Laparoscopic colonic surgery in Denmark 2004–2007

Schulze, Svend; Iversen, Maria Gerding; Bendixen, Anette; Larsen, Trine Stigaard; Kehlet, Henrik

doi:10.1111/j.1463-1318.2008.01497.x

Cited by 11 publications

(6 citation statements)

References 22 publications

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“…With a median postoperative hospital stay of 5 days, median 15 lymph nodes in the specimens, and 79% of cases without complications, we were able to produce results comparable with, or even better than our nationwide data [9, 10] and large multicentre controlled trials [11–18]. …”

Section: Discussionsupporting

confidence: 63%

Short Hospital Stay after Laparoscopic Colorectal Surgery without Fast Track

Burgdorf

Rosenberg

2012

Minimally Invasive Surgery

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Purpose. Short hospital stay and equal or reduced complication rates have been demonstrated after fast track open colonic surgery. However, fast track principles of perioperative care can be difficult to implement and often require increased nursing staff because of more concentrated nursing tasks during the shorter hospital stay. Specific data on nursing requirements after laparoscopic surgery are lacking. The purpose of the study was to evaluate the effect of operative technique (open versus laparoscopic operation), but without changing nurse staffing or principles for peri- or postoperative care, that is, without implementing fast track principles, on length of stay after colorectal resection for cancer. Methods. Records of all patients operated for colorectal cancer from November 2004 to December 2008 in our department were reviewed. No specific patients were selected for laparoscopic repair, which was solely dependent on the presence of two specific surgeons at the same time. Thus, the patients were not selected for laparoscopic repair based on patient-related factors, but only on the simultaneous presence of two specific surgeons on the day of the operation. Results. Of a total of 540 included patients, 213 (39%) were operated by a laparoscopic approach. The median hospital stay for patients with a primary anastomosis was significantly shorter after laparoscopic than after conventional open surgery (5 versus 8 days, P < 0.001) while there was no difference in patients receiving a stoma (10 versus 10 days, ns), with no changes in the perioperative care regimens. Furthermore there were significant lower blood loss (50 versus 200 mL, P < 0.001) and lower complication rate (21% versus 32%, P = 0.006) in the laparoscopic group. Conclusion. Implementing laparoscopic colorectal surgery in our department resulted in shorter hospital stay without using fast track principles for peri- and postoperative care in patients not receiving a stoma during the operation. Consequently, we aimed to reduce hospitalisation without increasing cost in nursing staff per hospital bed. Length of stay was not reduced in patients receiving a stoma pointing at this group for specific intervention in the future. Furthermore, the complication rate was reduced in the laparoscopic group.

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Section: Discussionsupporting

confidence: 63%

Short Hospital Stay after Laparoscopic Colorectal Surgery without Fast Track

Burgdorf

Rosenberg

2012

Minimally Invasive Surgery

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“…It does give information on the use of a mesh and allows registration of all readmissions independent of the primary site of surgery and type of institution (public or private). The validity of the NPR system with respect to the type of surgical procedure, independent of diagnosis, has been established previously for several surgical procedures9–11. Based on NPR data and patient discharge records, the analysis included total hospital stay (primary plus readmission within 30 days), readmission rate, 30‐day mortality and 30‐day morbidity.…”

Section: Introductionmentioning

confidence: 99%

Nationwide study of early outcomes after incisional hernia repair

Bisgaard

Kehlet

Bay‐Nielsen

et al. 2009

British Journal of Surgery

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“…Despite the increase of laparoscopic colon surgery in the USA, UK and Denmark over the past decade, the percentage of surgeries completed laparoscopically has remained low, ranging from 6.7% to 19.3% in 2006-2007 [11][12][13]. The province of Ontario has adopted a more positive approach to elective laparoscopic resection for colon cancer with one-third of all colon resections in 2007 being completed laparoscopically.…”

Section: Discussionmentioning

confidence: 99%