From the Divisions of Urogynecology.
Gynecologic Oncology, Department of Obstetrics and Gynecology, Northwell Health, New Hyde Park, NY.
Female Pelvic Med Reconstr Surg. 2022 Jul 1;28(7):421-428. doi: 10.1097/SPV.0000000000001191. Epub 2022 May 4.
There is increasing overlap in the urogynecologic and gynecologic oncologic patient populations. To improve patient advocacy and access to care, a collaborative surgical approach may benefit this cohort.
The aim of the study was to evaluate surgeon attitudes toward performing concurrent urogynecologic and gynecologic oncology procedures. We hypothesized that most surgeons are amenable to collaboration.
We conducted a cross-sectional questionnaire of members of the Society of Gynecologic Oncology and the American Urogynecologic Society from August to November 2020. A 23-item online survey was created to assess surgeon demographics, practice and screening patterns, and attitudes toward surgical collaboration. We also evaluated obstacles to performing joint procedures and assessed whether attitudes could be influenced by new information.
A total of 338 surveys were included in the analysis, including 158 urogynecologists and 226 gynecologic oncologists (GOs). Most surgeons (77.8%) will recommend concurrent procedures with another specialty, and 97.8% of urogynecologists and 95.7% of oncologists currently perform joint surgical procedures. Male surgeons, regardless of specialty, were more likely to recommend staged procedures (44% vs 31%, P < 0.001), as were GOs (28% vs 10.1%, P < 0.001). However, oncologists were more likely than urogynecologists to initiate referrals for surgical collaboration (33.3% vs 14.4%, P < 0.001).
A total of 22.2% of urogynecologists and oncologists prefer staging surgical procedures. The most common barrier to a combined procedure was logistics. Urogynecologists were more concerned about the effects of cancer treatments on healing, the use of mesh implants, and financial reimbursements as compared with GOs. Treatment delay was a significantly greater concern for the oncologists.
在泌尿妇科和妇科肿瘤患者群体中，重叠现象越来越多。为了改善患者的权益和护理途径，协作式手术方法可能会使这一患者群体受益。
本研究旨在评估外科医生对同时进行泌尿妇科和妇科肿瘤手术的态度。我们假设大多数外科医生都愿意合作。
我们于 2020 年 8 月至 11 月对妇科肿瘤学会和美国泌尿妇科协会的成员进行了一项横断面问卷调查。创建了一份 23 项的在线调查，以评估外科医生的人口统计学、实践和筛查模式，以及对手术协作的态度。我们还评估了进行联合手术的障碍，并评估新信息是否会影响态度。
共分析了 338 份调查，包括 158 名泌尿妇科医生和 226 名妇科肿瘤医生。大多数外科医生（77.8%）会建议与其他专业同时进行手术，97.8%的泌尿妇科医生和 95.7%的肿瘤医生目前会进行联合手术。无论专业如何，男性外科医生更倾向于推荐分期手术（44%比 31%，P < 0.001），肿瘤医生也更倾向于推荐分期手术（28%比 10.1%，P < 0.001）。然而，与泌尿妇科医生相比，肿瘤医生更倾向于主动提出手术协作的转诊（33.3%比 14.4%，P < 0.001）。
22.2%的泌尿妇科医生和肿瘤医生更喜欢分期手术。联合手术的最常见障碍是后勤问题。与肿瘤医生相比，泌尿妇科医生更担心癌症治疗对愈合的影响、网片植入物的使用和财务报销。治疗延迟是肿瘤医生更关心的问题。
