Minimally Invasive Surgery for Colorectal Cancer: Hospital Type Drives Utilization and Outcomes

Abstract Introduction Minimally invasive surgery (MIS) for colorectal cancer (CRC) is increasingly common; however, uptake has differed by hospital type. It is unknown how these trends have evolved for laparoscopic or robotic approaches in different types of hospitals. This study assesses temporal trends for MIS utilization and examines differences in surgical outcomes by hospital type. Methods The National Cancer Database was queried for patients who underwent CRC surgery between 2010 and 2015. Time-trend analysis of MIS utilization was performed for both approaches by hospital type (community, comprehensive community, integrated network, academic). Multivariate logistic regression models were used to examine MIS utilization, differences in case severity, and surgical outcomes by hospital type, after controlling for patient characteristics. Results Across all hospital types, community hospitals had the lowest rate of laparoscopic (36.8%) and robotic (3.3%) procedures for CRC (P  Conclusions MIS for CRC lags at the community level and experiences worse postoperative outcomes. Future initiatives must focus on understanding and correcting this trend to ensure uniform access to high-quality surgical care.