Provider Experience and the Comparative Safety of Laparoscopic and Open Colectomy.

ABSTRACT:

Objective

To evaluate the comparative safety of laparoscopic and open colectomy across surgeons varying in experience with laparoscopy.

Data sources

National Medicare data (2008-2010) for beneficiaries undergoing laparoscopic or open colectomy.

Study design

Using instrumental variable methods to address selection bias, we evaluated outcomes of laparoscopic and open colectomy. Our instrument was the regional use of laparoscopy in the year prior to a patient's operation. We then evaluated outcomes stratified by surgeons' annual volume of laparoscopic colectomy.

Principal findings

Laparoscopic colectomy was associated with lower mortality (OR: 0.75, 95 percent CI: 0.70-0.78) and fewer complications than open surgery (OR: 0.82, 95 percent CI: 0.79-0.85). Increasing

SUBMITTER: Sheetz KH 

PROVIDER: S-EPMC5264110 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature