Adhesion-related readmissions after open and laparoscopic surgery
| العنوان: | Adhesion-related readmissions after open and laparoscopic surgery |
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| المؤلفون: | Harry van Goor, Martijn W J Stommel, Pille Pargmae, Erica A. Bakkum, Richard P. G. ten Broek, Harold Ellis, Ewen A. Griffiths, Nicole D. Bouvy, M. C. Parker, Pepijn Krielen |
| المساهمون: | Surgery, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health |
| المصدر: | Krielen, P, Stommel, M W J, Pargmae, P, Bouvy, N D, Bakkum, E A, Ellis, H, Parker, M C, Griffiths, E A, van Goor, H & ten Broek, R P G 2020, ' Adhesion-related readmissions after open and laparoscopic surgery : a retrospective cohort study (SCAR update) ', The Lancet, vol. 395, no. 10217, pp. 33-41 . https://doi.org/10.1016/S0140-6736Test(19)32636-4 Lancet, 395(10217), 33-41. Elsevier Science The Lancet (London), 395, 33-41 The Lancet (London), 395, 10217, pp. 33-41 |
| بيانات النشر: | Elsevier Science, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Laparoscopic surgery, medicine.medical_specialty, small-bowel obstruction, medicine.medical_treatment, Population, Adhesion (medicine), 030204 cardiovascular system & hematology, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, 0302 clinical medicine, medicine, 030212 general & internal medicine, Laparoscopy, education, RISK, education.field_of_study, medicine.diagnostic_test, business.industry, Incidence (epidemiology), PAIN, Retrospective cohort study, General Medicine, medicine.disease, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Cohort, HOSPITAL READMISSIONS, business, Abdominal surgery |
| الوصف: | Background: Adhesions are the most common driver of long-term morbidity after abdominal surgery. Although laparoscopy can reduce adhesion formation, the effect of minimally invasive surgery on long-term adhesion-related morbidity remains unknown. We aimed to assess the impact of laparoscopy on adhesion-related readmissions in a population-based cohort. Methods: We did a retrospective cohort study of patients of any age who had abdominal or pelvic surgery done using laparoscopic or open approaches between June 1, 2009, and June 30, 2011, using validated population data from the Scottish National Health Service. All patients who had surgery were followed up until Dec 31, 2017. The primary outcome measure was the incidence of hospital readmissions directly related to adhesions in the laparoscopic and open surgery cohorts at 5 years. Readmissions were categorised as directly related to adhesions, possibly related to adhesions, and readmissions for an operation that was potentially complicated by adhesions. We did subgroup analyses of readmissions by anatomical site of surgery and used Kaplan-Meier analyses to assess differences in survival across subgroups. We used multivariable Cox-regression analysis to determine whether surgical approach was an independent and significant risk factor for adhesion-related readmissions. Findings: Between June 1, 2009, and June 30, 2011, 72 270 patients had an index abdominal or pelvic surgery, of whom 21 519 (29·8%) had laparoscopic index surgery and 50 751 (70·2%) had open surgery. Of the 72 270 patients who had surgery, 2527 patients (3·5%) were readmitted within 5 years of surgery for disorders directly related to adhesions, 12 687 (17·6%) for disorders possibly related to adhesions, and 9436 (13·1%) for operations potentially complicated by adhesions. Of the 21 519 patients who had laparoscopic surgery, 359 (1·7% [95% CI 1·5–1·9]) were readmitted for disorders directly related to adhesions compared with 2168 (4·3% [4·1–4·5]) of 50 751 patients in the open surgery cohort (p |
| اللغة: | English |
| تدمد: | 1474-547X 0140-6736 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::27587ef74d6c965848386ff88a6d769bTest https://cris.maastrichtuniversity.nl/en/publications/fd5bc022-f080-46d1-be26-d28fd01ff1e5Test |
| حقوق: | RESTRICTED |
| رقم الانضمام: | edsair.doi.dedup.....27587ef74d6c965848386ff88a6d769b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1474547X 01406736 |
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