A national comparison of laparoscopic vs. open colectomy using the national surgical quality improvement project data.

摘要

INTRODUCTION: We used a publicly available limited data set from the National Surgical Quality Improvement Project to assess the preoperative risk factors and postoperative complication rates reported for laparoscopic colectomy and open colectomy. METHODS: Patients were evaluated from this nationally reported database who underwent either laparoscopic colectomy (n = 2728) or open colectomy (n = 4719) from December 1, 2005 through September 1, 2007. RESULTS: Body mass index was similar for laparoscopic (27.9, SD 5.8) and open colectomy patients (28.0, SD 7.2). The open colectomy group had significantly higher rates of diabetes (16.0 percent vs. 12.0 percent), smoking (18.0 percent vs. 15.0 percent), dyspnea (14.0 percent vs. 9.0 percent), chronic obstructive pulmonary disease (7.0 percent vs. 4.0 percent), congestive heart failure (2.0 percent vs. 0.6 percent), myocardial infarction within previous 6 months (0.9 percent vs. 0.4 percent), and hypertension (54 percent vs. 50 percent). All perioperative complications were more frequent in the open colectomy group; mortality (4.9 percent vs. 0.8 percent), surgical site infections (12 percent vs. 8.0 percent), wound disruption (2.0 percent vs. 0.8 percent), pneumonia (5.0 percent vs. 2.0 percent), and acute renal failure (1.0 percent vs. 0.3 percent). CONCLUSION: The data, derived from the publicly available limited data set from the National Surgical Quality Improvement Project audit process, suggest a higher rate for all commonly identified complications for open compared to laparoscopic colectomy; however, open colectomy patients have an apparent higher preoperative risk.