Laparoscopic Resection for Inflammatory Bowel Disease: Outcomes from a Nationwide Sample

We used data from the Nationwide Inpatient Sample 2004 and identified patients with IBD who underwent ileocolonic/colonic resection using appropriate ICD-9 codes. Procedures were considered to be laparoscopic if they had concomitant codes for laparoscopy (International Classification of Diseases, Ninth edition, clinical modification 54.21/54.51). Multivariate regression was performed to identify independent predictors and outcomes.

There were 209,206 IBD hospitalizations included in the study among whom, 884 underwent laparoscopic resections (5.3%). On multivariate analysis, fistulizing disease (odds ratio (OR) 0.35, 95% confidence interval (CI) 0.21–0.59) and emergent admission (OR 0.59, 95% CI 0.39–0.90) were negative while annual hospital IBD surgical volume of >50 procedures (OR 2.0, 95% CI 1.14–3.52) were positively associated with LS. LS was associated with a significantly lower proportion of postoperative complications (27.1% vs 35.4%, p < 0.001) and shorter postoperative length of stay compared to OP (−1.9 days, 95% CI −3.2 to −0.6 days). Propensity score adjustment for nonrandom allocation of patients into the treatment groups neutralized the OR for postoperative complication (OR 0.82) but not length of stay (−1.7 days).