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 : 000F38Implementation 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.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Radiobiologie, Médecine, Chirurgie.
English descriptors
- KwdEn :
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:
Links toward previous steps (curation, corpus...)
- to stream PascalFrancis, to step Corpus: 000350
- to stream PascalFrancis, to step Curation: 000436
- to stream PascalFrancis, to step Checkpoint: 000279
- to stream Main, to step Merge: 000F50
- to stream Main, to step Curation: 000F37
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Implementation of laparoscopic colectomy with fast-track care in an academic medical center : benefits of a fully ascended learning curve and specialty expertise</title>
<author><name sortKey="Bosio, Raul M" sort="Bosio, Raul M" uniqKey="Bosio R" first="Raul M." last="Bosio">Raul M. Bosio</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Surgery, University of Toledo, 3065 Arlington Avenue, Dowling Hall</s1>
<s2>Toledo, OH 43614-5807</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Smith, Bryan M" sort="Smith, Bryan M" uniqKey="Smith B" first="Bryan M." last="Smith">Bryan M. Smith</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Surgery, University of Toledo, 3065 Arlington Avenue, Dowling Hall</s1>
<s2>Toledo, OH 43614-5807</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Aybar, Pablo Serrano" sort="Aybar, Pablo Serrano" uniqKey="Aybar P" first="Pablo Serrano" last="Aybar">Pablo Serrano Aybar</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Surgery, University of Toledo, 3065 Arlington Avenue, Dowling Hall</s1>
<s2>Toledo, OH 43614-5807</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Senagore, Anthony J" sort="Senagore, Anthony J" uniqKey="Senagore A" first="Anthony J." last="Senagore">Anthony J. Senagore</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Surgery, University of Toledo, 3065 Arlington Avenue, Dowling Hall</s1>
<s2>Toledo, OH 43614-5807</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">INIST</idno>
<idno type="inist">07-0174385</idno>
<date when="2007">2007</date>
<idno type="stanalyst">PASCAL 07-0174385 INIST</idno>
<idno type="RBID">Pascal:07-0174385</idno>
<idno type="wicri:Area/PascalFrancis/Corpus">000350</idno>
<idno type="wicri:Area/PascalFrancis/Curation">000436</idno>
<idno type="wicri:Area/PascalFrancis/Checkpoint">000279</idno>
<idno type="wicri:doubleKey">0002-9610:2007:Bosio R:implementation:of:laparoscopic</idno>
<idno type="wicri:Area/Main/Merge">000F50</idno>
<idno type="wicri:Area/Main/Curation">000F37</idno>
<idno type="wicri:Area/Main/Exploration">000F37</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Implementation of laparoscopic colectomy with fast-track care in an academic medical center : benefits of a fully ascended learning curve and specialty expertise</title>
<author><name sortKey="Bosio, Raul M" sort="Bosio, Raul M" uniqKey="Bosio R" first="Raul M." last="Bosio">Raul M. Bosio</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Surgery, University of Toledo, 3065 Arlington Avenue, Dowling Hall</s1>
<s2>Toledo, OH 43614-5807</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Smith, Bryan M" sort="Smith, Bryan M" uniqKey="Smith B" first="Bryan M." last="Smith">Bryan M. Smith</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Surgery, University of Toledo, 3065 Arlington Avenue, Dowling Hall</s1>
<s2>Toledo, OH 43614-5807</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Aybar, Pablo Serrano" sort="Aybar, Pablo Serrano" uniqKey="Aybar P" first="Pablo Serrano" last="Aybar">Pablo Serrano Aybar</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Surgery, University of Toledo, 3065 Arlington Avenue, Dowling Hall</s1>
<s2>Toledo, OH 43614-5807</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Senagore, Anthony J" sort="Senagore, Anthony J" uniqKey="Senagore A" first="Anthony J." last="Senagore">Anthony J. Senagore</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Surgery, University of Toledo, 3065 Arlington Avenue, Dowling Hall</s1>
<s2>Toledo, OH 43614-5807</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Ohio</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">The American journal of surgery</title>
<title level="j" type="abbreviated">Am. j. surg.</title>
<idno type="ISSN">0002-9610</idno>
<imprint><date when="2007">2007</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">The American journal of surgery</title>
<title level="j" type="abbreviated">Am. j. surg.</title>
<idno type="ISSN">0002-9610</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Care</term>
<term>Colectomy</term>
<term>Colon</term>
<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>
<term>Teaching hospital</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Implémentation</term>
<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>
<term>Côlon</term>
<term>Traitement</term>
<term>Séjour</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Radiobiologie</term>
<term>Médecine</term>
<term>Chirurgie</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<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. $11,383; both P <.001). Conclusions: The data clearly show an institutional benefit for the implementation of specialty-based advanced laparoscopic procedures.</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Ohio</li>
</region>
</list>
<tree><country name="États-Unis"><region name="Ohio"><name sortKey="Bosio, Raul M" sort="Bosio, Raul M" uniqKey="Bosio R" first="Raul M." last="Bosio">Raul M. Bosio</name>
</region>
<name sortKey="Aybar, Pablo Serrano" sort="Aybar, Pablo Serrano" uniqKey="Aybar P" first="Pablo Serrano" last="Aybar">Pablo Serrano Aybar</name>
<name sortKey="Senagore, Anthony J" sort="Senagore, Anthony J" uniqKey="Senagore A" first="Anthony J." last="Senagore">Anthony J. Senagore</name>
<name sortKey="Smith, Bryan M" sort="Smith, Bryan M" uniqKey="Smith B" first="Bryan M." last="Smith">Bryan M. Smith</name>
</country>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Ticri/CIDE/explor/OcrV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000F37 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000F37 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Ticri/CIDE |area= OcrV1 |flux= Main |étape= Exploration |type= RBID |clé= Pascal:07-0174385 |texte= Implementation of laparoscopic colectomy with fast-track care in an academic medical center : benefits of a fully ascended learning curve and specialty expertise }}
![]() | This area was generated with Dilib version V0.6.32. | ![]() |