Outcomes of Laparoscopic Distal Gastrectomy for Gastric Cancer by Female and Male Resident Surgeons

Recently, opportunities for women to assume active roles are expanding, but it is noteworthy that the representation of female surgeons remains still low. As minimally invasive surgery penetrates, physical limitations such as muscle strength are diminishing. This evolution reduces obstacles and enhances the potential to widen opportunities for female surgeons to actively work.

This study retrospectively analyzed clinical outcomes of patients who received laparoscopic distal gastrectomy (LDG) (2013-2023) performed by resident surgeons as a primary operator. The patients were divided into two groups according to whether the primary surgeon was female or male. Perioperative outcomes and prognosis were examined after propensity score matching (PSM).

Overall, 417 patients were eligible, and 24 resident surgeons operated, 7 female (29%) and 17 male (71%). After PSM, 107 patients were extracted for each group. No significant differences were observed in patients' baseline. Operation time (225 vs. 221 min), intraoperative blood loss (10 vs. 14 g), and postoperative hospital stay (8 vs. 8 days) did not differ. The incidence of postoperative complications (all-grade) was 9% vs. 18%. The calculated risk ratio of the female surgeons was 0.53 (95% confidence intervals: 0.26-1.08) (p = 0.08), which upper limit was lower than the prespecified non-inferior margin (1.2), thus the non-inferiority was proved. We found no gender difference in clinical outcomes of LDG performed by resident surgeons. The results of this study help us understand the role of female surgeons and encourage women to apply for surgical positions in the future.