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

• Tác giả: Moshe Barnajian, Negin Fani, Kacey M Hamilton, Kristina La, Rachel Ma, Raanan Meyer, Yosef Nasseri, Rebecca Schneyer, Matthew T Siedhoff, Paola Solis-Pazmino, Kelly N Wright, Vincent Xu
• Ngôn ngữ: eng
• Ký hiệu phân loại: 612.665 Climacteric
• Thông tin xuất bản: England : Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland , 2025
• Bộ sưu tập: NCBI
• ID: 57287

Tóm tắt

 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.