Emergency Gynecologic Surgery Outcomes During Working and Off-Hours

Area of Science:

• Gynecology
• Surgical Outcomes
• Minimally Invasive Surgery

Background:

• Emergency gynecologic surgeries are often performed outside standard working hours.
• Understanding perioperative outcomes and surgical trends during off-hours is crucial for patient care.

Purpose of the Study:

• To compare perioperative outcomes of emergency gynecologic surgeries performed during working hours versus off-hours.
• To evaluate temporal trends in surgical approach, particularly the use of laparoscopy.

Main Methods:

• Retrospective cohort study of 386 patients undergoing emergency surgery for ovarian torsion, cyst rupture, or ectopic pregnancy (2020-2025).
• Comparison of outcomes between working hours and off-hours groups, including operative time, complications, and hospital stay.
• Analysis of annual trends in surgical approach, focusing on laparoscopy rates.

Main Results:

• Perioperative outcomes were comparable for ovarian torsion and cyst rupture between working hours and off-hours groups.
• For ruptured tubal ectopic pregnancy, off-hours surgery had longer operative times but similar complication and reoperation rates.
• Laparoscopic procedure rates increased dramatically from 17.9% in 2020 to 90.0% by late 2025.

Conclusions:

• Off-hours emergency gynecologic surgery generally yields comparable outcomes to working-hours surgery.
• The increasing adoption of laparoscopy highlights the growing integration of minimally invasive surgery in emergency gynecologic practice.