异位症行结直肠切除术的妇女。将普通/结直肠外科手术与妇科外科手术进行比较。根据Clavien-Dindo分类，主要结局是主要并发症。结果745例结直肠切除术中，82.3%由普通/结直肠外科医生完成，17.7%由妇科医生完成。种族和民族特征在两组之间有所不同，但其他基线特征具有可比性。普通/结直肠外科医生较少进行微创手术（29.9%对58.3%,p < 0.001）。普通/结直肠手术患者的术后并发症和轻微并发症发生率较低(14.8% vs 29.5%, p < 0.001；10.1% vs. 23.5% (p < 0.001)，而主要并发症发生率相似。多变量回归显示主要并发症与手术专科无相关性。在倾向评分匹配分析中，两个队列之间没有发现显著差异。结论大多数结直肠切除术是由普通/结直肠外科医生进行的，而微创手术在妇科医生中更为常见。在调整混杂变量后，两组之间的结果无显著差异。这建议考虑采用多学科或双手术团队的方法来治疗需要肠切除术的深浸润性子宫内膜异位症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Colorectal Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

11.80%

发文量

406

审稿时长

1.5 months

期刊介绍： Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate. Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases. Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies. Note that the journal does not usually accept paediatric surgical papers.