Association between surgeon sex and long-term postoperative outcomes: A systematic review and meta-analysis

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BACKGROUND: Female surgeons have demonstrated improved short-term postoperative outcomes, potentially reflecting sex-related differences in clinical practice. However, the impact on long-term outcomes remains unclear. METHODS: A systematic search of PubMed, Embase, and Cochrane Library was performed to identify studies comparing long-term postoperative outcomes between patients treated by female versus male surgeons. Pooled odds ratios (ORs) were calculated using random-effects models, and statistical significance was defined as p < 0.05. All analyses were performed using R software. RESULTS: Four studies comprising 3,467,096 patients were included. Patients treated by female surgeons had significantly lower odds of 90-day mortality (OR 0.85, 95% CI 0.77-0.93; p = 0.0097), 90-day (OR 0.95, 95% CI 0.93-0.97; p < 0.0001), and one-year readmission (OR 0.96, 95% CI 0.95-0.98; p < 0.0001). No significant differences were observed in one-year mortality or postoperative complications. CONCLUSION: Female surgeons were associated with lower 90-day mortality and readmission, although further evidence is needed for other longer-term outcomes.