| Abstrakt: |
To describe and assess the role of a pre-operative multidisciplinary "benign" tumor board (BTB) conference for managing complex gynecologic cases. Retrospective chart review from 11/2021-3/2024. MIGS department at a tertiary academic facility 130 patient cases. Patients suspected to have advanced endometriosis or anticipated complex surgery by three MIGS surgeons are presented at the monthly BTB conference. Attendees include MIGS, radiology, colorectal surgery (CRS), and urology. Patient scenarios and radiologic images are reviewed. The team then creates a plan for any further pre-operative evaluation followed by scheduling joint surgery with appropriate specialists. Since implementation, the number of cases presented each month has increased from 5 to 15. Retrospective chart review of 130 cases revealed 98 patients (75%) proceeded with surgery. Of the 72 patients who had undergone surgery at time of review, 58 (81%) had endometriosis, 19 (15%) had fibroids, and 34 (47%) had a complex surgical history. Forty patients (56%) had at least one pre-operative consultation with another surgical specialist. Thirty-three patients had CRS consultations: 12 (36%) underwent pre-operative colonoscopy and 18 (55%) required intra-op assistance from CRS. Only four surgeries required unanticipated operative assistance from CRS. Forty patients (69%) had Stage 3 or 4 endometriosis and 11 had co-occurring fibroids. Twenty-six patients are scheduled for future surgery and 15 (58%) have specialty consultations: 9 (35%) with CRS, two with GYN oncology, two with urology, one with general surgery, and one with thoracic surgery. Implementation of a monthly multidisciplinary BTB conference is feasible and has had a positive impact on care coordination and setting realistic patient expectations. In addition to being a great teaching tool for MIGS fellows, the collective review allows for clear communication between specialties and anecdotally decreases unplanned intra-operative consults. Further chart review is planned to compare this data to patient care coordination prior to BTB conference. [ABSTRACT FROM AUTHOR] |
