Short-term Outcomes After Open and Laparoscopic Colostomy Creation

Area of Science:

• Colorectal Surgery
• Surgical Outcomes Research
• Minimally Invasive Surgery

Background:

• Colostomy creation is a frequent procedure in colon and rectal surgery.
• Comparative outcomes between open and laparoscopic techniques require further investigation.

Purpose of the Study:

• To evaluate and compare outcomes of open versus laparoscopic colostomy creation.
• Identify predictors of 30-day mortality in colostomy procedures.

Main Methods:

• Retrospective review of patients undergoing colostomy creation.
• Utilized univariate and multivariate propensity score analyses.
• Data sourced from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2005-2011).

Main Results:

• Open colostomy (n=2179) was more common than laparoscopic (n=1132).
• Open procedures had higher 30-day mortality (8.7% vs 3.5%) and complication rates (25.4% vs 17.0%).
• Age >65 and dependent functional status were associated with increased 30-day mortality risk across all analyses.

Conclusions:

• Open colostomy creation is more prevalent than laparoscopic approach in ACS-NSQIP hospitals.
• Patient age and functional status are significant predictors of 30-day mortality.
• Study limitations include potential selection bias and limited generalizability.