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Implementation of laparoscopic colectomy with fast-track care in an academic medical center : benefits of a fully ascended learning curve and specialty expertise

Identifieur interne : 000F37 ( Main/Exploration ); précédent : 000F36; suivant : 000F38

Implementation of laparoscopic colectomy with fast-track care in an academic medical center : benefits of a fully ascended learning curve and specialty expertise

Auteurs : Raul M. Bosio [États-Unis] ; Bryan M. Smith [États-Unis] ; Pablo Serrano Aybar [États-Unis] ; Anthony J. Senagore [États-Unis]

Source :

The American journal of surgery [ 0002-9610 ] ; 2007.

RBID : Pascal:07-0174385

Descripteurs français

Pascal (Inist)
- Implémentation, Laparoscopie, Colectomie, Radiobiologie, Soin, Centre hospitalier universitaire, Apprentissage, Courbe, Expertise, Durée, Temps séjour, Analyse coût, Economie santé, Médecine, Chirurgie, Côlon, Traitement, Séjour.
Wicri :
- topic : Radiobiologie, Médecine, Chirurgie.

English descriptors

KwdEn :
- Care, Colectomy, Colon, Cost analysis, Curve, Duration, Expertise, Health economy, Implementation, Laparoscopy, Learning, Medicine, Radiobiology, Residence time, Surgery, Teaching hospital, Treatment.

Abstract

Background: There are few data describing successful institutional "conversion" from open colectomy/ standard care techniques to laparoscopic colectomy/fast-track care. Purpose: To assess the benefits of transitioning an institution from open to laparoscopic colectomy with fast-track care while avoiding a learning curve. Method: Twenty consecutive laparoscopic colorectal resections (LCRs) performed by a colorectal surgeon were compared with 20 matched open colorectal resections (OCRs) performed by general surgeons before the arrival of the colorectal surgeon. Results: Surgical procedures were as follows: sigmoidectomy: OCR 16 and LCR 11; right colectomy: OCR 3 and LCR 8; and total colectomy: OCR 1 and LCR 1. The mean operative time for sigmoidectomy was 250 and 109 minutes for OCR and LCR, respectively, and for right colectomy 181 and 97 minutes for OCR and LCR, respectively (P <.001). Morbidity was OCR 45% versus LCR 25%. There was no mortality. LCR showed significantly lower length of stay and direct cost (3.6 vs. 8.3 days;$4,993 vs. $11,383; both P <.001). Conclusions: The data clearly show an institutional benefit for the implementation of specialty-based advanced laparoscopic procedures.

Affiliations:

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Le document en format XML

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<term>Cost analysis</term>
<term>Curve</term>
<term>Duration</term>
<term>Expertise</term>
<term>Health economy</term>
<term>Implementation</term>
<term>Laparoscopy</term>
<term>Learning</term>
<term>Medicine</term>
<term>Radiobiology</term>
<term>Residence time</term>
<term>Surgery</term>
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<term>Laparoscopie</term>
<term>Colectomie</term>
<term>Radiobiologie</term>
<term>Soin</term>
<term>Centre hospitalier universitaire</term>
<term>Apprentissage</term>
<term>Courbe</term>
<term>Expertise</term>
<term>Durée</term>
<term>Temps séjour</term>
<term>Analyse coût</term>
<term>Economie santé</term>
<term>Médecine</term>
<term>Chirurgie</term>
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<front><div type="abstract" xml:lang="en">Background: There are few data describing successful institutional "conversion" from open colectomy/ standard care techniques to laparoscopic colectomy/fast-track care. Purpose: To assess the benefits of transitioning an institution from open to laparoscopic colectomy with fast-track care while avoiding a learning curve. Method: Twenty consecutive laparoscopic colorectal resections (LCRs) performed by a colorectal surgeon were compared with 20 matched open colorectal resections (OCRs) performed by general surgeons before the arrival of the colorectal surgeon. Results: Surgical procedures were as follows: sigmoidectomy: OCR 16 and LCR 11; right colectomy: OCR 3 and LCR 8; and total colectomy: OCR 1 and LCR 1. The mean operative time for sigmoidectomy was 250 and 109 minutes for OCR and LCR, respectively, and for right colectomy 181 and 97 minutes for OCR and LCR, respectively (P <.001). Morbidity was OCR 45% versus LCR 25%. There was no mortality. LCR showed significantly lower length of stay and direct cost (3.6 vs. 8.3 days;$4,993 vs. $11,383; both P <.001). Conclusions: The data clearly show an institutional benefit for the implementation of specialty-based advanced laparoscopic procedures.</div>
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Implementation of laparoscopic colectomy with fast-track care in an academic medical center : benefits of a fully ascended learning curve and specialty expertise

Implementation of laparoscopic colectomy with fast-track care in an academic medical center : benefits of a fully ascended learning curve and specialty expertise

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri