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Predictor of prolonged operative time in laparoscopic colorectal surgery

A study in the latest issue of the Diseases of the Colon & Rectum investigates factors that prolong operative time in laparoscopic colorectal surgery.

News image

Body surface area is a measurement of body size used in clinical settings. Its impact on laparoscopic colorectal surgery has not been previously studied.

Dr Carlos Vaccaro and colleagues from Argentina assessed the impact of body surface area on the conversion rate and laparoscopic operative time.

This study was conducted as a retrospective analysis of prospectively collected data at a single tertiary care institution.

The research team found evaluated 916 consecutive patients operated on between 2004 and 2011 were identified from a prospective database.

Conversion rates for quartile 4 was 15%
Diseases of the Colon & Rectum

The researchers analyzed conversion rate and laparoscopic operative time related to age, sex, obesity, disease location, type of disease, history of previous surgery, and body surface area.

Body surface area was calculated by the Mosteller formula. Body surface area was analyzed by the use of median and quartile cutoff values.

Multivariate models were adjusted for different confounders.

Interaction between body surface area and BMI was ruled out.

The team found that the conversion rate was 10%.

Conversion rates for quartiles 1, 2, 3, and 4 were 4%, 8%, 13%, and 15%.

The research team found that patients with body surface area 1.8 or more had a higher conversion rate than those with body surface area less than 1.8.

Multivariate analysis showed that body surface area 1.8 or more was associated with conversion, and a longer operative time after adjusting for sex, age, obesity, disease location, and type of laparoscopic approach.

Dr Vaccaro's team concludes, "Body surface area is a predictor for conversion and longer laparoscopic operative time."

"It should be considered when informing patients, selecting cases in the early learning curve, and assessing standard of care."

Dis Colon Rectum 2012: 55(11): 1153-9
12 November 2012

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