Can laparoscopic ileocolic resection be performed with comparable safety to open surgery for regional enteritis: data from National Surgical Quality Improvement Program.
Laparoscopic ileocolic resection is feasible for Crohn's disease but few studies adjust for the various preoperative, intraoperative, and postoperative variables that may confound comparisons with open surgery. The aim of this study is to compare outcomes after laparoscopic (LICR) and open ileocolic resection (OICR) performed for regional enteritis using National Surgical Quality Improvement Program (NSQIP) data. Retrospective evaluation of data prospectively accrued into the NSQIP database for patients undergoing ileocolic resection for Crohn's by LICR and OICR was performed. LICR (n = 104) and OICR (n = 203) groups had similar age (P = 0.1), body mass index (P = 0.9), smoking history (P = 0.6), steroid use (P = 0.7), diabetes (P = 0.3), serum albumin (P = 0.07), and American Society of Anesthesiologists class (P = 0.13). LICR group had more female patients (P = 0.005). Complications including surgical site infections (P = 0.5), wound dehiscence (P = 1), pneumonia (P = 0.1), deep vein thrombosis (P = 0.3), pulmonary embolism (P = 1), urinary infection (P = 0.1), and return to the operating room (P = 0.2) were similar. LICR had shorter length of hospital stay than OICR (P < 0.001). In current practice, as observed with the NSQIP data, LICR, performed by experienced surgeons, is comparable in safety to OICR and is associated with a shorter hospital stay.
Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Hasan T
HT
Kirat
Naveen
N
Pokala
Jon D
JD
Vogel
Victor W
VW
Fazio
Ravi P
RP
Kiran
D000328:Adult; D016208:Databases, Factual; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004751:Enteritis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology; D058996:Quality Improvement; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult