A population-based comparison of open versus minimally invasive abdominoperineal resection

American Journal of Surgery
Andrew T SchlusselScott R Steele

Abstract

Although minimally invasive colorectal surgery increases widely, outcomes following its use in complex operations such as the abdominoperineal resection (APR) remain indeterminate. A review of the Nationwide Inpatient Sample (2008 to 2011) of all patients undergoing elective laparoscopic or open APR was conducted. Risk-adjusted 30-day outcomes were assessed using regression modeling accounting for patient characteristics, comorbidities, and surgical procedure. We identified 3,191 admissions meeting inclusion criteria (1,019 laparoscopic; 2,172 open). The conversion rate was 5%. Mortality was low and similar between groups (.88% vs .83%, P = .91). In-hospital complication rates were lower in the laparoscopic group (19% vs 29%, odds ratio .59, 95% confidence interval .49 to .71, P < .01), but conversion was associated with a higher rate (29% vs 18%, P < .01). Finally, a laparoscopic APR was associated with a shorter length of stay (5.3 vs 7.0 days, P < .01). Laparoscopic APR is associated with improved outcomes and may be the preferred approach by surgeons with appropriate skills and experience.

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Citations

Jul 19, 2016·Thoracic Surgery Clinics·Eitan PodgaetzRafael S Andrade
Apr 7, 2018·International Journal of Colorectal Disease·Gabriela Batista RodríguezEduard M Targarona
Dec 22, 2016·Proceedings·L August Clark, Walter R Peters

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