Surgery ·
Laparoscopic Subtotal Colectomy Shows Similar Major Morbidity to Open Surgery
A propensity-matched study compared open and laparoscopic first-stage subtotal colectomy in 744 patients with ulcerative or indeterminate colitis. Major complications and mortality did not differ significantly, while laparoscopy was associated with faster gastrointestinal recovery and a shorter hospital stay but more reoperations.
- Matched cohort included 744 patients with UC or indeterminate colitis.
- Major complications and 30-day mortality did not differ significantly.
- Laparoscopy was linked to shorter stays but more reoperations.
Researchers evaluated patients with ulcerative or indeterminate colitis who underwent first-stage subtotal colectomy between 2005 and 2025. After 1:1 propensity-score matching on baseline characteristics, acuity and medication exposure, the analysis included 372 pairs. Outcomes included perioperative morbidity, recovery, length of stay, reoperation and 30-day mortality; regression models adjusted for surgical era.
Laparoscopy took longer than open surgery (225 vs. 150 minutes), but first stoma output occurred sooner (2 vs. 3 days) and hospital stay was shorter (6 vs. 7 days). Overall morbidity was 27.4% with laparoscopy and 25.5% with open surgery; major complications occurred in 7.3% and 4.6%, respectively, with neither difference statistically significant. Thirty-day mortality was 0.5% in each group. Reoperations were more frequent after laparoscopy (5.1% vs. 1.3%), often for diagnostic re-laparoscopy, washout or drainage, or hemostasis.
The retrospective, propensity-matched findings suggest no statistically significant increase in major morbidity with laparoscopy, but do not establish equivalence. Age and preoperative steroid use, rather than surgical approach, were independent predictors of major complications. The results concern first-stage colectomy and should not be assumed to apply to restorative pouch surgery.
In practice
For patients with ulcerative or indeterminate colitis undergoing first-stage subtotal colectomy, this propensity-matched retrospective study found no statistically significant difference in major complications or 30-day mortality between laparoscopic and open approaches. Laparoscopy was associated with earlier stoma output and a one-day shorter median hospital stay, but more reoperations. These findings may inform discussion of operative trade-offs, but matching cannot eliminate residual confounding, and the study does not establish equivalence or address restorative pouch surgery.
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Surgical Endoscopy: Laparoscopic first-stage subtotal colectomy for ulcerative and indeterminate colitis: a propensity-matched study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.