Trends and Outcomes for Minimally Invasive Surgery for Inflammatory Bowel Disease

Tanmay Gaglani, Catherine H. Davis, Harold R Bailey, Marianne V Cusick

Research output: Contribution to journalArticle

Abstract

Background: The relapsing and remitting nature of inflammatory bowel disease (IBD) predisposes patients to the development of fibrotic strictures, which must often be managed surgically. Laparoscopy provides the potential for enhanced perioperative care. Previous studies comparing morbidity and trends of open versus laparoscopic resection have been constrained by length of study and sample size. Methods: Using the American College of Surgeons National Surgical Quality Improvement Program database, patients with primary diagnosis of IBD undergoing surgical resection from 2005 to 2015 were identified. Morbidity and mortality rates were then compared between open and laparoscopic resections using multiple logistic regression analyses. Results: A total of 10,699 resections were performed on IBD patients; 4816 (45.0%) of which were performed laparoscopically. The use of laparoscopy increased annually from 20.9% in 2005 to 55.4% in 2015. Comparing laparoscopic versus open, all 30-d outcomes tended to favor laparoscopy with the exception of operating room time, which was equal between the two groups. The difference in 30-d outcomes was statistically significant in laparoscopy versus open technique for pneumonia (1.0% versus 2.0%), ventilator use >48 h (0.6% versus 1.9%), acute renal failure (0.1% versus 0.4%), renal insufficiency (0.2% versus 0.6%), superficial surgical site infection (4.6% versus 7.7%), deep incisional surgical site infection (1.1% versus 1.8%), organ space infection (5.4% versus 7.3%), urinary tract infection (1.3% versus 2.2%), death (0.2% versus 0.7%), and length of hospital stay (6.4 versus 9.4 d). Conclusions: These data not only display trends that indicate that the number of laparoscopic resections for IBD have increased over time but are associated with favorable complication rates, operating time, and length of hospital stay, suggesting that laparoscopy may be a safer option for treatment of fibrotic strictures associated with IBD.

LanguageEnglish
Pages303-307
Number of pages5
JournalJournal of Surgical Research
Volume235
DOIs
StatePublished - Mar 1 2019

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Colorectal Surgery
Minimally Invasive Surgical Procedures
Inflammatory Bowel Diseases
Laparoscopy
Length of Stay
Surgical Wound Infection
Pathologic Constriction
Morbidity
Perioperative Care
Operating Rooms
Mechanical Ventilators
Quality Improvement
Acute Kidney Injury
Urinary Tract Infections
Sample Size
Renal Insufficiency
Pneumonia
Logistic Models
Regression Analysis
Databases

Keywords

  • Colorectal surgery
  • Inflammatory bowel disease
  • Laparoscopy
  • Minimally invasive surgery
  • Outcomes

ASJC Scopus subject areas

  • Surgery

Cite this

Trends and Outcomes for Minimally Invasive Surgery for Inflammatory Bowel Disease. / Gaglani, Tanmay; Davis, Catherine H.; Bailey, Harold R; Cusick, Marianne V.

In: Journal of Surgical Research, Vol. 235, 01.03.2019, p. 303-307.

Research output: Contribution to journalArticle

Gaglani, Tanmay ; Davis, Catherine H. ; Bailey, Harold R ; Cusick, Marianne V. / Trends and Outcomes for Minimally Invasive Surgery for Inflammatory Bowel Disease. In: Journal of Surgical Research. 2019 ; Vol. 235. pp. 303-307.
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