The Distribution of Colorectal Surgeons in the United States

Lu, Pamela; McCarty, Justin C; Fields, Adam C.; Azzeh, Mahmoud; Goldberg, Joel; Irani, Jennifer; Bleday, Ronald

doi:10.1016/j.jss.2020.01.015

Cited by 6 publications

(1 citation statement)

References 37 publications

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“…27 It is possible that the lack of colorectal surgeons may contribute to the racial disparity that we observed as there is a geographic and sociodemographic variability in the distribution of colorectal surgeons. 28 This could not be examined in this report as ACS-NSQIP only documents that the procedure was performed by general surgeons. The introduction of the robotic platform has further expanded the potential for minimally invasive colectomy in the management of diverticulitis.…”

Section: Discussionmentioning

confidence: 99%

Racial Disparity in the Surgical Management of Diverticular Disease

Akram

Vohra

Irish

et al. 2021

The American Surgeon™

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Introduction Although minimally invasive surgery (MIS) has clearly been associated with improved colorectal surgery outcomes, not all populations benefit from this approach. Using a national database, we analyzed both, the trend in the utilization of MIS for diverticulitis and differences in utilization by race. Methods Colon-targeted participant user files (PUFs) from 2012 to 18 were linked to respective PUFs in National Surgical Quality Improvement Project. Patients undergoing colectomy for acute diverticulitis or chronic diverticular disease were included. Surgical approach was stratified by race and year. To adjust for confounding and estimate the association of covariates with approach, data were fit using multivariable binary logistic regression main effects model. Using a joint effects model, we evaluated whether the odds of a particular approach over time was differentially affected by race. Results Of the 46 713 patients meeting inclusion criteria, 83% were white, with 7% black and 10% other. Over the study period, there was a decrease in the rate of open colectomy of about 5% P < .001, and increase in the rate of utilization of laparoscopic and robotic approaches (RC) P < .0001. After adjusting for confounders, black race was associated with open surgery P < .0001. Conclusion There is disparity in the utilization of MIS for diverticulitis. Further research into the reasons for this disparity is critical to ensure known benefits of MIC are realized across all races.

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Section: Discussionmentioning

confidence: 99%