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Journal of Gastrointestinal Surgery

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01-11-2011 | 2011 SSAT Quick Shot Presentation

Laparoscopic and Open Abdominoperineal Resection for Cancer: How Patient Selection and Complications Differ by Approach

Authors: David B. Stewart, Christopher Hollenbeak, Melissa Boltz

Published in: Journal of Gastrointestinal Surgery | Issue 11/2011

Abstract

Background

Outcomes between laparoscopic (LAPR) and open abdominoperineal resections (OAPR) are poorly described.

Methods

After IRB approval, 2005–2008 NSQIP data were used to identify patients undergoing LAPR and OAPR for rectal cancer. Logistic regression identified variables influencing the selection of LAPR vs. OAPR as well as the likelihood of postoperative events. Chi-square analysis was used to compare the incidence of 30-day postoperative events.

Results

One thousand one hundred ninety-seven OAPRs and 143 LAPRs were identified. LAPRs were less likely to have a body mass index (BMI) of ≥30 (p = 0.04) and were associated with equivalent mean operative times (p = 0.36). LAPRs and OAPRs were found to have similar rates of surgical site infections (p = 0.13), transfusion requirements (p = 0.17), myocardial infarction (p = 0.48), and need for reoperation within 30 days (p = 0.20). Neoadjuvant radiotherapy did not directly increase complication rates in either group. Few factors predicted choice of LAPR but included BMI <25 (OR, 1.54; p = 0.02).

Conclusion

Complication rates between LAPR and OAPR were similar despite the greater technical challenge of LAPR. Wound infection rates were equivalent, which may reflect similar rates of perineal wound infections. Few patients are offered LAPR, possibly due to surgeon preferance as opposed to patient factors.

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Title: Laparoscopic and Open Abdominoperineal Resection for Cancer: How Patient Selection and Complications Differ by Approach
Authors: David B. Stewart
Christopher Hollenbeak
Melissa Boltz
Publication date: 01-11-2011
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 11/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-011-1663-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Laparoscopic and Open Abdominoperineal Resection for Cancer: How Patient Selection and Complications Differ by Approach

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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