ABSTRACT
OBJECTIVE: The objective of this study was to examine representation of women on CT journal editorial boards over the past two decades to identify changes over time compared to women CT surgeon and trainee representation, and to highlight additional opportunities for improvement. METHODS: The editorial boards of two high impact CT journals were reviewed from 2000 to 2023. Data on editorial board positions including editors-in-chief, associate/deputy editors, feature editors, and general members of the editorial board were abstracted. The proportion of women editors was assessed. Data were compared to publicly available information from the Association of American Medical Colleges (AAMC) on physician specialty by sex. RESULTS: Of 3,460 editorial positions, 332 (9.6%) were held by women. Women occupied 2.2% (n=1/45) of editor-in-chief positions, 13.2% (n=78/592) of senior editor positions, 11.5% (n=33/287) of feature editor positions, and 8.3% (n=221/2,663) of general editorial board positions. The proportion of women holding any editorial board position significantly increased from 2.4% in 2000 to 18.2% in 2023 (p=0.01). Overall, editorial board representation increased at a mean ± standard deviation rate of 0.7%±1.3% per year, not significantly different from the growth of practicing women CT surgeons at 0.3%±0.5% per year (p=0.584). DISCUSSION: Representation of women on CT journal editorial boards has increased commensurate with the increasing proportion of practicing women CT surgeons, though remains at 16%. Work remains to continue the recruitment of women to CT surgery as well as to identify the key elements that can support them in positions of leadership.
ABSTRACT
BACKGROUND: Cardiothoracic surgeons and general surgeons (including surgical oncologists) perform most esophagectomies. The purpose of this study was to explore whether specialty-driven differences in surgical techniques and the use of minimally invasive surgical approaches exist and are associated with postoperative outcomes after esophagectomy. METHODS: This was a retrospective review of the American College of Surgeons National Surgical Quality Improvement Program esophagectomy-targeted participant user file (2016-2018). Patients who underwent esophagectomy were sorted into cardiothoracic and general surgeon cohorts based on surgeon specialty. Perioperative characteristics and postoperative outcomes were compared using the χ2 analysis or independent t test. Multivariable logistic regression controlling for perioperative variables was performed to generate risk-adjusted rates of postoperative outcomes compared by surgical specialty. RESULTS: Of 3,247 patients included, 1,792 (55.2%) underwent esophagectomy by cardiothoracic surgeons and 1,455 (44.5%) by general surgeons as the primary surgeon. Cardiothoracic surgeons were more likely to use traditional minimally invasive surgical (P = .0004) or open approaches (P < .0001) and less likely to use robotic (P = .04) or a hybrid robotic and traditional approaches (P < .0001). Cardiothoracic surgeons performed more Ivor Lewis esophagectomies and fewer transhiatal and McKeown esophagectomies (P < .0001). After risk adjustment, there were no differences in rates of postesophagectomy complications, such as anastomotic leaks or positive margins, between cardiothoracic surgeons and general surgeons (all P > .05). However, cardiothoracic surgeons were more likely than general surgeons to treat anastomotic leaks with surgery rather than procedural interventions (odds ratio = 1.76; 95% confidence interval, 1.24-2.52). CONCLUSION: Cardiothoracic surgeons and general surgeons use minimally invasive surgical subtypes differently when performing esophagectomy. However, there were no risk-adjusted differences in postoperative complications when compared by surgical subspecialty. Esophagectomy is being performed safely by surgeons with different specialties and training pathways.
