Evidence map›Paper›PMID 34853919›Full record

ArticleSurgical endoscopy2022

Open versus minimally invasive small bowel resection for Crohn's disease: a NSQIP retrospective review and analysis.

Michael L Horsey, Debra Lai, Aalap Herur-Raman, Richard Amdur, Matthew Chandler, Matthew Ng, Vincent Obias

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 23% of its field
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

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Perioperative optimization of Crohn's disease.Annals of gastroenterological surgery · 2023
    Review
  4. 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

7 authors at 3 institutions in 1 country.

Michael L HorseyWalter Reed National Military Medical Center, Bethesda, MD, USA. michael.horsey1@gmail.com.ORCID http://orcid.org/0000-0002-0939-3539
Debra LaiDepartment of Surgery, George Washington University, Washington, DC, USA.
Aalap Herur-RamanGeorge Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Richard AmdurDepartment of Surgery, George Washington University, Washington, DC, USA.
Matthew ChandlerDepartment of Gastroenterology at the George Washington University Hospital, Washington, DC, USA.
Matthew NgDepartment of Colon and Rectal Surgery at the George Washington University Hospital, Washington, DC, USA.
Vincent ObiasDepartment of Colon and Rectal Surgery at the George Washington University Hospital, Washington, DC, USA.
George Washington University · USGeorge Washington University Hospital · USWalter Reed National Military Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMany patients with Crohn's Disease will require surgical resection. While many studies have described outcomes following ileocecectomy, few have evaluated surgical resection of other portions of small bowel. We sought to compare open and minimally invasive surgery (MIS) approaches for small bowel resection excluding ileocecectomy of patients with Crohn's Disease using the National Surgical Quality Improvement Program (NSQIP) database.

methodsThe NSQIP database was queried for patients with Crohn's disease or complications related to Crohn's disease who underwent segmental small bowel resection utilizing open or minimally invasive approaches between 2012 and 2018. Patients requiring ileocecectomy or diagnosed with ascites, disseminated cancer, pre-operative sepsis, ASA class 5, and patients requiring mechanical ventilation were excluded. The association of pre-operative variables including patient demographic information and comorbidities with surgical approach were examined using Fishers exact test. Intraoperative, and 30-day post-operative outcomes were compared between the groups using both univariate and multivariate logistical regression models. SAS was used for data analysis with p < 0.05 considered significant.

resultsAfter exclusions, we found 1697 patients with Crohn's disease who underwent segmental small bowel resection, 1252 of whom underwent open surgery and 445 of whom underwent MIS. After adjusting for possible confounders with multivariable analysis, patients who underwent MIS had a lower incidence of wound events (surgical site, organ space, or deep wound infection, or dehiscence), post-operative bleeding, need for return to the operating room, and shorter total hospital length of stay despite longer operative times compared with open surgery.

conclusionsThis retrospective review of NSQIP shows that minimally invasive small bowel resection is associated with equivalent or improved morbidity over open surgery in select patients with small bowel Crohn's Disease. We show that in select patients minimally invasive small bowel resection can be safe and performed for patients with isolated small bowel Crohn's disease.

Indexed as

Crohn DiseaseDigestive System Surgical ProceduresHumansMinimally Invasive Surgical ProceduresPostoperative ComplicationsQuality ImprovementRetrospective StudiesTreatment OutcomeCrohn’s diseaseMinimally invasive surgerySmall bowel

Identifiers

PMID34853919
OpenAlexW3217251939

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.