Trends of complications and innovative techniques' utilization for colectomies in the United States.
Détails
Demande d'une copie Sous embargo indéterminé.
Accès restreint UNIL
Etat: Public
Version: Final published version
Licence: Non spécifiée
Accès restreint UNIL
Etat: Public
Version: Final published version
Licence: Non spécifiée
ID Serval
serval:BIB_4EFB98CC35E3
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Trends of complications and innovative techniques' utilization for colectomies in the United States.
Périodique
Updates in surgery
ISSN
2038-3312 (Electronic)
ISSN-L
2038-131X
Statut éditorial
Publié
Date de publication
02/2021
Peer-reviewed
Oui
Volume
73
Numéro
1
Pages
101-110
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Despite an increasing trend towards utilization of minimally invasive approaches (MIS), results regarding their safety profile are contradictory. All patients who underwent elective colectomy for any underlying disease with an identifiable operative approach available from the targeted colectomy files of the ACS-NSQIP PUFs 2013 to 2018 were included. The trend of utilization and complication rates of the different operative approaches (open, laparoscopic, robotic) were assessed during the inclusion period. Furthermore, overall, surgical, and medical complications were compared between the three approaches. The study cohort included 78,987 patients. Of them, 12,335 (15.6%) patients underwent open, 57,874 (73.3%) laparoscopic, and 8,778 (11.1%) robotic surgery. There was an increasing trend towards the utilization of robotic surgery (2.5% increase per year) at the expense of the other approaches. With the increasing trend toward the utilization of the robotic approach, a decreasing trend in overall and surgical complications and length of stay was observed. After adjusting for the baseline confounders, robotic surgery was associated with shorter length of stay, lower rate of overall (OR 0.397; p < 0.05 compared to open and OR: 0.763; p < 0.05 compared to laparoscopy) and surgical complications (OR: 0.464; p < 0.05 compared to open and OR: 0.734; p < 0.05 compared to laparoscopy). This study revealed an increasing trend toward the utilization of MIS for elective colectomy in the US. Robotic surgery was associated with a decreasing trend in overall and surgical morbidity and length of stay.
Mots-clé
Aged, Aged, 80 and over, Colectomy/adverse effects, Colectomy/methods, Elective Surgical Procedures/adverse effects, Elective Surgical Procedures/methods, Female, Humans, Laparoscopy/adverse effects, Laparoscopy/methods, Length of Stay/statistics & numerical data, Male, Postoperative Complications/epidemiology, Postoperative Complications/etiology, Procedures and Techniques Utilization/statistics & numerical data, Procedures and Techniques Utilization/trends, Robotic Surgical Procedures/adverse effects, Robotic Surgical Procedures/methods, Safety, United States/epidemiology, Colectomy, Laparoscopic, Open, Robotic, Surgical complications, Trend analysis
Pubmed
Web of science
Création de la notice
29/11/2021 13:57
Dernière modification de la notice
15/06/2023 6:56