title: Surgical training in gastrointestinal procedures within a UK gynaecological oncology subspecialty programme.
abstract: OBJECTIVE
  An analysis of surgical experience in gastrointestinal procedures within a UK-based gynaecological oncology centre to which subspecialty fellows within the subject are exposed.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Northern Gynaecological Oncology Centre, Gateshead, UK.
  
  
  METHODS
  All women undergoing bowel surgery over a six-year period, 1 January 2000 to 31 December 2005.
  
  
  METHODS
  Cases were analysed by specialty and grade of surgeon performing the procedure.
  
  
  METHODS
  Proportion of cases to which subspecialty fellows were exposed.
  
  
  RESULTS
  Two hundred and sixty-two women (11.5%) underwent bowel surgery out of 2280 women undergoing major surgery for gynaecological cancer. This included ovarian/primary peritoneal cancer in 186 women (71%). Of these 262 cases, 238 operations (91%) were performed by a gynaecological oncologist, 20 (7.5%) were performed jointly with the gastrointestinal surgeons and four (1.5%) were performed solely by the gastrointestinal surgeons. A gynaecological oncology subspecialty fellow performed 21 (8%) and assisted in an additional 204 operations (78%). Perioperative morbidity and mortality statistics in addition to overall survival outcomes were comparable to the published literature.
  
  
  CONCLUSIONS
  A significant proportion of major surgical operations performed within a gynaecological oncology centre require gastrointestinal procedures. The majority of these procedures can be performed by gynaecological oncologists with an acceptable perioperative morbidity and mortality rate. Subspecialty training has the potential to allow trainees significant exposure to these procedures. An accredited post-Fellowship Training Programme can provide the opportunity for hands-on experience to allow gynaecological oncologists the confidence and credibility to perform these procedures independently.
authors.affiliation: Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, UK. raj.naik@ghnt.nhs.uk
authors.forename: R
authors.initials: R
authors.lastname: Naik
authors.forename: K
authors.initials: K
authors.lastname: Galaal
authors.forename: B
authors.initials: B
authors.lastname: Alagoda
authors.forename: M
authors.initials: M
authors.lastname: Katory
authors.forename: M
authors.initials: M
authors.lastname: Mercer-Jones
authors.forename: R
authors.initials: R
authors.lastname: Farrel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D005762:Gastroenterology / Q000706:statistics & numerical data; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006176:Gynecology / Q000706:statistics & numerical data; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery*; D008495:Medical Oncology / Q000706:statistics & numerical data; D008875:Middle Aged; D012189:Retrospective Studies; D006113:United Kingdom; D055815:Young Adult