Goldman Jennifer, Hu Anna, Hammer Adam, Akiska Yagiz Matthew, Gombaut Cindy, Ranganath Bharat, Chao Jerry
From The George Washington University School of Medicine and Health Sciences, Washington, DC.
Ann Plast Surg. 2025 Jan 1;94(1):94-99. doi: 10.1097/SAP.0000000000004069. Epub 2024 Sep 4.
Gender-affirming bottom surgeries (GABS) play a central role in treating gender dysphoria to improve quality of life for transgender and nonbinary (TGNB) patients. However, there exists limited data on operative risks and outcomes for patient populations undergoing GABS. The goal of this study is to identify sociodemographic and clinical risk factors for determining 30-day postoperative complications in patients undergoing GABS.
The ACS - NSQIP database from 2010 to 2020 was used to identify patients undergoing gender affirmation surgery (GAS) using Current Procedural Terminology (CPT) codes included in transfeminine and transmasculine bottom surgery. IBS-SPSS software was used to perform a multivariate analysis to determine risk factors for increased 30-day postoperative complications including unplanned reoperation and readmission rates.
A total of 1809 GABS were performed in the NSQIP database from 2010 to 2020. There was an upward trend in GABS procedures throughout the years, with 2017 having the most GABS (n = 629). Transmasculine patients with a BMI of 29 and over were at a greater risk for wound complications ( P < 0.05). Diabetic transfeminine patients were also at a greater risk for wound complications ( P < 0.05).
This study identified that several sociodemographic and clinical risk factors, such as BMI and diabetes mellitus type 2, had increased postoperative complications for patients undergoing gender-affirming bottom surgeries. Wound care management and patient education are essential in GABS to prevent long-term complications. Physician awareness of risk factors and social determinants of health can help prevent and improve postoperative care education and patient compliance.
性别肯定性下半身手术（GABS）在治疗性别焦虑症以改善跨性别和非二元性别（TGNB）患者的生活质量方面发挥着核心作用。然而，关于接受GABS的患者群体的手术风险和结果的数据有限。本研究的目的是确定社会人口统计学和临床风险因素，以确定接受GABS的患者术后30天的并发症。
使用2010年至2020年的美国外科医师学会国家外科质量改进计划（ACS-NSQIP）数据库，通过女性化和男性化下半身手术中包含的当前程序术语（CPT）代码来识别接受性别肯定手术（GAS）的患者。使用IBM SPSS软件进行多变量分析，以确定术后30天并发症增加的风险因素，包括计划外再次手术和再入院率。
2010年至2020年期间，NSQIP数据库中共进行了1809例GABS手术。这些年来，GABS手术呈上升趋势，2017年的GABS手术最多（n = 629）。体重指数（BMI）在29及以上的男性化患者发生伤口并发症的风险更高（P < 0.05）。患有糖尿病的女性化患者发生伤口并发症的风险也更高（P < 0.05）。
本研究确定，一些社会人口统计学和临床风险因素，如BMI和2型糖尿病，会增加接受性别肯定性下半身手术患者的术后并发症。在GABS中，伤口护理管理和患者教育对于预防长期并发症至关重要。医生对风险因素和健康社会决定因素的认识有助于预防和改善术后护理教育及患者依从性。
