Racial Disparity in the Surgical Management of Diverticular Disease

Area of Science:

• Colorectal surgery
• Surgical outcomes
• Health disparities

Background:

• Minimally invasive surgery (MIS) offers improved outcomes in colorectal surgery.
• However, not all patient populations equally benefit from MIS.
• Racial disparities in MIS utilization for diverticulitis are not well understood.

Purpose of the Study:

• To analyze trends in MIS utilization for diverticulitis.
• To investigate differences in MIS utilization based on race.
• To identify potential racial disparities in surgical approaches for diverticulitis.

Main Methods:

• Utilized national database (2012-2018) linking participant user files with the National Surgical Quality Improvement Project.
• Included patients undergoing colectomy for acute or chronic diverticulitis.
• Employed multivariable binary logistic regression and joint effects models, adjusting for confounders and evaluating race-specific trends.

Main Results:

• A total of 46,713 patients were analyzed; 83% were white, 7% black, and 10% other races.
• Over the study period, open colectomy decreased by ~5% (P < .001), while laparoscopic and robotic colectomy increased (P < .0001).
• After adjusting for confounders, Black race was significantly associated with open surgery (P < .0001).

Conclusions:

• Significant racial disparities exist in the utilization of MIS for diverticulitis.
• Black patients are disproportionately more likely to undergo open surgery.
• Further investigation is crucial to understand and address these disparities, ensuring equitable access to MIS benefits across all races.