caa a22 4500 475780205 CHVBK 20180406123642.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s004640000050 doi (NATIONALLICENCE)springer-10.1007/s004640000050 Determinants of outcomes in laparoscopic colorectal surgery [Elektronische Daten] A multiple regression analysis of 416 resections [C. M. Schlachta, J. Mamazza, P. A. Seshadri, M. Cadeddu, E. C. Poulin] Background: To date, most large series of laparoscopic colorectal procedures have been descriptive reports that do not account for the potentially complex interaction of outcome predictors. The purpose of this study was to identify the preoperative factors that predict operative time, conversion to open surgery, and intraoperative and postoperative complications in laparoscopic colorectal surgery. Methods: Multiple regression techniques were used to analyze 416 laparoscopic resections from a prospective database of laparoscopic colorectal procedures performed between April 1991 and April 1998. The preoperative factors considered were patient-specific (age, gender, weight) or disease-specific (diagnosis of cancer, Crohn's disease, diverticulitis, fistula). Surgical experience of ≤50 cases was also considered. Finally, all resections were represented by a combination of the following five procedure components: resections of the (a) hepatic flexure, (b) splenic flexure, (c) sigmoid, and (d) rectum, or (e) a perineal dissection. Results: Patient weight, Crohn's disease, and each of the five individual procedure components incrementally lengthened operative time. Conversion to open surgery was influenced by the patient's weight, malignancy, and early experience of the surgeon. The risk of a postoperative complication was increased by the patient's age, resection of the perineum, and the presence of a fistula. No factors significantly influenced the risk of an intraoperative complication. Conclusions: Several preoperative factors that significantly affect outcomes in laparoscopic colorectal resections have been identified. Consideration of these factors may help in case selection and estimation of operating time; they should also be valuable when patients are informed of their risk of conversion and complications. Springer-Verlag New York Inc., 2000 Key words: Colorectal surgery — Laparoscopic colectomy — Laparoscopy — Outcomes — Regression analysis nationallicence Schlachta C. M. The University of Toronto Centre for Minimally Invasive Surgery, Saint Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, Canada aut Mamazza J. The University of Toronto Centre for Minimally Invasive Surgery, Saint Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, Canada aut Seshadri P. A. The University of Toronto Centre for Minimally Invasive Surgery, Saint Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, Canada aut Cadeddu M. The University of Toronto Centre for Minimally Invasive Surgery, Saint Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, Canada aut Poulin E. C. The University of Toronto Centre for Minimally Invasive Surgery, Saint Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, Canada aut Surgical Endoscopy Springer-Verlag 14/3(2000-03-01), 258-263 0930-2794 14:3<258 2000 14 464 https://doi.org/10.1007/s004640000050 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000050 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schlachta C. M. The University of Toronto Centre for Minimally Invasive Surgery, Saint Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, Canada aut NATIONALLICENCE 700 1- Mamazza J. The University of Toronto Centre for Minimally Invasive Surgery, Saint Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, Canada aut NATIONALLICENCE 700 1- Seshadri P. A. The University of Toronto Centre for Minimally Invasive Surgery, Saint Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, Canada aut NATIONALLICENCE 700 1- Cadeddu M. The University of Toronto Centre for Minimally Invasive Surgery, Saint Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, Canada aut NATIONALLICENCE 700 1- Poulin E. C. The University of Toronto Centre for Minimally Invasive Surgery, Saint Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, Canada aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/3(2000-03-01), 258-263 0930-2794 14:3<258 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer