Literature DB >> 24692089

Minimally invasive technique leads to decreased morbidity and mortality in small bowel resections compared to an open technique: an ACS-NSQIP identified target for improvement.

Shaun C Daly1, Andrew M Popoff, Louis Fogg, Amanda B Francescatti, Jonathan A Myers, Keith W Millikan, Daniel J Deziel, Minh B Luu.   

Abstract

BACKGROUND: We hypothesize that currently minimally invasive techniques are underutilized, leading to unnecessary morbidity and mortality. The objective of the study was to compare morbidity and mortality rates in patients receiving a minimally invasive (MIS) small bowel resection to patients receiving an open (OP) small bowel resection.
METHODS: Patients in the National Surgical Quality Improvement Program (NSQIP) database who underwent a small bowel resection between 2007 and 2011 were enrolled in the study and grouped whether they received a MIS procedure (n = 1,780) or an OP procedure (n = 17,701). The primary endpoint of the study was to evaluate the difference in morbidity (excluding mortality) and mortality in patients undergoing a minimally invasive procedure compared to an open procedure.
RESULTS: The MIS technique is utilized in 9.0 % of patients undergoing a small bowel resection. Significantly lower mortality rate (2.9 vs. 8.2 %; p < 0.001) and mean morbidity rate (1.7 vs. 4.3 %; p < 0.001) were demonstrated in the MIS group. Significantly lower mean major morbidity rate (1.4 vs. 3.9 %; p < 0.001) and mean minor morbidity rate (2.6 vs. 5.5 %; p < 0.001) were demonstrated in the MIS group.
CONCLUSION: The MIS technique in small bowel resections appears to be underutilized, with only 9.0 % of patients in need of a small bowel resection undergo the minimally invasive approach. Wider utilization of the MIS technique could lead to significantly decreased morbidity and mortality.

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Year:  2014        PMID: 24692089     DOI: 10.1007/s11605-014-2493-5

Source DB:  PubMed          Journal:  J Gastrointest Surg        ISSN: 1091-255X            Impact factor:   3.452


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