J Pediatr Surg. 2024 Nov 16;60(2):162068. doi: 10.1016/j.jpedsurg.2024.162068. Online ahead of print.
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.
LEVEL OF EVIDENCE: III.
PMID:39612516 | DOI:10.1016/j.jpedsurg.2024.162068
