Author:
Chen Yi-Chang,Tsai Yuan-Yao,Chang Sheng-Chi,Chen Hung-Chang,Ke Tao-Wei,Fingerhut Abe,Chen William Tzu-Liang
Abstract
Abstract
Introduction
Laparoscopic colectomy is rarely performed for ischemic colitis. The aim of this propensity score-matched study was to compare preoperative characteristics, intraoperative details and short-term outcomes for emergent laparoscopic colectomy versus the traditional open approach for patients with ischemic colitis.
Methods
Retrospective review of 96 patients who underwent emergent colectomy for ischemic colitis between January 2011 and December 2020 (39 via laparoscopy, 57 via laparotomy) was performed. We compared short-term outcomes after using a one-to-one ratio and nearest-neighbor propensity score matching to obtain similar preoperative and intraoperative parameters in each group.
Results
Patients in the open group experienced more surgical site complications (52.6% vs. 23.0%, p = 0.004), more intra-abdominal abscesses (47.3% vs. 17.9%, p = 0.003), longer need for ventilator support (20 days vs. 0 days, p < 0.001), more major complications (77.2% vs. 43.5%, p = 0.001), higher mortality (49.1% vs. 20.5%, p = 0.004), and longer hospital stay (32 days vs. 19 days, p = 0.001). After propensity score matching (31 patients in each group), patients undergoing open (vs. laparoscopy) had more surgical site complications (45.1% vs. 19.4%, p = 0.030) and required longer ventilator support (14 vs. 3 days, p = 0.039). After multivariate analysis, Charlson Comorbidity Index (p = 0.024), APACHE II score (p = 0.001), and Favier’s classification (p = 0.023) were independent predictors of mortality.
Conclusions
Laparoscopic emergent colectomy for ischemic colitis is feasible and is associated with fewer surgical site complications and better respiratory function, compared to the open approach.
Publisher
Springer Science and Business Media LLC
Subject
Emergency Medicine,Surgery
Reference47 articles.
1. Montoro MA, Brandt LJ, Santolaria S, Gomollon F, Puértolas BS, Vera J, et al. Clinical patterns and outcomes of ischaemic colitis: results of the Working Group for the Study of Ischaemic Colitis in Spain (CIE study). Scand J Gastroenterol. 2011;46:236–46.
2. Higgins PDR, Davis KJ, Laine L. The epidemiology of ischaemic colitis. Aliment Pharmacol Ther. 2004;19:729–38.
3. Favier C, Bonneau HP, Tran Minh V, Devic J. Endoscopic diagnosis of regressive ischemic colitis. Endoscopic, histologic and arteriographic correlations. Nouvelle Presse Med. 1976;5:77–9.
4. Trotter JM, Hunt L, Peter MB. Ischaemic colitis. BMJ. 2016;355:i6600.
5. Beppu K, Osada T, Nagahara A, Matsumoto K, Shibuya T, Sakamoto N, Otaka M, Terai T, Ogihara T, Watanabe S. Relationship between endoscopic findings and clinical severity in ischemic colitis. Intern Med. 2011;50:2263–7.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献