Surgical Treatment of XXXX : Hand-Assisted Laparoscopic Resection Is Predominantly Used for Complex Cases and Is Associated With Increased Postoperative Complications and Prolonged Hospitalization.

@entity1 @entity8566 @entity4436
INTRODUCTION: Laparoscopic (LAP) colectomy is now the "gold" standard for @entity4436 ; the role of @entity8566 ( @entity8566 ) and Open methods today is unclear. This study assessed the elective use of these methods for @entity4436 . METHODS: A retrospective review of demographic, comorbidity (Carlson Comorbidity Index [CCI]), resection type, and short-term outcomes was carried out. RESULTS: There were 125 (44.5%) LAP, 125 (44.5%) @entity8566 , and 31 (11%) Open cases (overall N = 281). The mean age, body mass index, and percentage of high-risk @entity1 (CCI score >2) of the @entity8566 group were greater (P < .05) than the LAP group (vs Open, P = ns). The Open group's mean age and percent with CCI >2 was greater when compared with the LAP group (P < .05). More Open (P < .05) and @entity8566 @entity1 had complex disease (Open, 63%; @entity8566 , 40%, LAP, 22%) and were diverted (Open, 35%; @entity8566 , 10%; LAP, 3%). Time to bowel movement was not different; however, there was a stepwise increase in median length of stay (LOS; days) from the LAP (5 days) to @entity8566 (6 days) to Open group (7 days) (P < .05 for all). The LAP complication rate (22.4%) was lower (P < .05) than the @entity8566 (42.4%) or Open groups' (45.2%) rates. The LAP surgical site infection rate (5.6%) was lower (P < .05) than the @entity8566 (12.8%) or Open groups (19.6%). CONCLUSION: The @entity8566 and Open groups had more high risk, complex disease, diverted, and older @entity1 than the LAP group; likewise, the overall complication rate and LOS was higher in the @entity8566 and Open groups. Use of @entity8566 methods likely contributed to the high minimally invasive surgery utilization rate (89%).
