The impact of laparoscopic versus open approach on reoperation rate after segmental colectomy: a propensity analysis.

Journal Article (Journal Article)

BACKGROUND: Reoperation rate has not been well studied as a primary outcome when comparing laparoscopic with open approaches for colorectal resection. The goal of this study was to determine the impact of a laparoscopic approach on rate of reoperation after elective segmental colectomy. METHODS: The NSQIP PUF for 2005-2011 was used to retrospectively identify patients who underwent open or laparoscopic elective segmental colectomy. The primary outcome measure was 30-day reoperation rate. A multivariable logistic regression model was constructed to determine the independent effect of surgical approach on rates of unplanned reoperation. This was validated with inverse propensity score weighting. RESULTS: A total of 39,063 patients met the study inclusion criteria. A total of 1,702 reoperations were identified. After open approach, 5.1 % required reoperation, compared to 3.8 % in the laparoscopic group. After adjusting for confounders, open resection had 1.17-fold higher odds than laparoscopy for risk of reoperation, but this was not statistically significant (p = 0.07). DISCUSSION: Using a large clinical dataset, we found that for segmental colectomy, there was not a statistically significant difference in odds of return to the operating room for laparoscopic versus open surgical approach. Reoperation is a relatively rare but costly complication and remains a potential area for quality improvement.

Full Text

Duke Authors

Cited Authors

  • Speicher, PJ; Englum, BR; Jiang, B; Pietrobon, R; Mantyh, CR; Migaly, J

Published Date

  • February 2014

Published In

Volume / Issue

  • 18 / 2

Start / End Page

  • 378 - 384

PubMed ID

  • 23897083

Pubmed Central ID

  • PMC4336176

Electronic International Standard Serial Number (EISSN)

  • 1873-4626

Digital Object Identifier (DOI)

  • 10.1007/s11605-013-2289-z


  • eng

Conference Location

  • United States