TY - JOUR
T1 - Outcomes of laparoscopic and open colectomy at academic centers
AU - Varela, J. Esteban
AU - Asolati, Massimo
AU - Huerta, Sergio
AU - Anthony, Thomas
PY - 2008/9
Y1 - 2008/9
N2 - Background: Laparoscopic techniques have emerged as a suitable approach for colon resection. This study determined and compared the outcomes of patients undergoing laparoscopic or open colectomy at United States academic centers. Methods: Using ICD-9-CM codes, we obtained data from the University HealthSystem Consortium database for 50,443 patients who underwent open (n = 47,090; 94%) or laparoscopic (n = 3,353; 6%) colectomy during a 5-year period (2002 to 2006). Outcomes studied included length of stay (LOS), costs, in-hospital morbidity and risk-adjusted mortality rates. Results: Mean LOS (open = 11 days and laparoscopic = 7 days) was significantly shorter and mean costs (open = $23,000 and laparoscopic = $17,000) significantly fewer with the laparoscopic approach. The overall in-hospital morbidity rate was significantly lower with laparoscopic colectomy (open = 33% and laparoscopic = 24%). The risk-adjusted mortality ratio was comparable between groups (open = .9 and laparoscopic = .7). Comments: Despite the major biases inherent in this retrospective review of the University Health System Consortium, which favors the use of laparoscopic colectomy by United States academic surgeons, laparoscopic colectomy offers the potential of significantly shorter LOS, fewer costs, lower in-hospital morbidity rates, and comparable risk-adjusted mortality rates compared with open colectomy. Laparoscopic colectomy is as safe as the open approach.
AB - Background: Laparoscopic techniques have emerged as a suitable approach for colon resection. This study determined and compared the outcomes of patients undergoing laparoscopic or open colectomy at United States academic centers. Methods: Using ICD-9-CM codes, we obtained data from the University HealthSystem Consortium database for 50,443 patients who underwent open (n = 47,090; 94%) or laparoscopic (n = 3,353; 6%) colectomy during a 5-year period (2002 to 2006). Outcomes studied included length of stay (LOS), costs, in-hospital morbidity and risk-adjusted mortality rates. Results: Mean LOS (open = 11 days and laparoscopic = 7 days) was significantly shorter and mean costs (open = $23,000 and laparoscopic = $17,000) significantly fewer with the laparoscopic approach. The overall in-hospital morbidity rate was significantly lower with laparoscopic colectomy (open = 33% and laparoscopic = 24%). The risk-adjusted mortality ratio was comparable between groups (open = .9 and laparoscopic = .7). Comments: Despite the major biases inherent in this retrospective review of the University Health System Consortium, which favors the use of laparoscopic colectomy by United States academic surgeons, laparoscopic colectomy offers the potential of significantly shorter LOS, fewer costs, lower in-hospital morbidity rates, and comparable risk-adjusted mortality rates compared with open colectomy. Laparoscopic colectomy is as safe as the open approach.
KW - Colectomy
KW - Laparoscopy
KW - Open
KW - Outcomes
UR - http://www.scopus.com/inward/record.url?scp=49349103307&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=49349103307&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2007.11.030
DO - 10.1016/j.amjsurg.2007.11.030
M3 - Article
C2 - 18718221
AN - SCOPUS:49349103307
SN - 0002-9610
VL - 196
SP - 403
EP - 406
JO - American journal of surgery
JF - American journal of surgery
IS - 3
ER -