Racial disparities in complications following elective colon cancer resection: Impact of laparoscopic versus robotic approaches

Am J Surg. 2024 Jan:227:85-89. doi: 10.1016/j.amjsurg.2023.09.038. Epub 2023 Sep 28.

Abstract

Background: We sought to examine differences in outcomes for Black and White patients undergoing robotic or laparoscopic colectomy to assess the potential impact of technological advancement.

Methods: We queried the ACS-NSQIP database for elective robotic (RC) and laparoscopic (LC) colectomy for cancer from 2012 to 2020. Outcomes included 30-day mortality and complications. We analyzed the association between outcomes, operative approach, and race using multivariable logistic regression.

Results: We identified 64,460 patients, 80.9% laparoscopic and 19.1% robotic. RC patients were most frequently younger, male, and White, with fewer comorbidities (P ​< ​0.001). After adjustment, there was no difference in mortality by approach or race. Black patients who underwent LC had higher complications (OR 1.10, 95% CI 1.03-1.08, P ​= ​0.005) than their White LC counterparts and RC patients.

Conclusions: Robotic colectomy was associated with lower rates of complications in minority patients. Further investigation is required to identify the causal pathway that leads to our finding.

Keywords: Colectomy; Laparoscopic colectomy; Racial discrepancies; Robotic colectomy; Surgical outcomes.

MeSH terms

  • Colectomy / adverse effects
  • Colonic Neoplasms* / complications
  • Colonic Neoplasms* / surgery
  • Humans
  • Laparoscopy* / adverse effects
  • Length of Stay
  • Male
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Robotic Surgical Procedures* / adverse effects
  • Treatment Outcome