2022-RA-456-ESGO Gynae-oncology surgeons’ preparedness to undertake colorectal procedures during cytoreductive surgery for ovarian cancer: a cross sectional survey

Abstract

<h3>Introduction/Background</h3> Cytoreductive surgery for advanced ovarian cancer commonly involves bowel resection. Although gynaecological oncologists in the UK are trained in bowel surgery, there exists national variations in the degree to which these specialists perform bowel surgery independently. A recent joint policy statement from the British Gynaecological Cancer Society (BGCS) emphasises the need for formalised colorectal support for cytoreductive surgery. <h3>Methodology</h3> An anonymous, online survey was emailed to members of the BGCS to assess the current status of multidisciplinary working between gynaecological oncology and colorectal/general surgical teams in the UK. The survey explored access to colorectal surgeons in the pre and peri operative periods and the role of colorectal/general surgical support in common bowel procedures performed during cytoreductive surgery, alongside their input with surgical complications and post-operative management. <h3>Results</h3> 46 members responded (8.2% response rate). There was a large variety in the involvement of colorectal and general surgical teams in pre-operative planning. Despite nearly all respondents working in tertiary care centres, 13% of respondents had no formalised agreement for intraoperative support. 72.1% of respondents independently performed rectal peritoneal stripping and 60.5% of respondents independently performed small bowel resection. This reduced to only 27.9% for right hemicolectomy with primary anastomosis and 16.3% for left hemicolectomy with primary anastomosis. Respondents often involved colorectal support for post-operative complications. <h3>Conclusion</h3> Overall, the degree to which gynaecological oncologists independently perform bowel procedures varies within the UK. The majority involve colorectal or general surgical teams in such procedures. Surgical team involvement is more common for large bowel procedures compared to small bowel and for left colon compared to right colon procedures. Nevertheless, 16.3% of respondents were able to independently perform all bowel procedures surveyed. Future research should examine factors such as training and experience within these groups to address this disparity.