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A Regional and National Database Comparison of Colorectal Outcomes
BACKGROUND AND OBJECTIVES: The traditional open approach is still a common option for colectomy and the most common option chosen for rectal resections for cancer. Randomized trials and large database studies have reported the merits of the minimally invasive approach, while studies comparing laparo...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Society of Laparoendoscopic Surgeons
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203949/ https://www.ncbi.nlm.nih.gov/pubmed/30410300 http://dx.doi.org/10.4293/JSLS.2018.00031 |
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author | Batool, Farwa Collins, Stacey D. Albright, Jeremy Ferraro, Jane Wu, Juan Krapohl, Greta L. Campbell, Darrell A. Cleary, Robert K. |
author_facet | Batool, Farwa Collins, Stacey D. Albright, Jeremy Ferraro, Jane Wu, Juan Krapohl, Greta L. Campbell, Darrell A. Cleary, Robert K. |
author_sort | Batool, Farwa |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: The traditional open approach is still a common option for colectomy and the most common option chosen for rectal resections for cancer. Randomized trials and large database studies have reported the merits of the minimally invasive approach, while studies comparing laparoscopic and robotic options have reported inconsistent results. METHODS: This study was designed to compare open, laparoscopic, and robotic colorectal surgery outcomes in protocol-driven regional and national databases. Logistic and multiple linear regression analyses were used to compare standard 30-day colorectal outcomes in the Michigan Surgical Quality Collaborative (MSQC) and American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) databases. The primary outcome was overall complications. RESULTS: A total of 10,054 MSQC patients (open 37.5%, laparoscopic 48.8%, and robotic 13.6%) and 80,535 ACS-NSQIP patients (open 25.0%, laparoscopic 67.1%, and robotic 7.9%) met inclusion criteria. Overall complications and surgical site infections were significantly favorable for the laparoscopic and robotic approaches compared with the open approach. Anastomotic leaks were significantly fewer for the laparoscopic and robotic approaches compared with the open approach in ACS-NSQIP, while there was no significant difference between robotic and open approaches in MSQC. Laparoscopic complications were significantly less than robotic complications in MSQC but significantly more in ACS-NSQIP. Laparoscopic 30-day mortality was significantly less than for the robotic approach in MSQC, but there was no difference in ACS-NSQIP. CONCLUSION: Minimally invasive colorectal surgery is associated with fewer complications and has several other outcomes advantages compared with the traditional open approach. Individual complication comparisons vary between databases, and caution should be exercised when interpreting results in context. |
format | Online Article Text |
id | pubmed-6203949 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Society of Laparoendoscopic Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-62039492018-11-08 A Regional and National Database Comparison of Colorectal Outcomes Batool, Farwa Collins, Stacey D. Albright, Jeremy Ferraro, Jane Wu, Juan Krapohl, Greta L. Campbell, Darrell A. Cleary, Robert K. JSLS Scientific Paper BACKGROUND AND OBJECTIVES: The traditional open approach is still a common option for colectomy and the most common option chosen for rectal resections for cancer. Randomized trials and large database studies have reported the merits of the minimally invasive approach, while studies comparing laparoscopic and robotic options have reported inconsistent results. METHODS: This study was designed to compare open, laparoscopic, and robotic colorectal surgery outcomes in protocol-driven regional and national databases. Logistic and multiple linear regression analyses were used to compare standard 30-day colorectal outcomes in the Michigan Surgical Quality Collaborative (MSQC) and American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) databases. The primary outcome was overall complications. RESULTS: A total of 10,054 MSQC patients (open 37.5%, laparoscopic 48.8%, and robotic 13.6%) and 80,535 ACS-NSQIP patients (open 25.0%, laparoscopic 67.1%, and robotic 7.9%) met inclusion criteria. Overall complications and surgical site infections were significantly favorable for the laparoscopic and robotic approaches compared with the open approach. Anastomotic leaks were significantly fewer for the laparoscopic and robotic approaches compared with the open approach in ACS-NSQIP, while there was no significant difference between robotic and open approaches in MSQC. Laparoscopic complications were significantly less than robotic complications in MSQC but significantly more in ACS-NSQIP. Laparoscopic 30-day mortality was significantly less than for the robotic approach in MSQC, but there was no difference in ACS-NSQIP. CONCLUSION: Minimally invasive colorectal surgery is associated with fewer complications and has several other outcomes advantages compared with the traditional open approach. Individual complication comparisons vary between databases, and caution should be exercised when interpreting results in context. Society of Laparoendoscopic Surgeons 2018 /pmc/articles/PMC6203949/ /pubmed/30410300 http://dx.doi.org/10.4293/JSLS.2018.00031 Text en © 2018 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way. |
spellingShingle | Scientific Paper Batool, Farwa Collins, Stacey D. Albright, Jeremy Ferraro, Jane Wu, Juan Krapohl, Greta L. Campbell, Darrell A. Cleary, Robert K. A Regional and National Database Comparison of Colorectal Outcomes |
title | A Regional and National Database Comparison of Colorectal Outcomes |
title_full | A Regional and National Database Comparison of Colorectal Outcomes |
title_fullStr | A Regional and National Database Comparison of Colorectal Outcomes |
title_full_unstemmed | A Regional and National Database Comparison of Colorectal Outcomes |
title_short | A Regional and National Database Comparison of Colorectal Outcomes |
title_sort | regional and national database comparison of colorectal outcomes |
topic | Scientific Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203949/ https://www.ncbi.nlm.nih.gov/pubmed/30410300 http://dx.doi.org/10.4293/JSLS.2018.00031 |
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