The Impact of Race and Ethnicity on Use of Minimally Invasive Surgery for Myomas.
J Minim Invasive Gynecol
; 29(11): 1241-1247, 2022 11.
Article
em En
| MEDLINE
| ID: mdl-35793780
ABSTRACT
STUDY OBJECTIVE:
To determine whether minimally invasive surgery (MIS) for uterine myomas is used differentially based on race and ethnicity.DESIGN:
Retrospective cohort study.SETTING:
Quaternary care academic hospital in the United States. PATIENTS Patients undergoing hysterectomy or myomectomy for uterine myomas between March 15, 2015, and March 14, 2020 (N = 1311). Cases involving correction of pelvic organ prolapse, malignancy, peripartum hysterectomy, or combined procedures with nongynecologic specialties were excluded. Racial/ethnic composition of the study population was 40.0% non-Hispanic white (white), 27.9% non-Hispanic black (black), 14.0% Hispanic, 13.7% non-Hispanic Asian (Asian), and 4.3% non-Hispanic American Indian/Alaska Native/Pacific Islander/Other.INTERVENTIONS:
Hysterectomy, myomectomy. MEASUREMENTS AND MAINRESULTS:
Of the 1311 cases, 35.9% were minimally invasive hysterectomy, 16.4% abdominal hysterectomy, 35.6% minimally invasive myomectomy, and 12.1% abdominal myomectomy. MIS rates were 94.7% among fellowship-trained minimally invasive gynecologic surgery subspecialists, 44.2% among obstetrics and gynecology specialists, and 46.8% among gynecologic oncologists. There were disparities in surgeon type based on race/ethnicity, with 59.8% of white patients having undergone surgery with a minimally invasive gynecologic surgery subspecialist vs 44.0% of black patients and 45.7% of Hispanic patients. Black and Hispanic patients were less likely to undergo MIS overall vs white patients (adjusted odds ratio [aOR] 0.33, 95% confidence interval [CI] 0.22-0.48 and aOR 0.44, 95% CI 0.28-0.72, respectively). Black and Hispanic patients undergoing hysterectomy were less likely than white patients to undergo MIS (aOR 0.33, 95% CI 0.21-0.51 and aOR 0.35, 95% CI 0.20-0.60, respectively). There were no significant differences in rates of MIS based on race/ethnicity for myomectomies nor differences in major or minor complications by race/ethnicity overall.CONCLUSION:
At a quaternary care institution, black and Hispanic patients were significantly less likely than white patients to undergo MIS for uterine myomas, particularly for hysterectomy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Leiomioma
/
Mioma
Tipo de estudo:
Observational_studies
Limite:
Female
/
Humans
/
Pregnancy
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Minim Invasive Gynecol
Assunto da revista:
GINECOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article