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Open colectomy vs. laparoscopic colectomy in Japan: a retrospective study using real-world data from the diagnosis procedure combination database.

Authors :
Tajima, Takehide
Nagata, Jun
Akiyama, Yasuki
Torigoe, Takayuki
Fujimoto, Kenji
Sato, Norihiro
Fujino, Yoshihisa
Shibao, Kazunori
Matsuda, Shinya
Hirata, Keiji
Source :
Surgery Today; Oct2020, Vol. 50 Issue 10, p1255-1261, 7p
Publication Year :
2020

Abstract

Purpose: To compare the short-term outcomes of conventional open colectomy with those of laparoscopic colectomy for colon cancer. Methods: We retrieved data between January 2014 and March 2016 from the Diagnosis Procedure Combination database. A total of 69,418 patients who underwent colectomy for colon cancer were analyzed from among 15,901,766 cases of colorectal cancer. We applied a multilevel logistic regression model using a 2-level structure of individuals nested from 1065 hospitals. Results: A total of 22,440 open colectomy and 46,978 laparoscopic colectomy procedures were performed. The in-hospital mortality rate was significantly lower in the laparoscopic group than in the open group (0.28% vs. 0.06%, odds ratio [OR] 0.40, p < 0.001). Similarly, the 30-day postoperative mortality rate (0.14% vs. 0.03%, OR 0.47, p = 0.019) and surgical morbidity rate (43.0% vs. 25.3%, OR 0.47, p < 0.001) were significantly lower in the laparoscopic group than in the open group. The postoperative length of stay was significantly longer in the open group (mean difference − 5.6 days, p < 0.001) than in the open group. The admission cost was significantly greater in the open group than in the laparoscopic group (mean difference − 95,080 yen, p < 0.001). Conclusions: Laparoscopic colectomy is safe and effective in the short term. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09411291
Volume :
50
Issue :
10
Database :
Complementary Index
Journal :
Surgery Today
Publication Type :
Academic Journal
Accession number :
145950038
Full Text :
https://doi.org/10.1007/s00595-020-02006-6