Determinants of Operative Time and Hospital Length of Stay After Laparoscopic Fundoplication: Analysis of 2052 Patients From the NSQIP Database

Prateek K Gupta, MD, Tommy H Lee, MD, Himani Gupta, MD, Weldon J Miller, MS, Lee E Morrow, MD, Robert J Fitzgibbons Jr, MD, Sumeet K Mittal, MD. Creighton University

Objective: Our objective was to analyze the American College of Surgeons’ National Surgical Quality Improvement database (NSQIP) to determine the effect of patient demographics and co-morbid conditions on operative time (OT) and hospital length of stay (LOS) in patients undergoing Laparoscopic Fundoplication.

Methods: Patients undergoing LF were identified from the American College of Surgeons’ 2007 NSQIP, a multicenter, prospective database. Analyses were performed using ANCOVA.

Results: Among 2052 patients, the mean and median OT were 135(±59) and 127 minutes, respectively. The mean and median LOS were 2.4(±3.8) and 2 days, respectively. Decline in functional status, severe COPD, and stroke were associated with a longer LOS (p< 0.05 for all). A history of recent angina, African American race, and advancing age were associated with increases in both OT and LOS (p<0.05 for all). Male gender and a higher BMI were significantly associated with increased OT (p<0.05). Other variables such as a history of smoking, alcohol use, hypertension, diabetes, recent myocardial infarction, and congestive heart failure did not affect LOS or OT.

Conclusions: Identification of modifiable factors and their optimization prior to surgery is a critical first step in decreasing associated morbidity and improving outcomes after laparoscopic fundoplication. Identifying non-modifiable factors will help in patient counseling and selection.

Session: Poster
Program Number: P307
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