Evidence map›Paper›PMID 26715021›Full record

ArticleSurgical endoscopy2016

A national evaluation of clinical and economic outcomes in open versus laparoscopic colorectal surgery.

Deborah S Keller, Conor P Delaney, Lobat Hashemi, Eric M Haas

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  17. Tissue damage force estimation in porcine small intestine from its elasticity.International journal of computer assisted radiology and surgery · 2023
    Article
  18. Article
  19. Complications in laparoscopic and robotic-assisted surgery: definitions, classifications, incidence and risk factors - an up-to-date review.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2021
    Review
  20. Laparoscopic Versus Open Colorectal Surgery in the Emergency Setting: A Systematic Review and Meta-analysis.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Deborah S KellerColorectal Surgical Associates, 7900 Fannin, Suite 2700, Houston, TX, 77054, USA. debby_keller@hotmail.com.
Conor P DelaneyUniversity Hospitals-Case Medical Center, Cleveland, OH, USA.
Lobat HashemiHealthcare Outcomes and Research, Covidien, Mansfield, MA, USA.
Eric M HaasColorectal Surgical Associates, 7900 Fannin, Suite 2700, Houston, TX, 77054, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgical value is based on optimizing clinical and financial outcomes. The clinical benefits of laparoscopic surgery are well established; however, many patients are still not offered a laparoscopic procedure. Our objective was to compare the modern clinical and financial outcomes of laparoscopic and open colorectal surgery.

methodsThe Premier Perspective database identified patients undergoing elective colorectal resections from January 1, 2013 to December 31, 2013. Cases were stratified by operative approach into laparoscopic and open cohorts. Groups were controlled on all demographics, diagnosis, procedural, hospital characteristics, surgeon volume, and surgeon specialty and then compared for clinical and financial outcomes. The main outcome measures were length of stay (LOS), complications, readmission rates, and cost by surgical approach.

resultsA total of 6343 patients were matched and analyzed in each cohort. The most common diagnosis was diverticulitis (p = 0.0835) and the most common procedure a sigmoidectomy (p = 0.0962). The LOS was significantly shorter in laparoscopic compared to open (mean 5.78 vs. 7.80 days, p < 0.0001). The laparoscopic group had significantly lower readmission (5.82 vs. 7.68 %, p < 0.0001), complication (32.60 vs. 42.28 %, p < 0.0001), and mortality rates (0.52 vs. 1.28 %, p < 0.0001). The total cost was significantly lower in laparoscopic than in open (mean $17,269 vs. $20,552, p < 0.0001). By category, laparoscopy was significantly more cost-effective for pharmacy (p < 0.0001), room and board (p < 0.0001), recovery room (p = 0.0058), ICU (p < 0.0001), and laboratory and imaging services (both p < 0.0001). Surgical supplies (p < 0.0001), surgery (p < 0.0001), and anesthesia (p = 0.0053) were higher for the laparoscopic group.

conclusionsLaparoscopy is more cost-effective and produces better patient outcomes than open colorectal surgery. Minimally invasive colorectal surgery is now the standard that should be offered to patients, providing value to both patient and provider.

Indexed as

AgedColectomyColon, SigmoidColorectal NeoplasmsColorectal SurgeryCost-Benefit AnalysisDatabases, FactualDiverticulitisElective Surgical ProceduresFemaleHospital CostsHumansLaparoscopyLaparotomyLength of StayMaleFinancial analysisLaparoscopic colorectal surgeryPatient outcomesSurgical quality

Identifiers

PMID26715021

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.