title: Laparoscopic versus open fecal diversion: does laparoscopy offer better outcomes in short term?
abstract: BACKGROUND
  Laparoscopic fecal diversion is performed in patients with complicated colon and rectal diseases. We aim to compare operative and short-term outcomes between laparoscopic and open fecal diversion.
  
  
  METHODS
  After obtaining institutional review board approval, patients undergoing laparoscopic or open fecal diversion between February 2010 and September 2012 were reviewed. A straight comparison of the open and laparoscopic groups was made initially; then, patients who underwent laparoscopic fecal diversion were case-matched with open counterparts based on stoma type and primary diagnosis.
  
  
  RESULTS
  While body mass index (BMI) was higher in the laparoscopy group (p = 0.04), American Society of Anesthesiologists (ASA) score (p = 0.33) and gender (p = 0.74) were comparable between the study groups in the straight comparison. In the case-matched analysis, type of prior operations (p > 0.05), age (p = 0.79), gender (p > 0.99), BMI (p = 0.1), and ASA (p = 0.25) score were comparable between the groups. Open surgery was associated with increased estimated blood loss (p = 0.01), longer hospital stay (p = 0.0002), higher postoperative ileus (p = 0.03), and higher readmission rates (p = 0.002).
  
  
  CONCLUSIONS
  Considering the short-term benefits as regards postoperative recovery and morbidity, fecal diversions should be performed laparoscopically when feasible.
authors: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Desk A 30, 9500 Euclid Ave, Cleveland, OH, 44195, USA, gorgune@ccf.org.
authors: E
authors: E
authors: Gorgun
authors: F C
authors: FC
authors: Gezen
authors: E
authors: E
authors: Aytac
authors: L
authors: L
authors: Stocchi
authors: M M
authors: MM
authors: Costedio
authors: F H
authors: FH
authors: Remzi
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003108:Colonic Diseases / Q000601:surgery*; D003125:Colostomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome