Evaluation of racial/ethnic disparities in surgical outcomes after rectal cancer resection: An ACS-NSQIP analysis

评估直肠癌切除术后手术结果中种族/民族差异:一项基于美国外科医师学会国家外科质量改进计划(ACS-NSQIP)的分析

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Abstract

BACKGROUND: Disparities exist the management of rectal cancer. We sought to evaluate short-term surgical outcomes among different racial/ethnic groups following rectal cancer resection. MATERIALS AND METHODS: National Surgical Quality Improvement Program (NSQIP) database (2016-2019) was queried. Patients undergoing rectal cancer resection were categorized by race/ethnicity. Circumferential resection margin positivity rate and postoperative outcomes were evaluated. 1:1 Propensity score matching (PSM) was used. RESULTS: Of 1,753 patients, 80.2 % were White, 7.6 % Black, 8.5 % Asian and 3.7 % Hispanic. On unadjusted analysis, Hispanic patients presented longer operative time(p = 0.029), and Black patients higher postoperative ileus(p = 0.003) and readmission(p = 0.023) rates. After PSM, Hispanics had a significantly higher circumferential resection margin positivity rate(p = 0.032), Black patients higher postoperative ileus rate(p = 0.014) and longer LOS(p = 0.0118) when compared to White counterparts. CONCLUSION: Racial disparities were found in short-term postoperative outcomes. Hispanic patients presented higher margin positivity rate and Black patients worst 30-day postoperative outcomes. Comparative studies evaluating trends and a higher number of minority patients included in databases are warranted.

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