ArticleHealth services research2017
Provider Experience and the Comparative Safety of Laparoscopic and Open Colectomy.
Article in Health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Patient Complexity and Bile Duct Injury After Robotic-Assisted vs Laparoscopic Cholecystectomy.JAMA network open · 2025Article
- Association of center-level operative volume and acute outcomes following robotic-assisted colectomy for colorectal cancer.PloS one · 2025Article
- Predictive factors for postoperative ileus after elective right hemicolectomy performed on over 80% Enhanced Recovery After Surgery-adherent patients: a retrospective cohort study.Annals of surgical treatment and research · 2024Article
- ERAS failure and major complications in elective colon surgery: Common risk factors.Surgery in practice and science · 2022Article
- Association of Insurance Coverage With Adoption of Sleeve Gastrectomy vs Gastric Bypass for Patients Undergoing Bariatric Surgery.JAMA network open · 2022Article
- Quality and Location of the Surgical Episode Mediate a Large Proportion of Socioeconomic-Based Survival Disparities in Patients with Resected Stage I-III Colon Cancer.Annals of surgical oncology · 2022Article
- A haptic laparoscopic trainer based on affine velocity analysis: engineering and preliminary results.BMC surgery · 2021Article
- Effect of Ultrasound-Guided Quadratus Lumborum Block Preemptive Analgesia on Postoperative Recovery of Patients with Open Radical Colon Cancer Surgery: A Retrospective Study.Cancer management and research · 2021Article
- Effects of laparoscopic vs open abdominal surgery on costs and hospital readmission rate and its effect modification by surgeons' case volume.Surgical endoscopy · 2020Article
- Observational
- How Patient Complexity and Surgical Approach Influence Episode-Based Payment Models for Colectomy.Diseases of the colon and rectum · 2019Article
- With widespread adoption of MIS colectomy for colon cancer, does hospital type matter?Surgical endoscopy · 2019Article
- Surgeon Experience and Medicare Expenditures for Laparoscopic Compared to Open Colectomy.Annals of surgery · 2018Article
- Minimally invasive versus open surgery in the Medicare population: a comparison of post-operative and economic outcomes.Surgical endoscopy · 2018Article
- Morbidity and mortality after surgery for nonmalignant colorectal polyps.Gastrointestinal endoscopy · 2018Article
- An Instrumental Variable Analysis Comparing Medicare Expenditures for Laparoscopic vs Open Colectomy.JAMA surgery · 2017Article
- Surgeon, not technique, defines outcomes after central venous port insertion.The Journal of surgical research · 2017Article
- Evaluation of optic nerve sheath diameter in patients undergoing laparoscopic surgery in the Trendelenburg position: a prospective observational study.Annals of Saudi medicineObservational
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the comparative safety of laparoscopic and open colectomy across surgeons varying in experience with laparoscopy. DATA SOURCES: National Medicare data (2008-2010) for beneficiaries undergoing laparoscopic or open colectomy. STUDY
designUsing instrumental variable methods to address selection bias, we evaluated outcomes of laparoscopic and open colectomy. Our instrument was the regional use of laparoscopy in the year prior to a patient's operation. We then evaluated outcomes stratified by surgeons' annual volume of laparoscopic colectomy. PRINCIPAL
findingsLaparoscopic colectomy was associated with lower mortality (OR: 0.75, 95 percent CI: 0.70-0.78) and fewer complications than open surgery (OR: 0.82, 95 percent CI: 0.79-0.85). Increasing surgeon volume was associated with better outcomes for both procedures, but the relationship was stronger for laparoscopy. The comparative safety depended on surgeon volume. High-volume surgeons had 40 percent lower mortality (OR: 0.60, 95 percent CI: 0.55-0.65) and 30 percent fewer complications (OR: 0.70, 95 percent CI: 0.67-0.74) with laparoscopy. Conversely, low-volume surgeons had 7 percent higher mortality (OR: 1.07, 95 percent CI: 1.02-1.13) and 18 percent more complications (OR: 1.18, 95 percent CI: 1.12-1.24) with laparoscopy.
conclusionsThis population-based study demonstrates that the comparative safety of laparoscopic and open colectomy is influenced by surgeon volume. Laparoscopic colectomy is only safer for patients whose surgeons have sufficient experience.
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