A population-based comparison of open versus minimally invasive abdominoperineal resection - 05/05/15
Abstract |
Background |
Although minimally invasive colorectal surgery increases widely, outcomes following its use in complex operations such as the abdominoperineal resection (APR) remain indeterminate.
Methods |
A review of the Nationwide Inpatient Sample (2008 to 2011) of all patients undergoing elective laparoscopic or open APR was conducted. Risk-adjusted 30-day outcomes were assessed using regression modeling accounting for patient characteristics, comorbidities, and surgical procedure.
Results |
We identified 3,191 admissions meeting inclusion criteria (1,019 laparoscopic; 2,172 open). The conversion rate was 5%. Mortality was low and similar between groups (.88% vs .83%, P = .91). In-hospital complication rates were lower in the laparoscopic group (19% vs 29%, odds ratio .59, 95% confidence interval .49 to .71, P < .01), but conversion was associated with a higher rate (29% vs 18%, P < .01). Finally, a laparoscopic APR was associated with a shorter length of stay (5.3 vs 7.0 days, P < .01).
Conclusion |
Laparoscopic APR is associated with improved outcomes and may be the preferred approach by surgeons with appropriate skills and experience.
Le texte complet de cet article est disponible en PDF.Keywords : Abdominoperineal resection, Laparoscopy, Proctectomy, Postoperative complications, Population database
Plan
| The authors declare no conflicts of interest. |
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| This is an original work by the above authors. The opinions expressed are the authors' and authors' alone. They do not necessarily reflect the opinion of the United States Government, the US Department of Defense, or Madigan Army Medical Center. |
Vol 209 - N° 5
P. 815-823 - mai 2015 Retour au numéro
Article précédent
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