• Natsumi Saka, Norio Yamamoto, Jun Watanabe, Christopher Wallis, Angela Jerath, Hidehiro Someko, Minoru Hayashi, Kyosuke Kamijo, Takashi Ariie, Toshiki Kuno, Hirotaka Kato, Hodan Mohamud, Ashton Chang, Raj Satkunasivam, and Yusuke Tsugawa.
• Department of Orthopedics, Teikyo University School of Medicine, Itabashi, Tokyo, Japan.
• Ann. Surg. 2024 May 10.

ObjectiveTo compare clinical outcomes of patients treated by female surgeons versus those treated by male surgeons.Summary Background DataIt remains unclear as to whether surgical performance and outcomes differ between female and male surgeons.MethodsWe conducted a meta-analysis to compare patients' clinical outcomes-including patients' postoperative mortality, readmission, and complication rates-between female versus male surgeons. MEDLINE, Embase, CENTRAL, ICTRP, and ClinicalTrials.gov were searched from inception to September 8, 2022. The update search was conducted on July 19, 2023. We used random-effects models to synthesize data and GRADE to evaluate the certainty.ResultsA total of 15 retrospective cohort studies provided data on 5,448,121 participants. We found that patients treated by female surgeons experienced a lower post-operative mortality compared with patients treated by male surgeons (8 studies; adjusted odds ratio [aOR], 0.93; 95%CI, 0.88 - 0.97; I2=27%; moderate certainty of the evidence). We found a similar pattern for both elective and non-elective (emergent or urgent) surgeries, although the difference was larger for elective surgeries (test for subgroup difference P=0.003). We found no evidence that female and male surgeons differed for patient readmission (3 studies; aOR, 1.20; 95%CI, 0.83 - 1.74; I2=92%; very low certainty of the evidence) or complication rates (8 studies; aOR, 0.94; 95%CI, 0.88 - 1.01: I2=38%; very low certainty of the evidence).ConclusionsThis systematic review and meta-analysis suggests that patients treated by female surgeons have a lower mortality compared with those treated by male surgeons.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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