The impact of surgeon speciality on surgical outcomes following colorectal resection for endometriosis

Yosef Nasseri, Rachel Ma, Negin Fani, Kristina La, Paola Solis-Pazmino, Vincent Xu, Matthew T. Siedhoff, Siedhoff MT, Kelly N. Wright, Schneyer R, Rebecca Schneyer, Kacey M. Hamilton, Barnajian M, Moshe Barnajian, Raanan Meyer
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025 · vol. 27(2) , pp. e70028 · doi:10.1111/codi.70028 · PMID:39949080
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-24 ⓘ

This study found that while general/colorectal surgeons performed most endometriosis-related colorectal resections, both general/colorectal and gynecological surgeons had similar major complication rates, despite differences in surgical approach.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This study used the National Surgical Quality Improvement Program (NSQIP) database to examine short-term postoperative outcomes after colorectal resection for endometriosis from 2012–2020, comparing surgeries performed by general/colorectal surgeons versus gynaecological surgeons; the primary outcome was major complications using the Clavien–Dindo classification. Among 745 resections, general/colorectal surgeons performed most cases and used fewer minimally invasive approaches than gynaecologists, while some baseline racial/ethnic differences were noted between groups. General/colorectal surgeons had lower rates of any postoperative complications and minor complications, but major complication rates were similar, and multivariable regression and propensity score-matched analyses found no significant association between surgeon speciality and major complications. This paper is centrally about endometriosis — it evaluates how surgeon speciality relates to surgical outcomes after colorectal resection for endometriosis.

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Abstract

AIM: An estimated 5%-25% of women with endometriosis have colorectal involvement. Colorectal resection is the most suitable surgical management for cases with large bowel infiltration. However, this method is also associated with the highest rate of postoperative complications. Data focusing on surgeon speciality and surgical outcomes are currently limited. The aim of this work was to evaluate the surgical characteristics and short-term postoperative outcomes following colorectal resection for endometriosis according to surgeon speciality. METHOD: Using the National Surgical Quality Improvement Program (NSQIP) database, we included women who underwent colorectal resection for endometriosis between 2012 and 2020. Surgeries by general/colorectal surgeons were compared with those by gynaecological surgeons. The primary outcome was major complications according to the Clavien-Dindo classification. RESULTS: Among 745 colorectal resections, 82.3% were performed by general/colorectal surgeons and 17.7% by gynaecologists. Racial and ethnic characteristics differed between groups, but other baseline characteristics were comparable. General/colorectal surgeons performed fewer minimally invasive surgeries (29.9% vs. 58.3%, p < 0.001). General/colorectal surgery cases had lower rates of any postoperative complications and minor complications (14.8% vs. 29.5%, p < 0.001; 10.1% vs. 23.5%, p < 0.001), while major complication rates were similar. Multivariable regression showed no association between major complications and surgical speciality. In a propensity score-matched analysis, no significant differences were found between the two cohorts. CONCLUSION: Most colorectal resections are performed by general/colorectal surgeons while a minimally invasive approach is more common among gynaecologists. There were no significant differences in outcomes between the two groups after adjusting for confounding variables. This suggests considering a multidisciplinary or dual surgery team approach to deep infiltrative endometriosis requiring bowel resection.
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Abstract

Aim An estimated 5%–25% of women with endometriosis have colorectal involvement. Colorectal resection is the most suitable surgical management for cases with large bowel infiltration. However, this method is also associated with the highest rate of postoperative complications. Data focusing on surgeon speciality and surgical outcomes are currently limited. The aim of this work was to evaluate the surgical characteristics and short-term postoperative outcomes following colorectal resection for endometriosis according to surgeon speciality.

Method

Using the National Surgical Quality Improvement Program (NSQIP) database, we included women who underwent colorectal resection for endometriosis between 2012 and 2020. Surgeries by general/colorectal surgeons were compared with those by gynaecological surgeons. The primary outcome was major complications according to the Clavien–Dindo classification.

Results

Among 745 colorectal resections, 82.3% were performed by general/colorectal surgeons and 17.7% by gynaecologists. Racial and ethnic characteristics differed between groups, but other baseline characteristics were comparable. General/colorectal surgeons performed fewer minimally invasive surgeries (29.9% vs. 58.3%, p < 0.001). General/colorectal surgery cases had lower rates of any postoperative complications and minor complications (14.8% vs. 29.5%, p < 0.001; 10.1% vs. 23.5%, p < 0.001), while major complication rates were similar. Multivariable regression showed no association between major complications and surgical speciality. In a propensity score-matched analysis, no significant differences were found between the two cohorts.

Conclusion

Most colorectal resections are performed by general/colorectal surgeons while a minimally invasive approach is more common among gynaecologists. There were no significant differences in outcomes between the two groups after adjusting for confounding variables. This suggests considering a multidisciplinary or dual surgery team approach to deep infiltrative endometriosis requiring bowel resection. CONFLICT OF INTEREST STATEMENT Yosef Nasseri, Rachel Ma, Kristina La, Paola Solis-Pazmino, Vincent Xu, Moshe Barnajian, and Ranaan Meyer have no conflicts of interest to disclose. DATA AVAILABILITY STATEMENT The data that support these findings are housed with the American College of Surgeons. Data are available in a de-identified fashion to participants of the NSQIP database.

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Condition tags

endometriosis

MeSH descriptors

Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy Colectomy

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