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Converting laparoscopic colectomies to open is associated with similar outcomes as a planned open approach among Crohn's disease patients
- Source :
- International Journal of Colorectal Disease
- Publication Year :
- 2021
-
Abstract
- Purpose There has been a noted reluctance to offer laparoscopic surgery to Crohn’s Disease patients due to the potential risks, and high rate, of converting the procedure to open. The purpose of this study was to compare clinical outcomes between Crohn’s Disease patients undergoing a planned open colectomy, to those undergoing a laparoscopic colectomy that was converted to open. Methods Crohn’s Disease patients undergoing an elective colectomy were identified using the ACS-NSQIP database (2012–2019). Patients were stratified based on operative approach: open, laparoscopic, and laparoscopic converted to open. Multivariable logistic regression was used to assess the impact of conversion to open on overall and serious postoperative morbidity. Results Among 8039 elective colectomies, 40.5% were performed open, 46.9% were completed laparoscopically, and 12.6% were converted to open. The conversion rate among all laparoscopic cases was 21.3%. On unadjusted analysis, conversion to open demonstrated similar rates of overall morbidity (P = 0.355) and serious morbidity (P = 0.724) compared to a planned open approach. On multivariable analysis, conversion to open was not associated with increased odds of overall morbidity (OR 1.12, 95% CI 0.94–1.30, P = 0.238) or serious morbidity (OR 1.20, 95% CI 0.98–1.46, P = 0.074), when compared to an open approach. Conclusion Among Crohn’s Disease patients, cases converted from laparoscopic to open exhibited similar outcomes as a planned open approach. Despite the limitations associated with this retrospective study, our findings suggest that laparoscopic surgery may be safely pursued among Crohn’s Disease patients, as the risks of conversion are potentially balanced by the benefits of laparoscopic surgery.
- Subjects :
- Laparoscopic surgery
Crohn’s disease
medicine.medical_specialty
Colectomies
Conversion to open
medicine.medical_treatment
Disease
Outcomes
Logistic regression
Open surgery
Postoperative Complications
Crohn Disease
Internal medicine
medicine
Humans
Colectomy
Retrospective Studies
Crohn's disease
business.industry
Gastroenterology
Retrospective cohort study
Hepatology
Length of Stay
medicine.disease
Surgery
Treatment Outcome
Laparoscopy
Original Article
business
Subjects
Details
- ISSN :
- 14321262
- Volume :
- 37
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- International journal of colorectal disease
- Accession number :
- edsair.doi.dedup.....df9c66ddb01c2e24fafe481ecdc80937