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

Publication ,  Journal Article
Speicher, PJ; Englum, BR; Jiang, B; Pietrobon, R; Mantyh, CR; Migaly, J
Published in: J Gastrointest Surg
February 2014

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.

Duke Scholars

Published In

J Gastrointest Surg

DOI

EISSN

1873-4626

Publication Date

February 2014

Volume

18

Issue

2

Start / End Page

378 / 384

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Reoperation
  • Propensity Score
  • Middle Aged
  • Male
  • Laparoscopy
  • Humans
  • Female
  • Colectomy
 

Citation

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Speicher, P. J., Englum, B. R., Jiang, B., Pietrobon, R., Mantyh, C. R., & Migaly, J. (2014). The impact of laparoscopic versus open approach on reoperation rate after segmental colectomy: a propensity analysis. J Gastrointest Surg, 18(2), 378–384. https://doi.org/10.1007/s11605-013-2289-z
Speicher, Paul J., Brian R. Englum, Betty Jiang, Ricardo Pietrobon, Christopher R. Mantyh, and John Migaly. “The impact of laparoscopic versus open approach on reoperation rate after segmental colectomy: a propensity analysis.J Gastrointest Surg 18, no. 2 (February 2014): 378–84. https://doi.org/10.1007/s11605-013-2289-z.
Speicher PJ, Englum BR, Jiang B, Pietrobon R, Mantyh CR, Migaly J. The impact of laparoscopic versus open approach on reoperation rate after segmental colectomy: a propensity analysis. J Gastrointest Surg. 2014 Feb;18(2):378–84.
Speicher, Paul J., et al. “The impact of laparoscopic versus open approach on reoperation rate after segmental colectomy: a propensity analysis.J Gastrointest Surg, vol. 18, no. 2, Feb. 2014, pp. 378–84. Pubmed, doi:10.1007/s11605-013-2289-z.
Speicher PJ, Englum BR, Jiang B, Pietrobon R, Mantyh CR, Migaly J. The impact of laparoscopic versus open approach on reoperation rate after segmental colectomy: a propensity analysis. J Gastrointest Surg. 2014 Feb;18(2):378–384.
Journal cover image

Published In

J Gastrointest Surg

DOI

EISSN

1873-4626

Publication Date

February 2014

Volume

18

Issue

2

Start / End Page

378 / 384

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Reoperation
  • Propensity Score
  • Middle Aged
  • Male
  • Laparoscopy
  • Humans
  • Female
  • Colectomy