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突出 RLS 的性别差异:泌尿科与其他亚专业机器人和腹腔镜手术量的性别分析。

Highlighting Gender Differences in RLS: Analysis of Gender in Robotic and Laparoscopic Surgical Volume in Urology Vs Other Subspecialties.

机构信息

The Warren Alpert Medical School of Brown University, Providence, RI; Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI.

Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI.

出版信息

Urology. 2023 May;175:229-235. doi: 10.1016/j.urology.2022.11.055. Epub 2023 Feb 1.

DOI:10.1016/j.urology.2022.11.055
PMID:36736912
Abstract

OBJECTIVE

To evaluate the involvement of women surgeons in RLS over time and across fields. While women are an increasing proportion of the urological workforce, the overall percentage of women urologists remains low. As robotic/laparoscopic surgery (RLS) has become first-line for many surgical problems, we hypothesized that women in urology may have lower participation than other specialties.

MATERIALS AND METHODS

We obtained country-wide data by surgeon from the Data.CMS.gov database for 2014-2019 for major RLS procedures in colorectal surgery, gynecology, thoracic surgery, and urology. Data were sorted by gender and CPT code. Temporal trends were assessed, and estimation was performed by exponential regression comparing means and rates of change between departments and surgeon genders.

RESULTS

Surgeons across disciplines and genders showed increases in RLS volume over time (P <.05). There were significant differences between men and women surgeons between specialties in average number of surgeons (P <.0001) and rate of change over time (P = .0035). The difference of the rate of increase in the number of surgeons performing RLS between genders was significant for all disciplines, suggesting women were entering RLS surgery faster than men across specialties (P <.05).

CONCLUSION

There is a disparity in RLS procedure performance in men vs women across surgical disciplines. The greatest discrepancy in participation between genders existed in Urology, despite the field having a higher percentage of women physicians than other some subspecialties. Targeted action to address barriers to women surgeons' participation in RLS will increase diversity of thought and improve clinical care.

摘要

目的

评估女性外科医生在 RLS 方面的参与度随时间和领域的变化情况。尽管女性在泌尿科工作人员中所占比例不断增加,但女性泌尿科医生的总体比例仍然较低。由于机器人/腹腔镜手术(RLS)已成为许多外科问题的一线治疗方法,我们假设泌尿科女性的参与度可能低于其他专业。

材料和方法

我们从 Data.CMS.gov 数据库中获取了 2014 年至 2019 年期间全国范围内的外科医生数据,用于结直肠手术、妇科、胸外科和泌尿科的主要 RLS 手术。数据按性别和 CPT 代码进行分类。评估了时间趋势,并通过比较部门和外科医生性别的平均值和变化率来进行指数回归估计。

结果

各学科和性别的外科医生的 RLS 量随时间增加(P<.05)。在各专业中,男女外科医生之间的平均外科医生人数(P<.0001)和随时间变化的增长率(P=0.0035)存在显著差异。各学科中,男女外科医生执行 RLS 的外科医生数量增长率之间的差异具有统计学意义,表明女性在各专业中比男性更快地进入 RLS 手术(P<.05)。

结论

在外科各专业中,RLS 手术的执行情况在男性和女性之间存在差异。尽管泌尿科的女性医生比例高于其他一些亚专业,但在参与度方面,男女之间的最大差异存在于泌尿科。有针对性地采取行动,解决女性外科医生参与 RLS 的障碍,将增加思维的多样性并改善临床护理。

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