Department of Surgery, University of California Davis, Sacramento, California.
Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
J Surg Res. 2024 Nov;303:181-188. doi: 10.1016/j.jss.2024.09.004. Epub 2024 Oct 3.
Gender discrimination is prevalent worldwide in medical and surgical care. In the setting of short-term surgical missions (STSMs) conducted to address the global burden of surgical disease, patient selection raises ethical considerations regarding equitable distribution of limited clinical resources. The goal of this study was to examine if equitable distribution of operative care between male and female patients occurs in STSMs.
The International Surgical Health Initiative (ISHI) is a US based nonprofit, nongovernmental organization. Records from surgical missions to Ghana (2014-2023) and Sierra Leone (2013-2023) were analyzed to evaluate for gender equity in inguinal hernia repairs, the most common procedure performed. A control group was created from a literature review inclusive of all studies of inguinal hernia repairs that included over 500 patients and patient gender.
The review of 26 studies, representing 3,239,043 patients, demonstrated a gender distribution of 13% female. In Sierra Leone 246 inguinal hernia repairs were performed between 2013 and 2023. 28 (11.4%) of the hernia repairs were in females, which was not significantly different from the control group (P = 0.45). In Ghana 150 inguinal hernia repairs were performed between 2014 and 2023. 12 (8%) of the hernia repairs were in females. This was not significantly different from the control group (P = 0.07).
This is the first study investigating the gender equity conducted within the context of humanitarian surgical outreach. Equitable patient selection is a paramount consideration in STSMs, particularly to address gender-related disparities in surgical care.
在医疗和外科护理中，性别歧视在全球普遍存在。在为解决全球外科疾病负担而进行的短期外科任务（STSM）中，患者选择引发了关于有限临床资源公平分配的伦理问题。本研究旨在探讨在 STSM 中，男女患者之间是否存在手术护理的公平分配。
国际外科卫生倡议（ISHI）是一家总部设在美国的非营利性非政府组织。分析了 2014 年至 2023 年在加纳和 2013 年至 2023 年在塞拉利昂进行的外科任务的记录，以评估腹股沟疝修补术（最常见的手术）中的性别公平。通过文献回顾创建了一个对照组，其中包括超过 500 名患者且包含患者性别的所有腹股沟疝修补术研究。
对 26 项研究的回顾，涉及 3239043 名患者，显示女性患者的性别分布为 13%。2013 年至 2023 年期间，塞拉利昂共进行了 246 例腹股沟疝修补术。其中 28 例（11.4%）为女性，与对照组无显著差异（P=0.45）。2014 年至 2023 年期间，加纳共进行了 150 例腹股沟疝修补术。其中 12 例（8%）为女性，与对照组无显著差异（P=0.07）。
这是第一项在人道主义外科援助背景下调查性别公平的研究。公平的患者选择是 STSM 的首要考虑因素，特别是要解决外科护理中与性别相关的差距。
