Introduction: The number of female doctors is increasing worldwide, but the percentage of female general surgeons and gastrointestinal surgeons remains low, at only 6% in Japan. Furthermore, in rural areas, the number of doctors is small and training opportunities are limited, and training in surgical techniques is reportedly inadequate compared with urban areas. This study examined the current status and surgical outcomes of colorectal cancer surgery by surgeon sex using a multicenter database in a Japanese rural area.
Methods: We retrospectively reviewed 3440 consecutive patients who underwent laparoscopic colorectal surgery in six participating hospitals between April 2016 and March 2023. Clinical and perioperative outcomes were compared between patients who underwent surgery by a male surgeon (M group; n = 3142) or by a female surgeon (F group; n = 298).
Results: Years of experience as a doctor was significantly shorter (M group vs. F group: 12 years vs. 9 years, p < 0.001), frequency of participation of an expert surgeon was higher (79.9% vs. 89.9%, p = 0.038), frequency of preoperative treatment was lower (8.2% vs. 2.3%, p < 0.001), clinical T status was lower (p = 0.011), and re-operation rate was lower (3.1% vs. 1.0%, p = 0.045) in the F group. Multivariate analysis of clinical factors predicting postoperative severe complications revealed comorbidities (odds ratio 1.442, 95% confidence interval 1.045-1.990, p = 0.025) as an independent predictor of severe postoperative complications but not the presence of a female surgeon.
Conclusion: Female surgeons in our study achieved comparable short-term outcomes to male surgeons, including for laparoscopic procedures. Establishing an educational system in rural areas could provide improved surgical techniques.
Keywords: colorectal cancer; educational system; female surgeon; rural hospital; short‐term outcome.
© 2025 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.