Vigna Carolina, Ore Ana Sofia, Fabrizio Anne, Messaris Evangelos
Division of Colorectal Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Surg Pract Sci. 2024 Apr 17;17:100248. doi: 10.1016/j.sipas.2024.100248. eCollection 2024 Jun.
Disparities exist the management of rectal cancer. We sought to evaluate short-term surgical outcomes among different racial/ethnic groups following rectal cancer resection.
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.
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( = 0.029), and Black patients higher postoperative ileus( = 0.003) and readmission( = 0.023) rates. After PSM, Hispanics had a significantly higher circumferential resection margin positivity rate( = 0.032), Black patients higher postoperative ileus rate( = 0.014) and longer LOS( = 0.0118) when compared to White counterparts.
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.
直肠癌的治疗存在差异。我们试图评估直肠癌切除术后不同种族/族裔群体的短期手术结果。
查询国家外科质量改进计划（NSQIP）数据库（2016 - 2019年）。接受直肠癌切除术的患者按种族/族裔分类。评估环周切缘阳性率和术后结果。采用1:1倾向评分匹配（PSM）。
1753例患者中，80.2%为白人，7.6%为黑人，8.5%为亚洲人，3.7%为西班牙裔。未经调整的分析显示，西班牙裔患者手术时间更长（P = 0.029），黑人患者术后肠梗阻（P = 0.003）和再入院率（P = 0.023）更高。PSM后，与白人患者相比，西班牙裔患者环周切缘阳性率显著更高（P = 0.032），黑人患者术后肠梗阻发生率更高（P = 0.014）且住院时间更长（P = 0.0118）。
术后短期结果存在种族差异。西班牙裔患者切缘阳性率更高，黑人患者术后30天结果最差。有必要进行评估趋势的比较研究，并在数据库中纳入更多的少数族裔患者。
