Clapp Benjamin, Klingsporn William, Harper Brittany, Swinney Ira L, Dodoo Christopher, Davis Brian, Tyroch Alan
Department of Surgery, TX Tech HSC Paul Foster School of Medicine, El Paso TX.
JSLS. 2019 Jul-Sep;23(3). doi: 10.4293/JSLS.2019.00032.
Laparoscopic surgery has become the standard of care for the most common surgical procedures performed. However, laparoscopic techniques have not reached this same penetrance in colorectal surgery. We wanted to determine the percentage of colon operations performed in Texas that were done via laparoscopic, robotic and open techniques.
The Texas Inpatient Public Use Data File (PUDF) was queried using ICD-9-CM diagnostic and procedure codes to determine overall utilization of laparoscopic colectomies (LC) in Texas between 2013-14 for reporting facilities. We specifically looked at cost and the length of stay for LC, open colectomy (OC) and robotic assisted colectomy (RAC).
In the state of Texas between 2013-14 there were 20,454 colectomies performed. Of these 12,328 (60.3%) were OC, 7,536 (36.8%) were LC, and 590 (3.9%) were RAC. Average total cost was $117,113 for OC, $75,741.9 for LC, and $81,996.2 for RAC. Average length of stay for each technique was 10.6 days for OC, 6.1 days for LC, and 5.1 days for RAC. The risk of a postoperative complication occurring was higher in the open procedure than a laparoscopic procedure.
LC accounted for only 36.8% of all colectomies performed in Texas between 2013-14. OC costs twice as much as LC and increased the length of stay by nearly 4 d. LC and RAC are both associated with significantly less cost and length of stay for patients undergoing surgery, while lowering perioperative complications.
None of the authors have any relevant disclosures.
腹腔镜手术已成为大多数常见外科手术的标准治疗方式。然而，腹腔镜技术在结直肠手术中的普及程度尚未达到相同水平。我们希望确定在德克萨斯州通过腹腔镜、机器人和开放技术进行的结肠手术的比例。
使用ICD - 9 - CM诊断和手术编码查询德克萨斯州住院患者公共使用数据文件（PUDF），以确定2013 - 2014年间德克萨斯州报告机构腹腔镜结肠切除术（LC）的总体使用情况。我们特别关注了LC、开放结肠切除术（OC）和机器人辅助结肠切除术（RAC）的成本和住院时间。
在2013 - 2014年间，德克萨斯州共进行了20454例结肠切除术。其中，12328例（60.3%）为OC，7536例（36.8%）为LC，590例（3.9%）为RAC。OC的平均总成本为117113美元，LC为75741.9美元，RAC为81996.2美元。每种技术的平均住院时间分别为：OC为10.6天，LC为6.1天，RAC为5.1天。开放手术术后发生并发症的风险高于腹腔镜手术。
在2013 - 2014年间，LC仅占德克萨斯州所有结肠切除术的36.8%。OC的成本是LC的两倍，住院时间增加了近4天。LC和RAC对于接受手术的患者而言，成本和住院时间均显著降低，同时降低了围手术期并发症。
所有作者均无相关披露。
