Laparoscopic colon surgery performed safely by general surgeons in a community hospital: a review of 154 consecutive cases.
BACKGROUND
The primary end point of this study was documentation of the feasibility, safety, and benefits of laparoscopic colon resection (LCR) performed by general surgeons in a community hospital.


METHODS
The charts of 154 patients who underwent LCR between March 1998 and August 2003 by a group of three surgeons working in a community hospital were reviewed. Data extracted from the charts included patients' demographics, surgical indications and procedures, conversion rate, history, operative time, postoperative recovery time, and complication rates.


RESULTS
Of the 154 patients, 70 were men. The mean age of the patients was 60 years. Overall, 62% of the patients had a history of prior abdominal surgery. In the majority of cases (77%), LCR was performed for benign disease. Segmental resection involving the left colon was performed for 122 patients, and right hemicolectomy was performed for 32 patients. The rates of conversion were 9.6% for open surgery and 12% for diverticulitis (n = 83). For LCR, the median operative time was 120 min, and the median hospital stay was 5 days. The complication rate was 21.6% for LCR, and the mortality rate was 2.1%.


CONCLUSIONS
The outcomes for LCR performed by a team of general surgeons working together in a community hospital are similar to the historical results from academic health science centers.
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Department of Surgery, Hôpital Sainte-Croix, Drummondville, Quebec, Canada.
Laplante
R
R
Miller
S
S
Gagné
J-P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D003108:Colonic Diseases / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D013502:General Surgery / Q000592:standards*; D006764:Hospitals, Community; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D008297:Male; D008875:Middle Aged; D012449:Safety