Outcomes of laparoscopic and open colectomy at academic centers.
BACKGROUND
Laparoscopic techniques have emerged as a suitable approach for colon resection. This study determined and compared the outcomes of patients undergoing laparoscopic or open colectomy at United States academic centers.


METHODS
Using ICD-9-CM codes, we obtained data from the University HealthSystem Consortium database for 50,443 patients who underwent open (n = 47,090; 94%) or laparoscopic (n = 3,353; 6%) colectomy during a 5-year period (2002 to 2006). Outcomes studied included length of stay (LOS), costs, in-hospital morbidity and risk-adjusted mortality rates.


RESULTS
Mean LOS (open = 11 days and laparoscopic = 7 days) was significantly shorter and mean costs (open = $23,000 and laparoscopic = $17,000) significantly fewer with the laparoscopic approach. The overall in-hospital morbidity rate was significantly lower with laparoscopic colectomy (open = 33% and laparoscopic = 24%). The risk-adjusted mortality ratio was comparable between groups (open = .9 and laparoscopic = .7).


CONCLUSIONS
Despite the major biases inherent in this retrospective review of the University Health System Consortium, which favors the use of laparoscopic colectomy by United States academic surgeons, laparoscopic colectomy offers the potential of significantly shorter LOS, fewer costs, lower in-hospital morbidity rates, and comparable risk-adjusted mortality rates compared with open colectomy. Laparoscopic colectomy is as safe as the open approach.
Varela
J Esteban
JE
Minimally Invasive Surgery, Surgical Service, Veterans Affairs North Texas Health Care System, Dallas, TX, USA. esteban.varela@utsouthwestern.edu
Asolati
Massimo
M
Huerta
Sergio
S
Anthony
Thomas
T
D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D003082:Colectomy / Q000379:methods* / Q000706:statistics & numerical data; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology