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Published in: Journal of Gastrointestinal Surgery 11/2015

01-11-2015 | Original Article

Hand-Assisted Laparoscopic Approach in Colon Surgery

Authors: Zhobin Moghadamyeghaneh, Joseph C. Carmichael, Steven Mills, Alessio Pigazzi, Ninh T. Nguyen, Michael J. Stamos

Published in: Journal of Gastrointestinal Surgery | Issue 11/2015

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Abstract

Background

This study sought to compare outcomes of patients who underwent hand-assisted laparoscopic (HAL) colectomy with open and laparoscopic colectomy (LP).

Study Design

The NSQIP databases were used to examine the clinical data of patients who underwent elective colectomy during 2012–2013. Multivariate regression analysis was performed to compare the three surgical approaches.

Results

We sampled a total of 21,090 patients who underwent colectomy. Of these, 7480 (35.5 %) had open colectomy (OC), 8751 (41.5 %) had a laparoscopic colectomy, 2860 (13.6 %) had a HAL colectomy, and 1999 (9.5 %) had an open procedure converted from LC or HAL. Multivariate regression analysis revealed HAL colectomy had a similar mortality (AOR 0.53, P = 0.07) and a lower morbidity (AOR 0.37, P < 0.01) compared to OC. LC had lower mortality (AOR 0.58, P = 0.02) and morbidity (AOR 0.43, P < 0.01) compared to OC. Mortality of patients who underwent HAL was not significantly different from LC (AOR 0.90, P = 0.79); however, morbidity of such patients was significantly higher than for patients who underwent LC (AOR 1.29, P < 0.01).

Conclusions

HAL colectomy is a safe approach with significant advantages compared to open colectomy. Although the morbidity of patients who underwent HAL is higher than patients who underwent LC, the morbidity rate is still lower than OC.
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Metadata
Title
Hand-Assisted Laparoscopic Approach in Colon Surgery
Authors
Zhobin Moghadamyeghaneh
Joseph C. Carmichael
Steven Mills
Alessio Pigazzi
Ninh T. Nguyen
Michael J. Stamos
Publication date
01-11-2015
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 11/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-015-2924-y

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