Laparoscopic versus open emergent colectomy for ischemic colitis : a propensity score-matched comparison
© 2022. The Author(s)..
INTRODUCTION: Laparoscopic colectomy is rarely performed for ischemic colitis. The aim of this propensity score-matched study was to compare preoperative characteristics, intraoperative details and short-term outcomes for emergent laparoscopic colectomy versus the traditional open approach for patients with ischemic colitis.
METHODS: Retrospective review of 96 patients who underwent emergent colectomy for ischemic colitis between January 2011 and December 2020 (39 via laparoscopy, 57 via laparotomy) was performed. We compared short-term outcomes after using a one-to-one ratio and nearest-neighbor propensity score matching to obtain similar preoperative and intraoperative parameters in each group.
RESULTS: Patients in the open group experienced more surgical site complications (52.6% vs. 23.0%, p = 0.004), more intra-abdominal abscesses (47.3% vs. 17.9%, p = 0.003), longer need for ventilator support (20 days vs. 0 days, p < 0.001), more major complications (77.2% vs. 43.5%, p = 0.001), higher mortality (49.1% vs. 20.5%, p = 0.004), and longer hospital stay (32 days vs. 19 days, p = 0.001). After propensity score matching (31 patients in each group), patients undergoing open (vs. laparoscopy) had more surgical site complications (45.1% vs. 19.4%, p = 0.030) and required longer ventilator support (14 vs. 3 days, p = 0.039). After multivariate analysis, Charlson Comorbidity Index (p = 0.024), APACHE II score (p = 0.001), and Favier's classification (p = 0.023) were independent predictors of mortality.
CONCLUSIONS: Laparoscopic emergent colectomy for ischemic colitis is feasible and is associated with fewer surgical site complications and better respiratory function, compared to the open approach.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2022 |
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Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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Enthalten in: |
World journal of emergency surgery : WJES - 17(2022), 1 vom: 13. Okt., Seite 53 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Chen, Yi-Chang [VerfasserIn] |
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Links: |
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Themen: |
Emergent colectomy |
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Anmerkungen: |
Date Completed 17.10.2022 Date Revised 22.11.2022 published: Electronic Citation Status MEDLINE |
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doi: |
10.1186/s13017-022-00458-4 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM347449093 |
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520 | |a © 2022. The Author(s). | ||
520 | |a INTRODUCTION: Laparoscopic colectomy is rarely performed for ischemic colitis. The aim of this propensity score-matched study was to compare preoperative characteristics, intraoperative details and short-term outcomes for emergent laparoscopic colectomy versus the traditional open approach for patients with ischemic colitis | ||
520 | |a METHODS: Retrospective review of 96 patients who underwent emergent colectomy for ischemic colitis between January 2011 and December 2020 (39 via laparoscopy, 57 via laparotomy) was performed. We compared short-term outcomes after using a one-to-one ratio and nearest-neighbor propensity score matching to obtain similar preoperative and intraoperative parameters in each group | ||
520 | |a RESULTS: Patients in the open group experienced more surgical site complications (52.6% vs. 23.0%, p = 0.004), more intra-abdominal abscesses (47.3% vs. 17.9%, p = 0.003), longer need for ventilator support (20 days vs. 0 days, p < 0.001), more major complications (77.2% vs. 43.5%, p = 0.001), higher mortality (49.1% vs. 20.5%, p = 0.004), and longer hospital stay (32 days vs. 19 days, p = 0.001). After propensity score matching (31 patients in each group), patients undergoing open (vs. laparoscopy) had more surgical site complications (45.1% vs. 19.4%, p = 0.030) and required longer ventilator support (14 vs. 3 days, p = 0.039). After multivariate analysis, Charlson Comorbidity Index (p = 0.024), APACHE II score (p = 0.001), and Favier's classification (p = 0.023) were independent predictors of mortality | ||
520 | |a CONCLUSIONS: Laparoscopic emergent colectomy for ischemic colitis is feasible and is associated with fewer surgical site complications and better respiratory function, compared to the open approach | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Emergent colectomy | |
650 | 4 | |a Ischemic colitis | |
650 | 4 | |a Laparoscopy | |
700 | 1 | |a Tsai, Yuan-Yao |e verfasserin |4 aut | |
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700 | 1 | |a Ke, Tao-Wei |e verfasserin |4 aut | |
700 | 1 | |a Fingerhut, Abe |e verfasserin |4 aut | |
700 | 1 | |a Chen, William Tzu-Liang |e verfasserin |4 aut | |
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