Our Summary

This study aimed to evaluate how well gynecologic oncology fellowships in the U.S. are preparing their trainees to carry out intestinal surgery independently. To do this, a survey was sent to members of the Society of Gynecologic Oncology who were either currently in training or had recently completed their fellowship. The survey asked about their training experiences, how ready they felt to perform intestinal surgery on their own, and their views on whether gynecologic oncologists should perform such procedures.

Out of 374 members invited to participate, 108 (29%) responded. The majority (96%) had received training in intestinal surgery from gynecologic oncologists, and 64% reported that all faculty regularly performed such surgeries. However, only 58% felt ready to perform these procedures independently, and just 59% planned to do so.

Those who had done more than 10 intestinal diversion procedures, had active involvement in intestine-related consultations during surgery, or reported that all faculty performed intestinal surgery were more likely to feel ready to perform these surgeries independently. Factors such as gender, training region, intended work environment, and curriculum did not influence this feeling of readiness.

Overall, the study concluded that almost half of the trainees did not feel ready to perform intestinal procedures independently after their training. The researchers suggested that giving trainees more direct involvement and experience in intestinal surgery could potentially improve their readiness.

FAQs

  1. What was the main aim of this study about gynecologic oncology fellowships in the U.S.?
  2. What factors were found to influence a trainee’s readiness to perform intestinal surgeries independently?
  3. What recommendations did the researchers make to improve trainees’ readiness to perform intestinal surgeries independently?

Doctor’s Tip

A helpful tip a doctor might tell a patient about oncologic surgery is to follow their post-operative care instructions carefully to aid in a smooth recovery and to minimize complications. This may include proper wound care, pain management, activity restrictions, and follow-up appointments. It is also important for patients to communicate any concerns or changes in their condition to their healthcare team.

Suitable For

Patients who are typically recommended for oncologic surgery include those with a confirmed or suspected diagnosis of cancer, specifically in the areas of gynecologic oncology. This may include patients with ovarian cancer, cervical cancer, endometrial cancer, or other gynecologic malignancies that require surgical intervention. Additionally, patients who have undergone chemotherapy or radiation therapy and are not responding well to treatment may also be recommended for oncologic surgery to remove the tumor or affected tissues. Ultimately, the decision to recommend oncologic surgery is made on a case-by-case basis by the patient’s healthcare team.

Timeline

Before oncologic surgery, a patient typically undergoes a series of steps including consultation with an oncologist, diagnostic tests (such as imaging and biopsies), pre-operative appointments to discuss the procedure and recovery, and possibly chemotherapy or radiation therapy to shrink the tumor before surgery. The patient will also undergo pre-operative preparations such as fasting, medication adjustments, and possibly bowel preparation.

After oncologic surgery, the patient will initially recover in the hospital where they will be monitored for any complications. They may experience pain, fatigue, and discomfort as they recover. The patient will gradually increase their activity level and may need physical therapy to regain strength and mobility. Follow-up appointments will be scheduled to monitor the patient’s recovery, discuss pathology results, and plan any additional treatments such as chemotherapy or radiation therapy. The patient will also receive education on managing any side effects of treatment and maintaining their overall health. Long-term follow-up will be necessary to monitor for any signs of cancer recurrence.

What to Ask Your Doctor

Some questions a patient should ask their doctor about oncologic surgery include:

  1. What is the specific type of oncologic surgery that I will be undergoing?
  2. What are the potential risks and complications associated with this surgery?
  3. How experienced are you and your team in performing this type of surgery?
  4. What is the expected recovery time and rehabilitation process after the surgery?
  5. Will I need any additional treatments, such as chemotherapy or radiation therapy, after the surgery?
  6. How will you ensure that the cancer is completely removed during the surgery?
  7. What are the long-term outcomes and prognosis for patients who undergo this type of surgery?
  8. Are there any alternative treatment options available besides surgery?
  9. What should I expect in terms of pain management and post-operative care?
  10. How often will I need follow-up appointments or monitoring after the surgery?

Reference

Authors: Connor EV, Moulton LJ, Costales AB, Vargas R, Michener CM, AlHilli MM. Journal: Int J Gynecol Cancer. 2018 Jun;28(5):983-988. doi: 10.1097/IGC.0000000000001250. PMID: 29595760