Surgical Endoscopy

, Volume 32, Issue 3, pp 1286–1292 | Cite as

Laparoscopic colectomy reduces complications and hospital length of stay in colon cancer patients with liver disease and ascites

  • Kevin Y. Pei
  • David T. Asuzu
  • Kimberly A. Davis
Article

Abstract

Background

Ascites increases perioperative complications and risk of death, but is not an absolute contraindication for colectomy in patients with colon cancer. It remains unclear whether postoperative risks can be minimized using a laparoscopic versus open approach.

Methods

Data were retrospectively analyzed from 2152 patients with ascites who underwent laparoscopic or open partial colectomy with diagnosis of colon cancer from 2005 to 2013 using the American College of Surgeons National Surgical Quality Improvement Program database. Postoperative outcomes were analyzed using two-sample tests of proportions and two-sample T tests. Adjusted odds ratios (OR) or β coefficients for postoperative complications, hospital length of stay, and 30-day mortality were calculated using multivariable logistic or linear regression. P values <0.05 two-tailed were considered statistically significant.

Results

205 patients (9.53%) with ascites underwent laparoscopic colectomy (LC). There was no significant difference in operative time between laparoscopic versus open surgery (145 vs. 146 min, P = 0.69). LC was associated with decreased likelihood of overall complications (adjusted OR 0.7 95% CI 0.4–1.0, P = 0.046) and shorter hospital length of stay (9 days vs. 15 days, adjusted β = −4.2, 95% CI −7.7 to −0.7, P = 0.018). There was no difference in 30-day mortality (adjusted OR 0.82, 95% CI 0.50–1.35, P = 0.429).

Conclusions

Laparoscopic colectomy decreases postoperative complications and hospital length of stay in patients with colon cancer and ascites. Laparoscopic approach should be considered for patients in this high-risk population.

Keywords

Ascites Partial colectomy Colon cancer Liver disease 

Notes

Acknowledgements

Disclosures

Kevin Y. Pei, David T. Asuzu, and Kimberly A. Davis have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2017_5806_MOESM1_ESM.docx (16 kb)
Supplementary material 1 (DOCX 16 kb)

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Kevin Y. Pei
    • 1
    • 2
  • David T. Asuzu
    • 2
    • 3
  • Kimberly A. Davis
    • 1
    • 2
  1. 1.Section of General Surgery, Trauma, and Surgical Critical Care, Department of SurgeryYale School of MedicineNew HavenUSA
  2. 2.Department of SurgeryYale School of MedicineNew HavenUSA
  3. 3.Harvard T.H. Chan School of Public HealthBostonUSA

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