Comparison of clinical outcome between laparoscopic and open right hemicolectomy: a nationwide study.
BACKGROUND
This study aimed to compare clinical outcome between laparoscopic and open right hemicolectomy.


METHODS
The data were sourced from Taiwan's National Health Insurance Research Database. This study included 14,320 and 1313 patients who underwent open and laparoscopic right hemicolectomies, respectively. The study outcome included "intensive care unit (ICU) admission," "over 2 h of general anesthesia," "use of mechanical ventilation," "acute respiratory failure," "in-hospital death," and "hospitalization for pneumonia." Separate conditional logistic regressions were performed for each clinical outcome.


RESULTS
The results showed that patients who underwent an open right hemicolectomy had significantly higher likelihood of ICU admission (31.4 vs. 13.4%, p<0.001), acute respiratory failure (3.6 vs. 0.8%, p<0.001), mechanical ventilation (12.8 vs. 4.1%, p<0.001), in-hospital death (3.7 vs. 0.9%, p<0.001), over 2 h of general anesthesia (4.6 vs. 1.2%, p<0.001), and hospitalization for pneumonia (5.8 vs. 3.1%, p<0.001) than patients who underwent a laparoscopic right hemicolectomy. Adjusted conditional logistic regression analyses revealed that patients who underwent an open right hemicolectomy were 2.96, 4.98, 3.41, 4.01, 3.44, and 1.78 times more likely to be admitted to the ICU, to have acute respiratory failure, the use of mechanical ventilation, in-hospital death, over 2 h of general anesthesia, and hospitalization for pneumonia, respectively, than patients who underwent a laparoscopic right hemicolectomy.


CONCLUSIONS
Laparoscopic right hemicolectomy reduced risk of post-operative pulmonary complications.
Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Cha-Ze
CZ
Lee
Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan.
Li-Ting
LT
Kao
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
Herng-Ching
HC
Lin
Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan. poliwei@tmu.edu.tw.|Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan. poliwei@tmu.edu.tw.|Cancer Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan. poliwei@tmu.edu.tw.
Po-Li
PL
Wei
D000293:Adolescent; D000328:Adult; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult