eP698 - Outcomes of Colorectal Surgery at the Time of Gynecologic Surgery

ePoster Presenter(s)

• 

  Selim Gebran, MD

  resident
  Allegheny Health Network
  Allegheny Health Network
  Pittsburgh, PA, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• SJ

  Salvatore Jerris, DO

  PGY-1 General Surgery Resident
  Allegheny Health Network
  Pittsburgh, Pennsylvania, United States

  Disclosure information not submitted.
• HT

  Hao Tang, DO

  PGY-2 General Surgery Resident
  Allegheny Health Network
  Pittsburgh, Pennsylvania, United States

  Disclosure information not submitted.
• HW

  Heitham Wady, MD

  Fellow
  AHN Health Network
  Pittsburg, Pennsylvania, United States

  Disclosure information not submitted.
• 

  Taryn Hassinger, MD, FACS, FASCRS

  Colorectal Surgeon
  Allgheny Health Network
  Pittsburgh, Pennsylvania, United States

  Disclosure information not submitted.
• AR

  Ari Reichstein, MD, FACS, FASCRS

  Colorectal Surgeon
  Allegheny Health Network
  Pittsburgh, Pennsylvania, United States

  Disclosure information not submitted.
• 

  Richard Fortunato, DO, FACS, FASCRS (he/him/his)

  Colorectal Surgeon
  Allegheny Health Network
  Drexel University College Of Medicine
  Pittsburgh, PA, United States

  Disclosure information not submitted.
• JM

  James McCormick, DO, FACS, FASCRS

  Professor of Surgery, Drexel University; Chief, Colorectal Surgery, AHN; Chair, CRC program, AHNCI
  Allegheny Health Network
  pittsburgh, Pennsylvania, United States

  Disclosure information not submitted.

Senior Author(s)

• SN

  Stanislav Nosik, MD, FASCS, FACRS

  Colorectal Surgeon
  Allegheny Health Network
  Pittsburgh, Pennsylvania, United States

  Disclosure information not submitted.

Purpose/Background: Gynecologic (GYN) operations are often performed in hostile abdomens with adhesions from endometriosis and neoplasia, or from prior abdominal operations. Patients requiring colorectal surgery (CRS) at the time of GYN operations constitute an understudied population.Methods/Interventions: Joint operations between GYN and CRS (2022-2023) were retrospectively examined at a tertiary care center. Overall and colorectal-specific complications were collected. Patient and operative characteristics were compared in the complication groups.Results/Outcomes: A total of 96 patients were included. The mean age was 50 years (SD 15). Most patients had prior abdominal operations (75%) and 9% had a prior colectomy. The most common GYN pathology was GYN malignancy (32%) followed by endometriosis (24%) and other benign pathologies. The most common GYN operation was a TAH (77.1%). The most common CRS operation was lysis of adhesions with any indicated repair of bowel or resection of pelvic lesion (45%), followed by colectomy (22%, LAR most common 38%). Colorectal cancer was diagnosed preoperatively in 7% of patients. Intraoperative colonoscopy was performed in 29% of patients. Complications were superficial SSI (7.9%), reoperation (7.9%), deep SSI (4.5%), SBO (4.5%) and incisional hernia (3.4%). Post colectomy complications were anastomotic leak (2/21, 9.5%), stricture (2/21, 9.5%), hemorrhage (1/21, 4.8%). Clavien-Dindo 3-4 complications more commonly occurred in patients with concomitant colorectal cancer (50% vs 13% overall, p=0.194) and those who underwent a colectomy (33%, p=0.031).Conclusion/

Discussion: Rates and risk factors of post-operative complication in this study are similar to those reported in the colorectal population. The early involvement of colorectal surgeons in complex gynecologic surgery leads to timely management. This collaboration between departments should be nurtured and may lead to improved outcomes."Table 1. Baseline Characteristics of Patient Cohort.

Table 2. Patient, Comorbidity and Procedural Factors Associated with Complications.
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