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

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.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.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).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.