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Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
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Risk of readmission after laparoscopic vs. open colorectal surgery
Iyare O Esemuede1, Alodia Gabre-Kidan1, Dennis L Fowler1
1Division of Colorectal Surgery, Columbia University Medical Center, 177 Fort Washington Avenue, 7 South Knuckle, New York, NY, 10032, USA.
International Journal of Colorectal Disease
|August 13, 2015
Summary
Laparoscopic colorectal resection (LC) offers shorter hospital stays and fewer complications than open colorectal resection (OC). This approach does not increase readmission risk, highlighting its benefits for patients undergoing colorectal surgery.
Area of Science:
- Minimally Invasive Surgery
- Gastrointestinal Surgery
- Surgical Outcomes Research
Background:
- Laparoscopic colorectal resection (LC) is known for faster recovery and earlier discharge compared to open colorectal resection (OC).
- The impact of earlier discharge on readmission rates after LC versus OC is not well-established.
- This study investigates readmission risks associated with LC and OC in a large patient cohort.
Purpose of the Study:
- To compare the risk of readmission following laparoscopic colorectal resection (LC) versus open colorectal resection (OC).
- To analyze patient factors, complications, and readmission rates in a nationally representative sample.
- To identify factors associated with readmission after colorectal resection.
Main Methods:
- Utilized data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database for patients undergoing colorectal resection in 2011.
- Compared patient characteristics, complications, and readmission rates between LC and OC groups.
- Performed multivariable analysis to identify predictors of readmission, controlling for significant confounding factors.
Main Results:
- Of 30,428 patients, 40.2% underwent LC, with a significantly shorter length of stay (5.7 vs. 9.7 days) compared to OC.
- LC was associated with lower rates of surgical site infections, bleeding, reoperation, 30-day mortality, and overall complications.
- While proctectomy had higher readmission rates than colectomy, LC demonstrated lower readmission risk than OC for both procedures after adjusting for confounders. Obesity, diabetes mellitus, prolonged operating time, steroid use, and higher ASA class were linked to readmission.
Conclusions:
- Laparoscopic colorectal resection (LC) can be safely performed without an increased risk of complications or readmissions.
- The reduced length of stay and lower readmission rates confirm the significant advantages of the laparoscopic approach in colorectal surgery.
- LC represents a beneficial alternative to open surgery for colorectal resection, enhancing patient recovery and outcomes.
