TY - JOUR
T1 - Laparoscopic versus open colon resections in California
T2 - A cross-sectional analysis
AU - Patel, Supriya S.
AU - Patel, Madhukar S.
AU - Mahanti, Sanjit
AU - Ortega, Adrian
AU - Ault, Glenn T.
AU - Kaiser, Andreas M.
AU - Senagore, Anthony J.
PY - 2012/10
Y1 - 2012/10
N2 - Laparoscopic surgery is associated with decreased hospital length of stay, improved perioperative morbidity, and faster return to work compared with open procedures. Despite these benefits, laparoscopy has not been universally adopted with recent implementation estimates ranging from 10 to 30 per cent. The purpose of this study was to analyze the adoption of laparoscopic techniques for colon resections in California in 2009 based on institutional colectomy volume status. A total of 14,736 patients from 320 hospitals was analyzed. The laparoscopic to open case ratios for the low (zero to 17 cases/year), medium (18 to 50 cases/year), and high (greater than 50 cases/year) volume centers were: 0.32, 0.50, and 0.92, respectively. Although the data confirmed that a laparoscopic approach reduced length of stay (LOS) regardless of volume, lower adopters of laparoscopic colectomy had a longer overall total LOS, likely related to preponderance of open cases. Therefore, the data show that higher-volume institutions appear to have implemented laparoscopic colectomy for more of their case volume, and this adoption may account for the better institutional outcomes observed in these centers.
AB - Laparoscopic surgery is associated with decreased hospital length of stay, improved perioperative morbidity, and faster return to work compared with open procedures. Despite these benefits, laparoscopy has not been universally adopted with recent implementation estimates ranging from 10 to 30 per cent. The purpose of this study was to analyze the adoption of laparoscopic techniques for colon resections in California in 2009 based on institutional colectomy volume status. A total of 14,736 patients from 320 hospitals was analyzed. The laparoscopic to open case ratios for the low (zero to 17 cases/year), medium (18 to 50 cases/year), and high (greater than 50 cases/year) volume centers were: 0.32, 0.50, and 0.92, respectively. Although the data confirmed that a laparoscopic approach reduced length of stay (LOS) regardless of volume, lower adopters of laparoscopic colectomy had a longer overall total LOS, likely related to preponderance of open cases. Therefore, the data show that higher-volume institutions appear to have implemented laparoscopic colectomy for more of their case volume, and this adoption may account for the better institutional outcomes observed in these centers.
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U2 - 10.1177/000313481207801011
DO - 10.1177/000313481207801011
M3 - Article
C2 - 23025941
AN - SCOPUS:84866765378
SN - 0003-1348
VL - 78
SP - 1063
EP - 1065
JO - American Surgeon
JF - American Surgeon
IS - 10
ER -