Does Increasing Experience with Laparoscopic Colorectal Surgery Influence the Outcome of Complex Cases?

OBJECTIVES: To define major risk factors for intraoperative complications (IOC) in laparoscopic colorectal surgery, and to assess whether surgeon experience influences the outcomes of complex cases.
METHODS: Consecutive patients undergoing laparoscopic colorectal procedures from 1991-2005 were analyzed from a prospectively-collected database. All patients referred to the four surgeons involved in this study were offered a minimally invasive approach. Patient characteristics, perioperative variables, and surgeon experience data were analyzed and compared.
RESULTS: A total of 991 consecutive laparoscopic colorectal procedures were studied. The majority of operations were performed for malignant disease (n=526, 53.1%), and most frequently consisted of segmental colonic resections (n=714, 72.0%). A total of 85 (8.6%) IOCs were encountered. Previous intraabdominal surgery (IOC 12.3% vs. 7.6%, p=0.028) and increasing weight (p=0.0047) were identified as major risk factors for IOC. A total of 126 (12.7%) cases were converted to open surgery. Risk factors for conversion were increasing age (p=0.0003) and weight (p

Session: Podium Presentation

Program Number: S083

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