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Effect of Race on Peri-Operative Outcomes after Robotic-Assisted Pulmonary Lobectomy
Sarah M. Cool1, Diep Nguyen1, Jessica Cobb1, Collin Chase1, Ajay Varadhan1, Gregory Fishberger1, Maykel Dolorit1, Harrison Strang1, Emily Weeden1, Rahul Mhaskar1, Joseph R. Garrett2, Carla C. Moodie2, Jacques P. Fontaine3, Jenna Tew2, Jobelle J.A.R. Baldonado3, Eric M. Toloza3.
1University of South Florida Morsani College of Medicine, Tampa, FL, USA, 2Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA, 3Department of Thoracic Oncology, Moffitt Cancer Center, Tampa; Department of Surgery, University of South Florida Health Morsani College of Medicine; Department of Oncologic Sciences, University of South Florida Morsani College of Medicine, Tampa, FL, USA.

OBJECTIVE: Racial disparities have been identified in access to surgical treatment, post-operative outcomes, and survival rates in cancer treatment. This study aims to identify differences in peri-operative outcomes between patients categorized by self-reported Race after robotic-assisted pulmonary lobectomy. METHODS: We retrospectively analyzed 704 consecutive patients who underwent robotic-assisted pulmonary lobectomy by one surgeon at one institution over 10.8 years. Patients were grouped by Race from self-reported data within electronic medical records. Primary outcomes were skin-to-skin operative time, estimated blood loss (EBL), chest tube duration, hospital length of stay (LOS), and in-hospital mortality, and secondary outcomes included intra-operative and post-operative complications. Outcomes were analyzed by Wilcoxon Two-Sample Test, Kruskal-Wallis Test, or Chi-Square Test, with p≤0.05 as significant. RESULTS: Of 704 total patients, there were 656 White, 18 Black, 12 Asian/Pacific Islander (API), 3 Native American/Alaskan (NAA), or 15 Other. Neither skin-to-skin operative time nor EBL differed significantly among Race groups. There were significant differences among Race groups for median chest tube duration (White=4d, Black=3d, API=2d, NAA=2d, Other=3d; p=0.0267), median hospital LOS (White=4d, Black=3d, API=3d, NAA=3d, Other=3d; p=0.0144). and postoperative complications of aspiration (White=10, Black=1, API=0, NAA=0, Other=2; p=0.0389) and mucous plug requiring bronchoscopy (White=26, Black=3, API=1, NAA=0, Other=2; p=0.0327). All 10 (1.4%) in-hospital mortality occurred in White patients. CONCLUSIONS: Following robotic-assisted pulmonary lobectomy, chest tube duration and hospital LOS differed significantly among Race groups. Investigation of other demographics and preoperative, intraoperative, and postoperative clinical factors is needed to further understand these differences in peri-operative outcomes by Race.



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