Our study demonstrates the existence of disparity in patient presentation with complicated ventral hernia. Despite clear disparity by race and SES, at our institution, disparate presentation did not equate to disparate treatment or postoperative complications. No difference was demonstrated by use of operative technique, perioperative outcome, or 12-month recurrence rate. This study illustrates the need for long-term measures directed at reevaluation of organizational and institutional factors that perpetuate inequality.

Presence of four or five variables significantly correlated with persistent CBD stone. Biliary evaluation by endoscopic retrograde cholangiopancreatography is suggested, as initial magnetic resonance cholangiopancreatography (MRCP) may only increase cost and delay time to intervention. In the absence of any variable, biliary evaluation by intraoperative cholangiogram may be sufficient. Decisions regarding patients with one to three variables should occur on a case-to-case basis. Initial biliary evaluation by MRCP is likely preferable, however, as no increased probability of CBD stone was identified, thus not warranting risks associated with intervention.

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The purpose of this study was to assess for disparity within a cohort of patients presenting with complicated colorectal cancer. A retrospective study of 522 patients who underwent surgery for colorectal cancer at a tertiary care institution was performed. Complicated cancer was defined by perforating or obstructing colonic lesions. Statistical analysis was conducted by χ2 test and analysis of variance. Of the 522 patients, 72 patients (14%) presented with complicated colorectal cancer. Blacks in low-income brackets (36 vs 0%, P < 0.001) and those with public insurance (55 vs 16%, P < 0.05) had increased presentation with complicated colorectal cancers as compared with whites. Black (91%) and Hispanic women (86%), when compared with white women (37%) had increased incidence of complicated colorectal cancer ( P < 0.05). Patients in low-income brackets, regardless of race, had increased cancer recurrence rates (57 vs 8%, P < 0.001) compared with patients in average or high-income brackets. Mortality rate was 57 per cent in Hispanic, 29 per cent in white, and 27 per cent in black patients ( P = nonsignificant). Specific targeting of colorectal cancer screening, education, and follow-up programs is imperative for minority women and patients of low socioeconomic status.

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