Open right colectomy is still effective compared to laparoscopy: Results of a randomized trial

Marco Braga, Matteo Frasson, Andrea Vignali, Walter Zuliani, Valerio Di Carlo

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

OBJECTIVE: The primary goal of this study was to clarify whether a laparoscopic (LPS) approach could be considered the dominant strategy in patients undergoing right colectomy. SUMMARY BACKGROUND DATA: Because few nonrandomized or small sized studies have been carried out so far, definitive conclusions about the role of LPS right colectomy cannot be drawn. METHODS: Two hundred twenty-six patients, candidates for right colectomy, were randomly assigned to LPS (n = 113) or open (n = 113) resection. The postoperative care protocol was the same for both groups. Trained members of the surgical staff who were not involved in the study registered postoperative morbidity. Follow-up was carried out for 30 days after hospital discharge. The following costs were calculated: surgical instruments, operative room occupation, routine care, postoperative morbidity, and hospitalization. RESULTS: Conversion rate in the LPS group was 2.6% (3 of 113). Operative time (in minutes) was longer in the LPS group (131 vs. 112, P = 0.01). Postoperative morbidity rate was 18.6% in the open group and 13.3% in the LPS group (P = 0.31). Postoperative stay was one day longer in the open group (P = 0.002). No difference was found in postoperative quality of life. The additional operative charge in the LPS group was €980 per patient randomized (€821 for surgical instruments and €159 for longer operative time). The savings in the LPS group was €390 per patient randomized (€144 for shorter length of hospital stay and €246 for the lower cost of postoperative morbidity). The net balance resulted in a €590 extra charge per patient randomly allocated to the LPS group. CONCLUSION: LPS slightly improved postoperative recovery. This translated into a savings that covered only 40% of the extra operative charge. Therefore, open right colectomy could be still considered an effective procedure.

Original languageEnglish
Pages (from-to)1010-1014
Number of pages5
JournalAnnals of Surgery
Volume246
Issue number6
DOIs
Publication statusPublished - Dec 2007

Fingerprint

Colectomy
Laparoscopy
Morbidity
Postoperative Care
Patient Rights
Operative Time
Surgical Instruments
Length of Stay
Costs and Cost Analysis
Occupations
Hospitalization
Quality of Life

ASJC Scopus subject areas

  • Surgery

Cite this

Open right colectomy is still effective compared to laparoscopy : Results of a randomized trial. / Braga, Marco; Frasson, Matteo; Vignali, Andrea; Zuliani, Walter; Di Carlo, Valerio.

In: Annals of Surgery, Vol. 246, No. 6, 12.2007, p. 1010-1014.

Research output: Contribution to journalArticle

Braga, Marco ; Frasson, Matteo ; Vignali, Andrea ; Zuliani, Walter ; Di Carlo, Valerio. / Open right colectomy is still effective compared to laparoscopy : Results of a randomized trial. In: Annals of Surgery. 2007 ; Vol. 246, No. 6. pp. 1010-1014.
@article{7ff8f0b7f2c343458ef541e39ff2e304,
title = "Open right colectomy is still effective compared to laparoscopy: Results of a randomized trial",
abstract = "OBJECTIVE: The primary goal of this study was to clarify whether a laparoscopic (LPS) approach could be considered the dominant strategy in patients undergoing right colectomy. SUMMARY BACKGROUND DATA: Because few nonrandomized or small sized studies have been carried out so far, definitive conclusions about the role of LPS right colectomy cannot be drawn. METHODS: Two hundred twenty-six patients, candidates for right colectomy, were randomly assigned to LPS (n = 113) or open (n = 113) resection. The postoperative care protocol was the same for both groups. Trained members of the surgical staff who were not involved in the study registered postoperative morbidity. Follow-up was carried out for 30 days after hospital discharge. The following costs were calculated: surgical instruments, operative room occupation, routine care, postoperative morbidity, and hospitalization. RESULTS: Conversion rate in the LPS group was 2.6{\%} (3 of 113). Operative time (in minutes) was longer in the LPS group (131 vs. 112, P = 0.01). Postoperative morbidity rate was 18.6{\%} in the open group and 13.3{\%} in the LPS group (P = 0.31). Postoperative stay was one day longer in the open group (P = 0.002). No difference was found in postoperative quality of life. The additional operative charge in the LPS group was €980 per patient randomized (€821 for surgical instruments and €159 for longer operative time). The savings in the LPS group was €390 per patient randomized (€144 for shorter length of hospital stay and €246 for the lower cost of postoperative morbidity). The net balance resulted in a €590 extra charge per patient randomly allocated to the LPS group. CONCLUSION: LPS slightly improved postoperative recovery. This translated into a savings that covered only 40{\%} of the extra operative charge. Therefore, open right colectomy could be still considered an effective procedure.",
author = "Marco Braga and Matteo Frasson and Andrea Vignali and Walter Zuliani and {Di Carlo}, Valerio",
year = "2007",
month = "12",
doi = "10.1097/SLA.0b013e31815c4065",
language = "English",
volume = "246",
pages = "1010--1014",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Open right colectomy is still effective compared to laparoscopy

T2 - Results of a randomized trial

AU - Braga, Marco

AU - Frasson, Matteo

AU - Vignali, Andrea

AU - Zuliani, Walter

AU - Di Carlo, Valerio

PY - 2007/12

Y1 - 2007/12

N2 - OBJECTIVE: The primary goal of this study was to clarify whether a laparoscopic (LPS) approach could be considered the dominant strategy in patients undergoing right colectomy. SUMMARY BACKGROUND DATA: Because few nonrandomized or small sized studies have been carried out so far, definitive conclusions about the role of LPS right colectomy cannot be drawn. METHODS: Two hundred twenty-six patients, candidates for right colectomy, were randomly assigned to LPS (n = 113) or open (n = 113) resection. The postoperative care protocol was the same for both groups. Trained members of the surgical staff who were not involved in the study registered postoperative morbidity. Follow-up was carried out for 30 days after hospital discharge. The following costs were calculated: surgical instruments, operative room occupation, routine care, postoperative morbidity, and hospitalization. RESULTS: Conversion rate in the LPS group was 2.6% (3 of 113). Operative time (in minutes) was longer in the LPS group (131 vs. 112, P = 0.01). Postoperative morbidity rate was 18.6% in the open group and 13.3% in the LPS group (P = 0.31). Postoperative stay was one day longer in the open group (P = 0.002). No difference was found in postoperative quality of life. The additional operative charge in the LPS group was €980 per patient randomized (€821 for surgical instruments and €159 for longer operative time). The savings in the LPS group was €390 per patient randomized (€144 for shorter length of hospital stay and €246 for the lower cost of postoperative morbidity). The net balance resulted in a €590 extra charge per patient randomly allocated to the LPS group. CONCLUSION: LPS slightly improved postoperative recovery. This translated into a savings that covered only 40% of the extra operative charge. Therefore, open right colectomy could be still considered an effective procedure.

AB - OBJECTIVE: The primary goal of this study was to clarify whether a laparoscopic (LPS) approach could be considered the dominant strategy in patients undergoing right colectomy. SUMMARY BACKGROUND DATA: Because few nonrandomized or small sized studies have been carried out so far, definitive conclusions about the role of LPS right colectomy cannot be drawn. METHODS: Two hundred twenty-six patients, candidates for right colectomy, were randomly assigned to LPS (n = 113) or open (n = 113) resection. The postoperative care protocol was the same for both groups. Trained members of the surgical staff who were not involved in the study registered postoperative morbidity. Follow-up was carried out for 30 days after hospital discharge. The following costs were calculated: surgical instruments, operative room occupation, routine care, postoperative morbidity, and hospitalization. RESULTS: Conversion rate in the LPS group was 2.6% (3 of 113). Operative time (in minutes) was longer in the LPS group (131 vs. 112, P = 0.01). Postoperative morbidity rate was 18.6% in the open group and 13.3% in the LPS group (P = 0.31). Postoperative stay was one day longer in the open group (P = 0.002). No difference was found in postoperative quality of life. The additional operative charge in the LPS group was €980 per patient randomized (€821 for surgical instruments and €159 for longer operative time). The savings in the LPS group was €390 per patient randomized (€144 for shorter length of hospital stay and €246 for the lower cost of postoperative morbidity). The net balance resulted in a €590 extra charge per patient randomly allocated to the LPS group. CONCLUSION: LPS slightly improved postoperative recovery. This translated into a savings that covered only 40% of the extra operative charge. Therefore, open right colectomy could be still considered an effective procedure.

UR - http://www.scopus.com/inward/record.url?scp=36549049351&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36549049351&partnerID=8YFLogxK

U2 - 10.1097/SLA.0b013e31815c4065

DO - 10.1097/SLA.0b013e31815c4065

M3 - Article

C2 - 18043103

AN - SCOPUS:36549049351

VL - 246

SP - 1010

EP - 1014

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 6

ER -