RT Journal
A1 Kang CY, Halabi WJ, Luo R, Pigazzi A, Nguyen NT, Stamos MJ
T1 Laparoscopic colorectal surgery: A better look into the latest trends
JF Archives of Surgery
JO Archives of Surgery
YR 2012
FD August 1
VO 147
IS 8
SP 724
OP 731
DO 10.1001/archsurg.2012.358
UL http://dx.doi.org/10.1001/archsurg.2012.358
AB Background 
                  The latest trends of laparoscopic colorectal surgery (LCRS) after the introduction of International Classification of Diseases, Ninth Revision laparoscopic procedure codes in 2008 remains unknown. This study evaluates LCRS trends before and after the application of specific codes for LCRS.Design 
                  Retrospective analysis of elective surgery for colon cancer, rectal cancer, and diverticulitis using Nationwide Inpatient Sample data from 2007 and 2009.Main Outcome Measure 
                  Primary outcome measures included in-hospital mortality, length of stay, and total charge.Results 
                  A total of 126  921 patients in 2007 and 117  177 patients in 2009 underwent colorectal surgery. Laparoscopic colorectal surgery increased dramatically from 13.8% in 2007 to 42.6% in 2009 (P < .01). This trend was disease and procedure specific. When compared with 2007, patients who underwent LCRS in 2009 had lower conversion rates (14.8% vs 32.1%, P < .001). In 2009, LCRS had lower in-hospital mortality (0.5% vs 1.1%, P < .001) and a shorter length of hospital stay (5 vs 6 days, P < .001) compared with open surgery. In 2009, when compared with successful LCRS, conversion to open surgery was associated with a longer length of hospital stay (6 vs 5 days, P < .01), increased hospital charges, and increased mortality (0.7% vs 0.5%, P < .01).Conclusion 
                  The marked increase in LCRS when comparing these 2 years is unlikely only due to the changing practice of colorectal surgery but brings into question the accuracy of data prior to 2009. Our report of Nationwide Inpatient Sample 2009 data represents the most accurate reflection of the use of LCRS in the United States. These data can serve as a benchmark for future comparative studies.