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- Title
Open Versus Laparoscopic Right Hemicolectomies in Pediatric Patients with Crohn's Disease.
- Authors
Quiroz, Hallie J.; Perez, Eduardo A.; El Tawil, Rana A.; Willobee, Brent A.; Galvez-Cabezas, Kevin; Ferrantella, Anthony R.; Thorson, Chad M.; Langshaw, Amber H.; Sola, Juan E.
- Abstract
Introduction: Surgery remains an important treatment modality for the management of pediatric Crohn's disease (CD). The objective of this study was to perform a comparative analysis of open right hemicolectomy (ORH) and laparoscopic right hemicolectomy (LRH) for the management of pediatric CD. Materials and Methods: The Kids' Inpatient Database (KID) was queried (2009-2012) for ICD-9 procedure codes for ORH (45.73) and LRH (17.33) in patients with CD (ICD-9 codes: 555.0, 555.1, 555.2, 555.9). Open and laparoscopic procedures were compared using propensity score (PS)-matched analysis (PSMA) of 41 variables. Results: Overall 889 patients were identified and after PS matching, there were 380 ORHs and 380 LRHs. There were zero in-hospital deaths (0/821). ORH patients were more likely to have septicemia, respiratory compromise, pneumonia, perforation and/or laceration, complications, and require blood transfusions (all, P < .05). Although LRH patients were more likely to develop postoperative nausea/vomiting/diarrhea (P < .0001), they had a shorter hospital length of stay (P < .0001) and lower overall hospital charges and cost (P < .001). Conclusion: ORH and LRH in KID have similar low in-hospital mortality in pediatric CD. However, ORH was associated with higher morbidity including an increased risk for respiratory complications, surgical complications, need for blood transfusions, and increased resource utilization than patients who had laparoscopic procedures. In select patients, LRH is safe, feasible, and potentially superior to ORH.
- Subjects
RIGHT hemicolectomy; CROHN'S disease; HOSPITAL charges; LENGTH of stay in hospitals; SURGICAL complications; HOSPITAL mortality; INJURY complications; COLECTOMY; COMPARATIVE studies; DATABASES; HOSPITAL care; LAPAROSCOPY; RESEARCH methodology; MEDICAL cooperation; PNEUMONIA; PROBABILITY theory; RESEARCH; RESPIRATORY diseases; SEPSIS; EVALUATION research; RELATIVE medical risk; TREATMENT effectiveness; RETROSPECTIVE studies; DISEASE complications
- Publication
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2020, Vol 30, Issue 7, p820
- ISSN
1092-6429
- Publication type
journal article
- DOI
10.1089/lap.2019.0814