TY - JOUR
T1 - Gynecologic Oncologist as surgical consultant
T2 - Intraoperative consultations during general gynecologic surgery as an important focus of gynecologic oncology training
AU - Aviki, Emeline M.
AU - Rauh-Hain, J. Alejandro
AU - Clark, Rachel M.
AU - Hall, Tracilyn R.
AU - Berkowitz, Lori R.
AU - Boruta, David M.
AU - Growdon, Whitfield B.
AU - Schorge, John O.
AU - Goodman, Annekathryn
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Objective. The aimof this study is to explore the previously unexamined role of the Gynecologic Oncologist as an intraoperative consultant during general gynecologic surgery. Methods. Demographic and clinical data were collected on 98major gynecologic surgeries that included both a general Gynecologist and a Gynecologic Oncologist between October 2010 and August 2014. Data were analyzed using XLSTAT-Prov2014.2.02. Results. Of 794 major gynecologic surgeries, 98 (12.3%) cases that involved an intraoperative consultation were identified. There were 36 (37%) planned consults and 62 (63%) unplanned consults. Significantly more planned consults were during laparoscopy (100% v 58%; p < 0.01) and significantly more unplanned consults were during laparotomy (42% v 0%; p < 0.01). The majority of planned consults were for surgical training (86%) and themost common reasons for unplanned consults were adhesions (40%), bowel injury (19%), inability to identify ureter (19%), and cancer (11%). The most common interventions performed during unplanned consults were identification of anatomy (55%), lysis of adhesions (42%), and retroperitoneal dissection (27%). Average surgeon years in practice were significantly lower for unplanned consults (9 v 15; p < 0.01). A total of 25 major adverse events occurred in 15 cases with the majority occurring in cases with unplanned consults (23% v 3%; p < 0.01). After controlling for laparotomy, unplanned consultation was not significantly associated with major events (OR = 6.67, 95%CI 0.69-64.39; p = 0.10). Conclusions. Gynecologic Oncologists play a pivotal role in the support of generalist colleagues during pelvic surgery. In this series, Gynecologic Oncologists were consulted frequently for complex major benign surgeries. It is important to incorporate the skills required of an intraoperative consultant into Gynecologic Oncology fellowship training.
AB - Objective. The aimof this study is to explore the previously unexamined role of the Gynecologic Oncologist as an intraoperative consultant during general gynecologic surgery. Methods. Demographic and clinical data were collected on 98major gynecologic surgeries that included both a general Gynecologist and a Gynecologic Oncologist between October 2010 and August 2014. Data were analyzed using XLSTAT-Prov2014.2.02. Results. Of 794 major gynecologic surgeries, 98 (12.3%) cases that involved an intraoperative consultation were identified. There were 36 (37%) planned consults and 62 (63%) unplanned consults. Significantly more planned consults were during laparoscopy (100% v 58%; p < 0.01) and significantly more unplanned consults were during laparotomy (42% v 0%; p < 0.01). The majority of planned consults were for surgical training (86%) and themost common reasons for unplanned consults were adhesions (40%), bowel injury (19%), inability to identify ureter (19%), and cancer (11%). The most common interventions performed during unplanned consults were identification of anatomy (55%), lysis of adhesions (42%), and retroperitoneal dissection (27%). Average surgeon years in practice were significantly lower for unplanned consults (9 v 15; p < 0.01). A total of 25 major adverse events occurred in 15 cases with the majority occurring in cases with unplanned consults (23% v 3%; p < 0.01). After controlling for laparotomy, unplanned consultation was not significantly associated with major events (OR = 6.67, 95%CI 0.69-64.39; p = 0.10). Conclusions. Gynecologic Oncologists play a pivotal role in the support of generalist colleagues during pelvic surgery. In this series, Gynecologic Oncologists were consulted frequently for complex major benign surgeries. It is important to incorporate the skills required of an intraoperative consultant into Gynecologic Oncology fellowship training.
KW - Benign Surgery
KW - Fellowship training
KW - Gynecologic Oncologist
KW - Intraoperative Consultation
KW - Surgical Complications
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U2 - 10.1016/j.ygyno.2015.01.536
DO - 10.1016/j.ygyno.2015.01.536
M3 - Article
C2 - 25617772
AN - SCOPUS:84929940720
SN - 0090-8258
VL - 137
SP - 93
EP - 97
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 1
ER -