Laparoscopy decreases anastomotic leak rate in sigmoid colectomy for XXXX .

@entity1 @entity834 @entity254 @entity260 @entity4436 @entity6679
BACKGROUND: Early studies comparing laparoscopic and open operations for @entity4436 failed to show any advantages of the laparoscopic approach. Our study compared the 30-day postoperative outcomes of laparoscopic and open sigmoid colectomy for @entity4436 by surgeons who had performed 20 or more laparoscopic colectomies before the study period. HYPOTHESIS: @entity1 who undergo an elective laparoscopic operation for @entity4436 have @entity260 compared with @entity1 who have a traditional open operation. DESIGN: Retrospective analysis. SETTING: Academic medical center. @entity1 : A total of 249 @entity1 who underwent elective open (n = 127) or laparoscopic (n = 122) sigmoid colectomy with primary @entity254 for @entity4436 between July 1, 2001, and February 1, 2008. MAIN OUTCOME MEASURES: Combined rates of free and contained @entity834 . A logistic regression model was used to determine predictors of @entity834 while controlling for significant differences between study groups. RESULTS: @entity1 who underwent laparoscopic or open operations were similar in age, sex, history of diagnosed intraabdominal abscess (9.4% vs 12.3%), and history of preoperative percutaneous abscess drainage (3.9% vs 4.9%). @entity1 who underwent the open procedure had a higher Charlson comorbidity index (1.6 vs 1.2; P = .04), and those who underwent laparoscopy more frequently underwent @entity6679 (82.8% vs 26.7%; P < .001). @entity1 who underwent a laparoscopy had lower rates of @entity834 (2.4% vs 8.2%; P = .04). This finding held true on logistic regression analysis (odds ratio, 0.67; 95% confidence interval, 0.008-0.567; P = .01), even when controlling for age, Charlson comorbidity index, @entity6679 , and length of resected bowel. CONCLUSION: @entity834 occurred less frequently after laparoscopic sigmoid colectomy performed by experienced laparoscopic colorectal surgeons.
