John D Salvemini, Kelly Brister, Wayne Shannon Orr, Wade O Christopher
{"title":"The Association of Social Vulnerability and Area Deprivation With Open Versus Laparoscopic Partial Colectomy for Colon Cancer.","authors":"John D Salvemini, Kelly Brister, Wayne Shannon Orr, Wade O Christopher","doi":"10.1177/00031348251363498","DOIUrl":null,"url":null,"abstract":"<p><p>IntroductionComparisons between open and laparoscopic partial colectomy for colon cancer are well documented. Social vulnerability (SVI) and area deprivation (ADI) indices reflect social determinants of health, often associated with worse surgical outcomes. Here we examine the association of SVI and ADI with partial colectomy approach.MethodsData came from the Epic Cosmos database for patients with colon cancer who underwent partial colectomy between 2013 and 2022. Only patients with documented SVI were included. Descriptive statistics and binary logistic regression were performed.ResultsThis study included 41,158 patients with colon cancer, of which 18,446 patients underwent open and 22,712 patients underwent laparoscopic partial colectomy. White patients were more likely to undergo laparoscopic colectomy than Black patients (OR: 1.11, 95% CI 1.05-1.17, <i>P</i> < .001). Thirty-day and 12-month mortality were higher in the open (4.7% and 14.5%) than laparoscopic group (1.0% and 4.9%). Upper quartile SVI and ADI had higher odds of open surgery (OR: 1.24, 95% CI 1.18-1.30, <i>P</i> < .001; OR: 1.45, 95% CI 1.39-1.52, <i>P</i> < .001, respectively).ConclusionUpper quartile SVI and ADI had higher odds of open partial colectomy for colon cancer. Clinical presentation and stage at diagnosis largely dictate the approach. Increasing CRC awareness and screenings while promoting laparoscopic partial colectomy would benefit populations with high social vulnerability and area deprivation.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251363498"},"PeriodicalIF":0.9000,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Surgeon","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00031348251363498","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
IntroductionComparisons between open and laparoscopic partial colectomy for colon cancer are well documented. Social vulnerability (SVI) and area deprivation (ADI) indices reflect social determinants of health, often associated with worse surgical outcomes. Here we examine the association of SVI and ADI with partial colectomy approach.MethodsData came from the Epic Cosmos database for patients with colon cancer who underwent partial colectomy between 2013 and 2022. Only patients with documented SVI were included. Descriptive statistics and binary logistic regression were performed.ResultsThis study included 41,158 patients with colon cancer, of which 18,446 patients underwent open and 22,712 patients underwent laparoscopic partial colectomy. White patients were more likely to undergo laparoscopic colectomy than Black patients (OR: 1.11, 95% CI 1.05-1.17, P < .001). Thirty-day and 12-month mortality were higher in the open (4.7% and 14.5%) than laparoscopic group (1.0% and 4.9%). Upper quartile SVI and ADI had higher odds of open surgery (OR: 1.24, 95% CI 1.18-1.30, P < .001; OR: 1.45, 95% CI 1.39-1.52, P < .001, respectively).ConclusionUpper quartile SVI and ADI had higher odds of open partial colectomy for colon cancer. Clinical presentation and stage at diagnosis largely dictate the approach. Increasing CRC awareness and screenings while promoting laparoscopic partial colectomy would benefit populations with high social vulnerability and area deprivation.
比较开放和腹腔镜部分结肠切除术结肠癌有很好的文献记载。社会脆弱性(SVI)和区域剥夺(ADI)指数反映了健康的社会决定因素,通常与较差的手术结果有关。在这里,我们研究SVI和ADI与部分结肠切除术入路的关系。数据来自Epic Cosmos数据库,数据来自2013年至2022年期间接受部分结肠切除术的结肠癌患者。仅纳入有SVI记录的患者。进行描述性统计和二元逻辑回归。结果本研究纳入41,158例结肠癌患者,其中18,446例患者行开放结肠切除术,22,712例患者行腹腔镜部分结肠切除术。白人患者比黑人患者更有可能接受腹腔镜结肠切除术(OR: 1.11, 95% CI 1.05-1.17, P < 0.001)。开腹组30天和12个月死亡率分别为4.7%和14.5%高于腹腔镜组(1.0%和4.9%)。上四分位数SVI和ADI的开放性手术几率较高(OR: 1.24, 95% CI 1.18-1.30, P < 0.001;OR: 1.45, 95% CI 1.39 ~ 1.52, P < 0.001)。结论上四分位数SVI和ADI有较高的结肠癌开腹部分结肠切除术的可能性。临床表现和诊断阶段在很大程度上决定了方法。在促进腹腔镜部分结肠切除术的同时,提高对结直肠癌的认识和筛查将使社会脆弱性高和地区贫困的人群受益。
期刊介绍:
The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.