Surgical training in gastrointestinal procedures within a UK gynaecological oncology subspecialty programme.

OBJECTIVE

An analysis of surgical experience in gastrointestinal procedures within a UK-based gynaecological oncology centre to which subspecialty fellows within the subject are exposed.

DESIGN

Retrospective study.

SETTING

Northern Gynaecological Oncology Centre, Gateshead, UK.

POPULATION

All women undergoing bowel surgery over a six-year period, 1 January 2000 to 31 December 2005.

METHODS

Cases were analysed by specialty and grade of surgeon performing the procedure.

MAIN OUTCOME MEASURE

Proportion of cases to which subspecialty fellows were exposed.

RESULTS

Two hundred and sixty-two women (11.5%) underwent bowel surgery out of 2280 women undergoing major surgery for gynaecological cancer. This included ovarian/primary peritoneal cancer in 186 women (71%). Of these 262 cases, 238 operations (91%) were performed by a gynaecological oncologist, 20 (7.5%) were performed jointly with the gastrointestinal surgeons and four (1.5%) were performed solely by the gastrointestinal surgeons. A gynaecological oncology subspecialty fellow performed 21 (8%) and assisted in an additional 204 operations (78%). Perioperative morbidity and mortality statistics in addition to overall survival outcomes were comparable to the published literature.

CONCLUSIONS

A significant proportion of major surgical operations performed within a gynaecological oncology centre require gastrointestinal procedures. The majority of these procedures can be performed by gynaecological oncologists with an acceptable perioperative morbidity and mortality rate. Subspecialty training has the potential to allow trainees significant exposure to these procedures. An accredited post-Fellowship Training Programme can provide the opportunity for hands-on experience to allow gynaecological oncologists the confidence and credibility to perform these procedures independently.