Diseases of the colon and rectum
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Previous studies suggest that minorities cluster in low-quality hospitals despite living close to better performing hospitals. This may contribute to persistent disparities in cancer outcomes. ⋯ Minority patients do not use high-volume hospitals despite improved outcomes and geographic access. Low socioeconomic status predicts low use of high-volume settings in select minority groups. Our results provide a roadmap for developing interventions to increase the use of and access to higher quality care and outcomes. Increasing minority use of high-volume hospitals may require community outreach programs and changes in physician referral practices.
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Patients with liver disease face significant risk of complications and death when considering elective colorectal resection for benign or malignant indications. ⋯ Consistent with previous reports, patients with higher Model of End-Stage Liver Disease scores have a significantly higher risk of death and major morbidity in the 30 days after elective colorectal resection (see Video, Supplemental Digital Content, http://links.lww.com/DCR/A180).
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Endoscopic ultrasound-guided fine needle aspiration is highly accurate for the diagnosis of malignancies surrounding the gastrointestinal tract. There is a lack of information on the usefulness of this technique in the diagnosis of colorectal cancer recurrence. ⋯ Endoscopic ultrasound-guided fine needle aspiration is a highly accurate tool for the cytologic diagnosis of perirectal recurrence in patients with previous colorectal cancer.