Laparoscopic colectomy is associated with a lower incidence of postoperative complications than open colectomy: a propensity score-matched cohort analysis

Aim Elective laparoscopic colectomy (LC) has been shown to provide short‐term results comparable with open colectomy (OC), but there is potential selection bias whereby LC patients may be healthier and therefore more likely to have a superior outcome. The aim of this study was to compare the inciden...

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Bibliographic Details
Published in:Colorectal disease 2014-05, Vol.16 (5), p.382-389
Main Authors: Wilson, M. Z., Hollenbeak, C. S., Stewart, D. B.
Format: Article
Language:English
Subjects:
Aged
colectomy
Colectomy - adverse effects
Colectomy - methods
Colectomy - statistics & numerical data
Female
Humans
Incidence
Laparoscopic
Laparoscopy - adverse effects
Laparoscopy - statistics & numerical data
Length of Stay
Male
Middle Aged
NSQIP
open
outcomes
Propensity Score
Retrospective Studies
Selection Bias
Surgical Wound Infection - epidemiology
Surgical Wound Infection - etiology
Urinary Tract Infections - epidemiology
Urinary Tract Infections - etiology
Venous Thrombosis - epidemiology
Venous Thrombosis - etiology
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Summary:Aim Elective laparoscopic colectomy (LC) has been shown to provide short‐term results comparable with open colectomy (OC), but there is potential selection bias whereby LC patients may be healthier and therefore more likely to have a superior outcome. The aim of this study was to compare the incidence of postoperative complications between matched laparoscopic and open colectomy cohorts, while controlling for differences in comorbidity. Method A retrospective cohort study (2005–2010) using National Surgical Quality Improvement Program data was performed, identifying laparoscopic and open partial colectomy patients through common procedural terminology codes. Patient having rectal resection were excluded. The cohorts were matched 1:1 on a propensity score to control for observable selection bias due to patient characteristics, comparing overall complication rates, length of hospital stay (LOS), the incidence of superficial (S‐SSI) surgical site infection, urinary tract infection (UTI) and deep‐venous thrombosis (DVT). Results We analysed 37 249 patients. After propensity score matching the LC group had a significantly lower overall incidence of postoperative complications (29.1 vs 21.2%; P 
ISSN:1462-8910
1463-1318
DOI:10.1111/codi.12537