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Laparoscopic cholecystectomy decreases extra surgical site morbidity compared with open cholecystectomy: A propensity matched analysis.

Identifieur interne : 000504 ( PubMed/Corpus ); précédent : 000503; suivant : 000505

Laparoscopic cholecystectomy decreases extra surgical site morbidity compared with open cholecystectomy: A propensity matched analysis.

Auteurs : Chadli Dziri ; Imen Samaali ; Samia Ben Osman ; A. Fingerhut ; Riadh Bédoui ; Youssef Chaker ; Ibtissem Bouasker ; Ramzi Nouira

Source :

La Tunisie medicale [ 0041-4131 ]

RBID : pubmed:26815513

English descriptors

KwdEn :
- Aged (MeSH), Cholecystectomy (methods), Female (MeSH), Humans (MeSH), Length of Stay (statistics & numerical data), Male (MeSH), Matched-Pair Analysis (MeSH), Middle Aged (MeSH), Operative Time (MeSH), Postoperative Complications (MeSH), Propensity Score (MeSH).
MESH :
- methods : Cholecystectomy.
- statistics & numerical data : Length of Stay.
- Aged, Female, Humans, Male, Matched-Pair Analysis, Middle Aged, Operative Time, Postoperative Complications, Propensity Score.

Abstract

BACKGROUND

The ideal way to show treatment effectiveness is through randomized controlled trials the 'gold standard' in evidence-based surgery. Indeed, not all surgical studies can be designed as randomized trials, sometimes for ethical and otherwise, for practical reasons. This article aimed to compare laparoscopic cholecystectomy to open cholecystectomy, according to data from an administrative database, managed by a propensity matched analysis.

METHODS

Were included all patients with cholelithiasis admitted in Department B between June 1st, 2008 and December 31st, 2009. In this study, the propensity score represented the probability that a patient would be treated by a procedure based on variables that were known or suspected to influence group assignment and was developed using multivariable logistic regression used here to match patients who had laparoscopic cholecystectomy to a control patient who had open cholecystectomy. The main outcome measure was morbidity. This was expressed as the number of patients with 1 or more complications occurring during the hospital stay or within 30 days following discharge.

RESULTS

According to intention to treat, 535 patients had a laparoscopic approach (LC group) and 60 patients had a traditional open approach (OC group) regarding associated cardiac disease, previous laparotomy or when choledocholithiasis was suspected, however intra operative cholangiography showed that there was no choledocolithiasis. According to the propensity score, 28 patients in OC were matched with 58 in LC. Comparison between OC and LC before and after propensity matched analysis showed that OC was associated with a higher rate of Extra Surgical Site morbidity (p= 0.010), a longer median duration of intervention, post-operative stay and overall hospital stay (p= 0. 0001).

CONCLUSION

LC should be considered as first-line therapy to treat cholelithiasis surgically even if it becomes necessary to convert to OC because of intra operative findings.

PubMed: 26815513

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pubmed:26815513

Le document en format XML

<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Laparoscopic cholecystectomy decreases extra surgical site morbidity compared with open cholecystectomy: A propensity matched analysis.</title>
<author><name sortKey="Dziri, Chadli" sort="Dziri, Chadli" uniqKey="Dziri C" first="Chadli" last="Dziri">Chadli Dziri</name>
</author>
<author><name sortKey="Samaali, Imen" sort="Samaali, Imen" uniqKey="Samaali I" first="Imen" last="Samaali">Imen Samaali</name>
</author>
<author><name sortKey="Ben Osman, Samia" sort="Ben Osman, Samia" uniqKey="Ben Osman S" first="Samia" last="Ben Osman">Samia Ben Osman</name>
</author>
<author><name sortKey="Fingerhut, A" sort="Fingerhut, A" uniqKey="Fingerhut A" first="A" last="Fingerhut">A. Fingerhut</name>
</author>
<author><name sortKey="Bedoui, Riadh" sort="Bedoui, Riadh" uniqKey="Bedoui R" first="Riadh" last="Bédoui">Riadh Bédoui</name>
</author>
<author><name sortKey="Chaker, Youssef" sort="Chaker, Youssef" uniqKey="Chaker Y" first="Youssef" last="Chaker">Youssef Chaker</name>
</author>
<author><name sortKey="Bouasker, Ibtissem" sort="Bouasker, Ibtissem" uniqKey="Bouasker I" first="Ibtissem" last="Bouasker">Ibtissem Bouasker</name>
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<author><name sortKey="Nouira, Ramzi" sort="Nouira, Ramzi" uniqKey="Nouira R" first="Ramzi" last="Nouira">Ramzi Nouira</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Laparoscopic cholecystectomy decreases extra surgical site morbidity compared with open cholecystectomy: A propensity matched analysis.</title>
<author><name sortKey="Dziri, Chadli" sort="Dziri, Chadli" uniqKey="Dziri C" first="Chadli" last="Dziri">Chadli Dziri</name>
</author>
<author><name sortKey="Samaali, Imen" sort="Samaali, Imen" uniqKey="Samaali I" first="Imen" last="Samaali">Imen Samaali</name>
</author>
<author><name sortKey="Ben Osman, Samia" sort="Ben Osman, Samia" uniqKey="Ben Osman S" first="Samia" last="Ben Osman">Samia Ben Osman</name>
</author>
<author><name sortKey="Fingerhut, A" sort="Fingerhut, A" uniqKey="Fingerhut A" first="A" last="Fingerhut">A. Fingerhut</name>
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<author><name sortKey="Bedoui, Riadh" sort="Bedoui, Riadh" uniqKey="Bedoui R" first="Riadh" last="Bédoui">Riadh Bédoui</name>
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<author><name sortKey="Chaker, Youssef" sort="Chaker, Youssef" uniqKey="Chaker Y" first="Youssef" last="Chaker">Youssef Chaker</name>
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<author><name sortKey="Bouasker, Ibtissem" sort="Bouasker, Ibtissem" uniqKey="Bouasker I" first="Ibtissem" last="Bouasker">Ibtissem Bouasker</name>
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<author><name sortKey="Nouira, Ramzi" sort="Nouira, Ramzi" uniqKey="Nouira R" first="Ramzi" last="Nouira">Ramzi Nouira</name>
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<series><title level="j">La Tunisie medicale</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term>
<term>Cholecystectomy (methods)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Length of Stay (statistics & numerical data)</term>
<term>Male (MeSH)</term>
<term>Matched-Pair Analysis (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Operative Time (MeSH)</term>
<term>Postoperative Complications (MeSH)</term>
<term>Propensity Score (MeSH)</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Cholecystectomy</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Length of Stay</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Matched-Pair Analysis</term>
<term>Middle Aged</term>
<term>Operative Time</term>
<term>Postoperative Complications</term>
<term>Propensity Score</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>The ideal way to show treatment effectiveness is through randomized controlled trials the 'gold standard' in evidence-based surgery. Indeed, not all surgical studies can be designed as randomized trials, sometimes for ethical and otherwise, for practical reasons. This article aimed to compare laparoscopic cholecystectomy to open cholecystectomy, according to data from an administrative database, managed by a propensity matched analysis.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>Were included all patients with cholelithiasis admitted in Department B between June 1st, 2008 and December 31st, 2009. In this study, the propensity score represented the probability that a patient would be treated by a procedure based on variables that were known or suspected to influence group assignment and was developed using multivariable logistic regression used here to match patients who had laparoscopic cholecystectomy to a control patient who had open cholecystectomy. The main outcome measure was morbidity. This was expressed as the number of patients with 1 or more complications occurring during the hospital stay or within 30 days following discharge.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>According to intention to treat, 535 patients had a laparoscopic approach (LC group) and 60 patients had a traditional open approach (OC group) regarding associated cardiac disease, previous laparotomy or when choledocholithiasis was suspected, however intra operative cholangiography showed that there was no choledocolithiasis. According to the propensity score, 28 patients in OC were matched with 58 in LC. Comparison between OC and LC before and after propensity matched analysis showed that OC was associated with a higher rate of Extra Surgical Site morbidity (p= 0.010), a longer median duration of intervention, post-operative stay and overall hospital stay (p= 0. 0001).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>LC should be considered as first-line therapy to treat cholelithiasis surgically even if it becomes necessary to convert to OC because of intra operative findings.</p>
</div>
</front>
</TEI>
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<Title>La Tunisie medicale</Title>
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Laparoscopic cholecystectomy decreases extra surgical site morbidity compared with open cholecystectomy: A propensity matched analysis.

Laparoscopic cholecystectomy decreases extra surgical site morbidity compared with open cholecystectomy: A propensity matched analysis.

Source :

English descriptors

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki