BACKGROUND. The ACS National Surgical Quality Improvement Program (ACS NSQIP) is the first nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care. The program employs a prospective, peer controlled, validated database to quantify 30-day risk-adjusted surgical outcomes, which allows valid comparison of outcomes among all hospitals in the program. The most recent 2008 National Surgical Quality Improvement Project (NSQIP) database, contains over 240,000 surgical cases.
The 2008 NSQIP database was queried for all patients undergoing colon resection. Patients were divided into laparoscopic and open groups based on CPT procedure codes. Difference in 30-day survival between subgroups was evaluated using Kaplan-Meier and logistic regression analysis. Pre-operative morbidity was compared using the unpaired t-test.
There were 17224 patients who underwent colon resection in 2008. Patients who underwent laparoscopic operation had a significantly better survival at thirty days over open (98.8% vs 94.7%, logrank p-value <.0001, c2 194). Length of stay was shorter in laprascopic group (5.9days vs 9.1days, p-value <.0001). The patients who underwent open colon resection were older (61.7y/o vs 63.4y/o, p-value <.0001), had higher pre-operative ASA Class (2.3 vs 2.6, p-value <.0001), and higher pre-operative NSQIP defined morbidity score (.156 vs .244, p-value <.0001).
Laparoscopic colon resection carries a significantly better outcome than open resection. Yet, these patients also had a significantly less pre-operative comorbidities.
Session: Podium Presentation
Program Number: S001