| Title |
Laparoscopic colectomy in obese patients: a comparison of laparoscopic and hand-assisted laparoscopic techniques
|
|---|---|
| Published in |
Surgical Endoscopy, March 2017
|
| DOI | 10.1007/s00464-017-5422-3 |
| Pubmed ID | |
| Authors |
Douglas M. Overbey, Michelle L. Cowan, Patrick W. Hosokawa, Brandon C. Chapman, Jon D. Vogel |
| Abstract |
Recent American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP)-based evidence indicates that laparoscopic (LAP) colectomy results in improved outcomes compared to hand-assisted laparoscopic (HAL) colectomy in the general population. Previous comparative studies demonstrated that the HAL technique offers distinct advantages for obese patients. The aim of this study was to perform comparative analyses of HAL and LAP colectomy and low anterior resection (LAR) in obese patients. The ACS-NSQIP public use file and targeted colectomy dataset, 2012-2014, were utilized for patients undergoing colectomy and LAR. Only obese patients (BMI > 30) and laparoscopic or hand-assisted operations were included. Patient, operation, and outcome variables were compared in two separate cohorts: colectomy and LAR. Bivariate analysis compared the approaches, followed by multivariable regression. Of 9610 obese patients included, HAL and LAP colectomy were performed in 3126 and 3793 patients and LAR in 1431 and 1260 patients, respectively. In comparison to LAP colectomy, HAL colectomy patients had increased comorbidities including class 2 and 3 obesity. HAL colectomy was associated with higher overall morbidity (20 vs. 16%, p < 0.001), infectious complications (10.2 vs. 7.7%, p < 0.001), anastomotic leaks (3.0 vs. 2.2%, p = 0.03), and ileus (11 vs. 8%, p < 0.001). Multivariate analysis indicated that overall morbidity (OR 1.27, 95% CI 1.11-1.44), infectious complications (OR 1.35, 95% CI 1.14-1.59), and ileus (OR 1.33, 95% CI 1.12-1.57) were each increased in the HAL colectomy cohort but not different for HAL and LAP LAR. In comparison to LAP colectomy, the HAL technique is used more often in obese patients with an increased operative risk profile. While inherent bias and unmeasured variables limit the analysis, the available data indicate that the HAL technique is associated with increased perioperative morbidity. Alternatively, HAL and LAP LAR are performed in obese patients with a similar risk profile and result in similar postoperative outcomes. |
X Demographics
The data shown below were collected from the profiles of 8 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 13% |
| United States | 1 | 13% |
| United Arab Emirates | 1 | 13% |
| United Kingdom | 1 | 13% |
| Unknown | 4 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 3 | 38% |
| Science communicators (journalists, bloggers, editors) | 2 | 25% |
| Members of the public | 2 | 25% |
| Practitioners (doctors, other healthcare professionals) | 1 | 13% |
Mendeley readers
The data shown below were compiled from readership statistics for 26 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 26 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 5 | 19% |
| Other | 4 | 15% |
| Student > Bachelor | 3 | 12% |
| Student > Postgraduate | 3 | 12% |
| Student > Master | 2 | 8% |
| Other | 4 | 15% |
| Unknown | 5 | 19% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 15 | 58% |
| Nursing and Health Professions | 2 | 8% |
| Social Sciences | 1 | 4% |
| Unknown | 8 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 October 2017.
All research outputs
#6,472,271
of 22,958,253 outputs
Outputs from Surgical Endoscopy
#1,320
of 6,091 outputs
Outputs of similar age
#105,220
of 307,900 outputs
Outputs of similar age from Surgical Endoscopy
#34
of 138 outputs
Altmetric has tracked 22,958,253 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 6,091 research outputs from this source. They receive a mean Attention Score of 4.1. This one has done well, scoring higher than 77% of its peers.
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We're also able to compare this research output to 138 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 74% of its contemporaries.