Nagata Hiromi, Kinoshita Takahiro, Komatsu Masaru, Habu Takumi, Yoshida Mitsumasa, Yura Masahiro
Division of Gastric Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
Course of Advanced Clinical Research on Cancer, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Asian J Endosc Surg. 2025 Jan-Dec;18(1):e70135. doi: 10.1111/ases.70135.
Recently, opportunities for women to assume active roles are expanding, but it is noteworthy that the representation of female surgeons remains still low. As minimally invasive surgery penetrates, physical limitations such as muscle strength are diminishing. This evolution reduces obstacles and enhances the potential to widen opportunities for female surgeons to actively work.
This study retrospectively analyzed clinical outcomes of patients who received laparoscopic distal gastrectomy (LDG) (2013-2023) performed by resident surgeons as a primary operator. The patients were divided into two groups according to whether the primary surgeon was female or male. Perioperative outcomes and prognosis were examined after propensity score matching (PSM).
Overall, 417 patients were eligible, and 24 resident surgeons operated, 7 female (29%) and 17 male (71%). After PSM, 107 patients were extracted for each group. No significant differences were observed in patients' baseline. Operation time (225 vs. 221 min), intraoperative blood loss (10 vs. 14 g), and postoperative hospital stay (8 vs. 8 days) did not differ. The incidence of postoperative complications (all-grade) was 9% vs. 18%. The calculated risk ratio of the female surgeons was 0.53 (95% confidence intervals: 0.26-1.08) (p = 0.08), which upper limit was lower than the prespecified non-inferior margin (1.2), thus the non-inferiority was proved. We found no gender difference in clinical outcomes of LDG performed by resident surgeons. The results of this study help us understand the role of female surgeons and encourage women to apply for surgical positions in the future.
近年来，女性承担积极角色的机会不断增加，但值得注意的是，女性外科医生的占比仍然较低。随着微创手术的普及，诸如肌肉力量等身体限制正在减少。这一演变减少了障碍，增强了扩大女性外科医生积极工作机会的潜力。
本研究回顾性分析了由住院医师作为主刀医生进行腹腔镜远端胃切除术（2013 - 2023年）的患者的临床结果。根据主刀医生是女性还是男性，将患者分为两组。在进行倾向评分匹配（PSM）后，检查围手术期结果和预后。
总体而言，417例患者符合条件，24名住院医师进行了手术，其中7名女性（29%），17名男性（71%）。PSM后，每组提取107例患者。患者基线无显著差异。手术时间（225分钟对221分钟）、术中失血量（10克对14克）和术后住院时间（8天对8天）无差异。术后并发症（所有级别）的发生率分别为9%和18%。女性外科医生的计算风险比为0.53（95%置信区间：0.26 - 1.08）（p = 0.08），其上限低于预先设定的非劣效界值（1.2），因此证明了非劣效性。我们发现住院医师进行的腹腔镜远端胃切除术的临床结果无性别差异。本研究结果有助于我们了解女性外科医生的作用，并鼓励女性未来申请外科职位。
