The impact of laparoscopic versus open approach on reoperation rate after segmental colectomy: a propensity analysis

J Gastrointest Surg. 2014 Feb;18(2):378-84. doi: 10.1007/s11605-013-2289-z. Epub 2013 Jul 30.


Background: Reoperation rate has not been well studied as a primary outcome when comparing laparoscopic with open approaches for colorectal resection. The goal of this study was to determine the impact of a laparoscopic approach on rate of reoperation after elective segmental colectomy.

Methods: The NSQIP PUF for 2005-2011 was used to retrospectively identify patients who underwent open or laparoscopic elective segmental colectomy. The primary outcome measure was 30-day reoperation rate. A multivariable logistic regression model was constructed to determine the independent effect of surgical approach on rates of unplanned reoperation. This was validated with inverse propensity score weighting.

Results: A total of 39,063 patients met the study inclusion criteria. A total of 1,702 reoperations were identified. After open approach, 5.1 % required reoperation, compared to 3.8 % in the laparoscopic group. After adjusting for confounders, open resection had 1.17-fold higher odds than laparoscopy for risk of reoperation, but this was not statistically significant (p = 0.07).

Discussion: Using a large clinical dataset, we found that for segmental colectomy, there was not a statistically significant difference in odds of return to the operating room for laparoscopic versus open surgical approach. Reoperation is a relatively rare but costly complication and remains a potential area for quality improvement.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Colectomy / adverse effects
  • Colectomy / methods*
  • Colectomy / mortality
  • Colectomy / statistics & numerical data*
  • Female
  • Humans
  • Laparoscopy / mortality
  • Laparoscopy / statistics & numerical data*
  • Male
  • Middle Aged
  • Propensity Score
  • Reoperation / statistics & numerical data
  • Retrospective Studies