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Title of Journal: Surg Endosc

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Abbravation: Surgical Endoscopy

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Springer-Verlag

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ISSN

1432-2218

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Safety efficacy and costeffectiveness of common

Authors: Manish M Tiwari Jason F Reynoso Robin High Albert W Tsang Dmitry Oleynikov
Publish Date: 2010/10/07
Volume: 25, Issue: 4, Pages: 1127-1135
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Abstract

Laparoscopic surgery has been shown to offer superior surgical outcomes for most abdominal surgical procedures However there is hardly any evidence on surgical outcomes with patient risk stratification This study aimed to compare outcomes of common laparoscopic and open surgical procedures for varying illness severityA retrospective analysis of surgical outcomes for six commonly performed surgical procedures including cholecystectomy appendectomy reflux surgery gastric bypass surgery ventral hernia repair and colectomy was performed using the University HealthSystem Consortium UHC Clinical Database/Resource Manager CDB/RM The 3year discharge data for the six commonly performed laparoscopic surgical procedures were analyzed for outcome measures including observed mortality overall patient morbidity intensive care unit ICU admissions 30day readmissions length of hospital stay and hospital costsIn this study 208314 patients underwent one of six common surgical procedures by either the open or the laparoscopic approach Overall the laparoscopic approach showed significantly lower mortality reduced morbidity fewer ICU admissions and 30day readmissions shorter hospital stay and significantly reduced hospital costs for all the procedures At stratification by illness severity the laparoscopic group showed better or comparable surgical outcomes across all the illness severity groups However the observed mortality was comparable for the minor and moderate severity patients between laparoscopic and open surgery for most procedures The 30day readmission rate for major/extreme severity patients was comparable between the two groups for most surgical proceduresThis study demonstrated the superiority of laparoscopy over conventional open surgery across all illness severity risk groups for common surgical procedures The results in general show that laparoscopic surgery is safe efficacious and costeffective compared with open surgery and suggest that laparoscopic surgery should be the procedure of choice for all common surgical procedures regardless of illness severity

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