ArticleSurgical endoscopy2016
National disparities in minimally invasive surgery for rectal cancer.
Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Factors contributing to the utilization of robotic colorectal surgery: a systematic review and meta-analysis.Surgical endoscopy · 2023Pooled it
- Systematic review of robotic low anterior resection for rectal cancer.Surgical endoscopy · 2018Pooled it
- Closing the Gap: Approaches to Improving Colorectal Surgery Care for the Uninsured and Underinsured.Clinics in colon and rectal surgery · 2025Review
- Advancing minimally invasive hepato-pancreato-biliary surgery: barriers to adoption and equitable access.Surgical endoscopy · 2024Article
- Open versus Minimally Invasive Nephroureterectomy: Contemporary Analysis from a Wide National Population-Based Database.Annals of surgical oncology · 2024Article
- Open versus Minimally Invasive Partial Nephrectomy: Trends and Outcomes from a Wide National Population-Based Database.Journal of clinical medicine · 2024Article
- Racial/Ethnic Disparities in the Era of Minimally Invasive Surgery for Treatment of Colorectal Cancer.Annals of surgical oncology · 2023Article
- Disparities in access to robotic technology and perioperative outcomes among patients treated with radical prostatectomy.Journal of surgical oncology · 2023Article
- Disparities in utilization of robotic surgery for colon cancer: an evaluation of the U.S. National Cancer Database.Journal of robotic surgery · 2022Article
- The impact of socioeconomic status on telemedicine utilization during the COVID-19 pandemic among surgical clinics at an academic tertiary care center.Surgical endoscopy · 2022Article
- Is robotic utilization associated with increased minimally invasive colorectal surgery rates? Surgeon-level evidence.Surgical endoscopy · 2022Article
- Are there disparities in access to robot-assisted laparoscopic surgery among pediatric urology patients? US institutional experience.International journal of urology : official journal of the Japanese Urological Association · 2022Article
- Operative Approach Does Not Impact Radial Margin Positivity in Distal Rectal Cancer.World journal of surgery · 2021Article
- Population demographics in geographic proximity to hospitals with robotic platforms do not correlate with disparities in access to robotic surgery.Surgical endoscopy · 2021Article
- Do specific operative approaches and insurance status impact timely access to colorectal cancer care?Surgical endoscopy · 2021Article
- Trends in the diffusion of robotic surgery in prostate, uterus, and colorectal procedures: a retrospective population-based study.Journal of robotic surgery · 2021Article
- The Trends in Adoption, Outcomes, and Costs of Laparoscopic Surgery for Colorectal Cancer in the Elderly Population.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States.International journal of environmental research and public health · 2021Review
- Robotic proctectomy for rectal cancer in the US: a skewed population.Surgical endoscopy · 2020Article
- Evaluation of Access to Hospitals Most Ready to Achieve National Accreditation for Rectal Cancer Treatment.JAMA surgery · 2019Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundSocial and racial disparities have been identified as factors contributing to differences in access to care and oncologic outcomes in patients with colorectal cancer. The aim of this study was to investigate national disparities in minimally invasive surgery (MIS), both laparoscopic and robotic, across different racial, socioeconomic and geographic populations of patients with rectal cancer.
methodsWe utilized the American College of Surgeons National Cancer Database to identify patients with rectal cancer from 2004 to 2011 who had undergone definitive surgical procedures through either an open, laparoscopic or robotic approach. Inclusion criteria included only one malignancy and no adjuvant therapy. Multivariate analysis was performed to investigate differences in age, gender, race, income, education, insurance coverage, geographic setting and hospital type in relation to the surgical approach.
resultsA total of 8633 patients were identified. The initial surgical approach included 46.5% open (4016), 50.9% laparoscopic (4393) and 2.6% robotic (224). In evaluating type of insurance coverage, patients with private insurance were most likely to undergo laparoscopic surgery [OR (odds ratio) 1.637, 95% CI 1.178-2.275], although there was a less statistically significant association with robotic surgery (OR 2.167, 95% CI 0.663-7.087). Patients who had incomes greater than $46,000 and received treatment at an academic center were more likely to undergo MIS (either laparoscopic or robotic). Race, education and geographic setting were not statistically significant characteristics for surgical approach in patients with rectal cancer.
conclusionsMinimally invasive approaches for rectal cancer comprise approximately 53% of surgical procedures in patients not treated with adjuvant therapy. Robotics is associated with patients who have higher incomes and private insurance and undergo surgery in academic centers.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.