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The Safety and Feasibility of Gynecologic Cancer Surgery Combined With Surgery for Pelvic Floor Dysfunction

McConnell, Nicole J., MD*; Stewart, J. Ryan, DO*; Martin, Alexandra, MD*; Gaskins, Jeremy T., PhD; Medlin, Erin E., MD*

Female Pelvic Medicine & Reconstructive Surgery: October 22, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000621
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Objectives Women with gynecologic cancer may also present with pelvic floor dysfunction that can have a significant effect on quality of life. Combined surgical intervention for both malignancy and pelvic floor dysfunction may improve quality of life with minimal additional risk. We sought to determine the safety, feasibility, and frequency of combined gynecologic cancer surgery and surgery for pelvic floor dysfunction.

Methods This is a retrospective cohort study that utilized the National Surgical Quality Improvement Program database provided through the American College of Surgeons. The National Surgical Quality Improvement Program database was queried for patients with a final diagnosis of gynecologic malignancy from 2011 to 2015. Common Procedural Terminology codes for gynecologic oncology procedures and pelvic floor dysfunction surgery were used to identify the study population. Baseline demographics and postoperative complications were abstracted from the database for these patients and compared for patients with combined surgeries versus gynecologic cancer surgeries alone.

Results One hundred twenty-nine women underwent combined procedures compared with 25,838 women undergoing gynecologic cancer surgery alone. Patients who underwent combined procedures were older, had lower body mass index, had higher preoperative albumin and hematocrit, and lower morbidity estimates (P < 0.05). Mean operative time was longer (226.4 vs 174.4 minutes, P < 0.01). There were no statistically significant differences in race, ethnicity, or medical comorbidities. There were no statistically significant differences in postoperative complications or readmissions between the 2 groups (P > 0.1).

Conclusions Combined gynecologic cancer and pelvic floor dysfunction procedures are feasible and can safely be performed without differences in postoperative complications in appropriately selected patients.

From the *Department of Obstetrics and Gynecology and Women's Health, University of Louisville School of Medicine; and

Department of Bioinformatics & Biostatistics, University of Louisville School of Public Health and Information Sciences, Louisville, KY.

Correspondence: Erin E. Medlin, MD, Lancaster General Health, 555 N Duke St, Lancaster, PA 17603. E-mail: erinmedlin@gmail.com.

The authors have declared they have no conflicts of interest.

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