Surgical Outcomes and Utilization of Laparoscopic Versus Robotic Techniques for Elective Colectomy in Asian American and Native Hawaiian-Pacific Islanders (AAPI) Diagnosed With Colon Cancer.

Autor: Ahuja V; VA Connecticut Healthcare System, US Department of Veterans Affairs, West Haven, Connecticut; Department of Surgery, Yale School of Medicine, New Haven, Connecticut., Murthy SS; VA Connecticut Healthcare System, US Department of Veterans Affairs, West Haven, Connecticut; Department of Surgery, Yale School of Medicine, New Haven, Connecticut., Leeds IL; VA Connecticut Healthcare System, US Department of Veterans Affairs, West Haven, Connecticut; Department of Surgery, Yale School of Medicine, New Haven, Connecticut., Paredes LG; VA Connecticut Healthcare System, US Department of Veterans Affairs, West Haven, Connecticut; Department of Surgery, Yale School of Medicine, New Haven, Connecticut; National Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut; Department of Surgery, Maine Medical Center, Portland, Maine., Su DG; Department of Surgery, Yale School of Medicine, New Haven, Connecticut., Tsutsumi A; Department of Surgery, Yale School of Medicine, New Haven, Connecticut., Perkal MF; VA Connecticut Healthcare System, US Department of Veterans Affairs, West Haven, Connecticut; Department of Surgery, Yale School of Medicine, New Haven, Connecticut., King JT Jr; VA Connecticut Healthcare System, US Department of Veterans Affairs, West Haven, Connecticut; Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2024 Oct; Vol. 302, pp. 40-46. Date of Electronic Publication: 2024 Jul 30.
DOI: 10.1016/j.jss.2024.07.007
Abstrakt: Introduction: Asian American and Native Hawaiian-Pacific Islanders (AAPI) are the fastest growing racial-ethnic group, with 18.9 million people in 2019, and is predicted to rise to 46 million by 2060. Colorectal cancer (CRC) is the most common cancer in AAPI men and the third most common in women. Treatment techniques like laparoscopic colectomy (LC) emerged as the standard of care for CRC resections; however, new robotic technologies can be advantageous. Few studies have compared clinical outcomes across minimally invasive approaches for AAPI patients with CRC. This study compares utilization and clinical outcomes of LC versus robotic colectomies (RCs) in AAPI patients.
Methods: We queried the American College of Surgeons National Surgical Quality Improvement Program database for elective RC and LC in AAPI patients from 2012 to 2020. Outcomes included unplanned conversion to open, operative time, complications, 30-d mortality, and length of stay. Multivariable logistic regression analyses assessed the association between outcomes and the operative approach.
Results: Between 2012 and 2020, 83,841 patients underwent elective LC or RC. Four thousand six hundred fifty-eight AAPI patients underwent 3817 (82%) LCs and 841 (18%) RCs. In 2012, all procedures were performed laparoscopically; by 2020, 27% were robotic. Mean operative time was shorter in LC (192 versus 249 min, P < 0.001). On multivariable logistic regression, there was no difference in infection (odds ratio [OR] 0.8, 95% confidence interval [CI] 0.59-1.12), anastomotic leak (OR 0.97, 95% CI 0.59-1.61), or death (OR 0.9, 95% CI 0.31-2.61). Length of stay was shorter for RC (-0.44 d, 95% CI -0.71 to -0.18 d).
Conclusions: Overall, AAPI postoperative outcomes are similar between LC and RC. Future studies that evaluate costs and resource utilization can assist hospitals in determining whether implementing robotic-assisted technologies in their hospitals and communities will be appropriate.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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