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Trends of complications and innovative techniques' utilization for colectomies in the United States

Mohamed A Abd El Aziz1, Fabian Grass1, Kevin T Behm1

  • 1Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 first St. Southwest, Rochester, MN, 55905, USA.

Updates in Surgery
|August 11, 2020
PubMed

Insights

Minimally invasive surgery (MIS) for colectomy is increasing. Robotic surgery, a type of MIS, shows a trend towards fewer complications and shorter hospital stays compared to open and laparoscopic approaches.

Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Health Services Research

Background:

  • Minimally invasive surgery (MIS) is increasingly adopted for colectomy, but its safety and comparative outcomes remain debated.
  • Elective colectomy represents a significant surgical procedure with varying approaches and potential complications.

Purpose of the Study:

  • To assess trends in the utilization of open, laparoscopic, and robotic approaches for elective colectomy.
  • To compare complication rates and length of stay among the three surgical approaches.
  • To evaluate the safety profile of robotic surgery in elective colectomy.

Main Methods:

  • Analysis of data from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Public Use Files (PUFs) from 2013 to 2018.
  • Inclusion of all patients undergoing elective colectomy with identifiable operative approaches.
  • Assessment of utilization trends and comparison of overall, surgical, and medical complication rates and length of stay across open, laparoscopic, and robotic procedures.

Main Results:

  • A cohort of 78,987 patients was analyzed, with utilization shifting towards robotic surgery (2.5% annual increase).
  • Robotic surgery was associated with a decreasing trend in overall and surgical complications and length of stay.
  • Adjusted analysis showed robotic surgery linked to shorter length of stay and lower rates of overall and surgical complications compared to open and laparoscopic methods.

Conclusions:

  • There is a clear increasing trend in the utilization of minimally invasive surgery for elective colectomy in the United States.
  • Robotic-assisted colectomy demonstrates a favorable safety profile, associated with reduced morbidity and shorter hospitalizations.
  • The findings support the growing adoption of robotic surgery for elective colectomy due to improved patient outcomes.
Keywords:
ColectomyLaparoscopicOpenRoboticSurgical complicationsTrend analysis

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