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World J Surg Oncol. 2015 Aug 15;13:250. doi: 10.1186/s12957-015-0666-7.

Comparison of clinical outcome between laparoscopic and open right hemicolectomy: a nationwide study.

Author information

1
Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
2
Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan.
3
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
4
Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan. poliwei@tmu.edu.tw.
5
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan. poliwei@tmu.edu.tw.
6
Cancer Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan. poliwei@tmu.edu.tw.

Abstract

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.

PMID:
26271770
PMCID:
PMC4536701
DOI:
10.1186/s12957-015-0666-7
[Indexed for MEDLINE]
Free PMC Article

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