Minimally Invasive Hysterectomy for Endometriosis: Surgical Outcomes Based on Surgeon Specialty

Abstract

Study Objective To examine differences in surgical outcomes of hysterectomy performed for endometriosis between general obstetricians and gynecologists (OB/GYNs) and gynecologic oncologists. Design Using the 2016 – 2018 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) hysterectomy dataset, we examined 30-day complications in patients who underwent a hysterectomy for endometriosis between general OB/GYN and gynecologic oncology groups. Setting Health systems that participate in the ACS NSQIP nationally. Patients or Participants 4,506 patients who underwent hysterectomy for endometriosis. Interventions Hysterectomy for endometriosis. Measurements and Main Results From 2016 – 2018, a total of 4,506 hysterectomies were performed for the primary diagnosis of endometriosis. Compared to OBGYNs, oncology patients were older (46.4±9.6 vs. 41.9±7.6), had a higher BMI (31.7±8.5 vs. 30.8±7.5) and a higher proportion of diabetes (8.3% vs. 5.4%) and hypertension (24.0% vs. 17.0%), were less likely smokers (13.3% vs. 19.0%), and included a higher proportion of non-Hispanic white patients (78.2% vs. 70.2%, all p Conclusion OB/GYNs were more likely to perform a hysterectomy for endometriosis in a minimally invasive fashion, however overall complications for minimally invasive hysterectomy were similar between groups and mortality was not affected. Differences in hysterectomy approach and individual complications may be due to patient selection for gynecologic oncologists.