Comparison of clinical outcome between laparoscopic and open right hemicolectomy: a nationwide study
Comparison of clinical outcome between laparoscopic and open right hemicolectomy: a nationwide study
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DOI：
10.1186/s12957-015-0666-7
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发表时间：
2015-08-15
影响因子：
3.2
通讯作者：
Wei, Po-Li
中科院分区：
文献类型：
--
作者：
Lee, Cha-Ze;Kao, Li-Ting;Wei, Po-Li
背景资料：本研究旨在比较腹腔镜与开腹右半结肠切除术的临床结果。本研究分别纳入了14，320例和1313例接受开放性和腹腔镜右半结肠切除术的患者。研究结果包括“入住重症监护室（ICU）”、“全身麻醉超过2小时”、“使用机械通气”、“急性呼吸衰竭”、“院内死亡”和“因肺炎住院”。“对每种临床结局进行单独的条件Logistic回归分析。结果显示，接受开放性右半结肠切除术的患者入住ICU的可能性明显较高（31.4 vs. 13.4%，p < 0.001），急性呼吸衰竭（3.6 vs. 0.8%，p < 0.001），机械通气（12.8 vs. 4.1%，p < 0.001），院内死亡（3.7 vs. 0.9%，p < 0.001），全身麻醉2小时以上（4.6 vs. 1.2%，p < 0.001）和肺炎住院率（5.8 vs. 3.1%，p < 0.001）。调整后的条件logistic回归分析显示，接受开放性右半结肠切除术的患者入住ICU、发生急性呼吸衰竭、使用机械通气、院内死亡、全身麻醉超过2小时和因肺炎住院的可能性分别为2.96、4.98、3.41、4.01、3.44和1.78倍，结论：腹腔镜右半结肠切除术降低了术后肺部并发症的风险。
Background: This study aimed to compare clinical outcome between laparoscopic and open right hemicolectomy.Methods: The data were sourced from Taiwan's National Health Insurance Research Database. This study included 14,320 and 1313 patients who underwent open and laparoscopic right hemicolectomies, respectively. The study outcome included "intensive care unit (ICU) admission," "over 2 h of general anesthesia," "use of mechanical ventilation," "acute respiratory failure," "in-hospital death," and " hospitalization for pneumonia."Separate conditional logistic regressions were performed for each clinical outcome.Results: The results showed that patients who underwent an open right hemicolectomy had significantly higher likelihood of ICU admission (31.4 vs. 13.4 %, p < 0.001), acute respiratory failure (3.6 vs. 0.8 %, p < 0.001), mechanical ventilation (12.8 vs. 4.1 %, p < 0.001), in-hospital death (3.7 vs. 0.9 %, p < 0.001), over 2 h of general anesthesia (4.6 vs. 1.2 %, p < 0.001), and hospitalization for pneumonia (5.8 vs. 3.1 %, p < 0.001) than patients who underwent a laparoscopic right hemicolectomy. Adjusted conditional logistic regression analyses revealed that patients who underwent an open right hemicolectomy were 2.96, 4.98, 3.41, 4.01, 3.44, and 1.78 times more likely to be admitted to the ICU, to have acute respiratory failure, the use of mechanical ventilation, in-hospital death, over 2 h of general anesthesia, and hospitalization for pneumonia, respectively, than patients who underwent a laparoscopic right hemicolectomy.Conclusions: Laparoscopic right hemicolectomy reduced risk of post-operative pulmonary complications.