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Racial disparities in access to minimally invasive proctectomy for rectal cancer-a National Surgical Quality Improvement Program study.
Nasseri, Yosef Y; La, Kristina H-T; Oka, Kimberly; Solis-Pazmino, Paola; Smiley, Abbas; Langenfeld, Sean; Cohen, Jason; Barnajian, Moshe.
Afiliação
  • Nasseri YY; Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • La KH; Surgery Group of LA, Los Angeles, California, USA.
  • Oka K; Surgery Group of LA, Los Angeles, California, USA.
  • Solis-Pazmino P; Surgery Group of LA, Los Angeles, California, USA.
  • Smiley A; Surgery Group of LA, Los Angeles, California, USA.
  • Langenfeld S; Westchester Medical Center Health Network, Valhalla, New York, USA.
  • Cohen J; University of Nebraska Medical Center, Omaha, Nebraska, USA.
  • Barnajian M; Cedars-Sinai Medical Center, Los Angeles, California, USA.
Colorectal Dis ; 26(6): 1223-1230, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38702908
ABSTRACT

AIM:

The aim of this work was to determine racial disparities in access to minimally invasive proctectomy using a national database.

METHOD:

A retrospective review of the American College of Surgeons National Surgical Quality Improvement Program evaluated for surgical approach (robotic, laparoscopic or open), demographics and comorbidity, and then compared by race.

RESULTS:

A total of 3511 patients (325 Asian, 2925 White, 261 African American/Black) with cancer who underwent a proctectomy between 2016 and 2020 were included. Both Asians and Whites had significantly higher rates of laparoscopic proctectomy relative to African Americans (38.5%, 33.8% and 28.7%, respectively; p = 0.0001). Asians had the highest rate of robotic proctectomy (38.2%, p = 0.0001). Conversely, Black patients had significantly higher rates of open proctectomy followed by Whites and then Asians (42.1%, 35.4% and 23.4%, respectively; p = 0.0001). In multivariable logistic regression with backward elimination, African Americans were 0.7 times as likely to undergo laparoscopic proctectomy and 1.4 times more likely to undergo open proctectomy than Whites (p = 0.043). Compared with Whites, Asians were 1.8, 1.7 and 1.9 times more likely to undergo minimally invasive, laparoscopic proctectomy and robotic proctectomy, respectively (p = 0.0001, p = 0.001, p = 0.0001).

CONCLUSION:

Asians had the highest rate of laparoscopic and robotic proctectomy, while Blacks had the highest rate of open proctectomy. African Americans were least likely to undergo laparoscopic proctectomy compared with all races. Race is an independent risk factor for access to minimally invasive proctectomy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Negro ou Afro-Americano / Laparoscopia / População Branca / Disparidades em Assistência à Saúde / Melhoria de Qualidade / Procedimentos Cirúrgicos Robóticos / Protectomia Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Colorectal Dis Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Negro ou Afro-Americano / Laparoscopia / População Branca / Disparidades em Assistência à Saúde / Melhoria de Qualidade / Procedimentos Cirúrgicos Robóticos / Protectomia Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Colorectal Dis Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos