A critical analysis of laparoscopic colectomy at a single institution

Lessons learned after 1000 cases

Anthony J. Senagore, Conor P. Delaney

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Background: A critical outcome analysis of a large, single-institution experience provides a better frame of reference for an assessment of the role of laparoscopic colectomy for colorectal pathology. Methods: Review of a prospectively gathered database was performed of a consecutive series of laparoscopic colectomy patients who were operated on by 2 surgeons at a single institution (tertiary referral center) using standardized techniques and care plans. Patients were assessed for operative indications, type of resection, operative time, conversion, complications, duration of stay, and readmission within 30 days. Results: One thousand consecutive patients undergoing laparoscopic colectomy from January 1999 thru June 2004 were analyzed. The types of resections were right colectomy = 314, left/sigmoid colectomy/anterior resection = 435, total colectomy = 61, total proctocolectomy = 14, and other = 176. The indications for surgery were diverticular disease = 285, colorectal neoplasia = 285, inflammatory bowel disease = 172, rectal prolapse = 81, and other = 177. The conversion rate was 11.4%. The mean operative time was 112 ± 45 minutes for all resections. The mean duration of hospitalization for all patients was 3.7 ± 3.8. The overall complication rate was 9.9%, with the most frequent complications being ileus 2.8%, pulmonary 1.6%, cardiac 1.4%, and wound infection 2.6%. The 30-day readmission rate was 9.1%, and the most frequent reasons for readmission were ileus/small-bowel obstruction, intra-abdominal infection, and anastomotic leak. Conclusions: This largest single-institution experience with laparoscopic colectomy confirms the benefits of a standardized approach including shorter hospital rehabilitation and low rates of cardiopulmonary and wound complications. Efforts must be directed at improving access to training in laparoscopic colectomy techniques so that patients can benefit from this new technology.

Original languageEnglish (US)
Pages (from-to)377-380
Number of pages4
JournalAmerican Journal of Surgery
Volume191
Issue number3
DOIs
StatePublished - Mar 2006
Externally publishedYes

Fingerprint

Colectomy
Ileus
Operative Time
Rectal Prolapse
Intraabdominal Infections
Anastomotic Leak
Sigmoid Colon
Wound Infection
Inflammatory Bowel Diseases
Tertiary Care Centers
Hospitalization
Rehabilitation
Databases
Pathology
Technology
Lung
Wounds and Injuries

Keywords

  • Laparoscopic colectomy
  • Length of stay

ASJC Scopus subject areas

  • Surgery

Cite this

A critical analysis of laparoscopic colectomy at a single institution : Lessons learned after 1000 cases. / Senagore, Anthony J.; Delaney, Conor P.

In: American Journal of Surgery, Vol. 191, No. 3, 03.2006, p. 377-380.

Research output: Contribution to journalArticle

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