The influence of surgeon volume on outcomes after pelvic exenteration for a gynecologic cancer / 부인종양
Journal of Gynecologic Oncology
;
: e68-2018.
Artículo
en Inglés
| WPRIM
| ID: wpr-717078
ABSTRACT
OBJECTIVE:
To determine the effect of surgeon experience on intraoperative, postoperative and long-term outcomes among patients undergoing pelvic exenteration for gynecologic cancer.METHODS:
This was a retrospective analysis of all women who underwent exenteration for a gynecologic malignancy at MD Anderson Cancer Center, between January 1993 and June 2013. A logistic regression was used to model the relationship between surgeon experience (measured as the number of exenteration cases performed by the surgeon prior to a given exenteration) and operative outcomes and postoperative complications. Cox proportional hazards regression was used to model survival outcomes.RESULTS:
A total of 167 exenterations were performed by 19 surgeons for cervix (78, 46.7%), vaginal (43, 25.8%), uterine (24, 14.4%), vulvar (14, 8.4%) and other cancer (8, 4.7%). The most common procedure was total pelvic exenteration (69.4%), incontinent urinary diversion (63.5%) and vertical rectus abdominis musculocutaneous reconstruction (42.5%). Surgical experience was associated with decreased estimated blood loss (p < 0.001), intraoperative transfusion (p = 0.009) and a shorter length of stay (p = 0.03). No difference was noted in the postoperative complication rate (p = 0.12–0.95). More surgeon experience was not associated with overall or disease specific survival OS (hazard ratio [HR] = 1.02; 95% confidence interval [CI] = 0.97–1.06; p = 0.46) and DSS (HR = 1.01; 95% CI = 0.97–1.04; p = 0.66), respectively.CONCLUSION:
Patients undergoing exenteration by more experienced surgeons had improvement in intraoperative factors such as estimated blood loss, transfusion rates and length of stay. No difference was seen in postoperative complication rates, overall or disease specific survival.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Exenteración Pélvica
/
Complicaciones Posoperatorias
/
Derivación Urinaria
/
Resultado del Embarazo
/
Modelos Logísticos
/
Cuello del Útero
/
Estudios Retrospectivos
/
Recto del Abdomen
/
Cirujanos
/
Neoplasias de los Genitales Femeninos
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Femenino
/
Humanos
/
Embarazo
Idioma:
Inglés
Revista:
Journal of Gynecologic Oncology
Año:
2018
Tipo del documento:
Artículo
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