Effect of laparoscopic surgery on the risk for surgical site infections in colorectal resection: results from the Health Insurance Review & Assessment Service Database.

Purpose: To compare the hospital length of stay (LOS), duration of antibiotic use, medical costs, and incidence of surgical site infection (SSI) between laparoscopic colorectal surgery (Lap-CRS) and open CRS (Open-CRS).

Methods: We retrospectively reviewed data of the Health Insurance Review and Assessment Service Surgical Antibiotic Prophylaxis assessment (7th assessment, 2015); the nationwide data were collected from patients who underwent CRS from September to November 2015 in low volume hospital to the tertiary hospital level in Korea.

Results: All 2,751 patients who underwent elective CRS were assessed. The mean hospital LOS (12.18 days 14.16 days, P < 0.001) and mean postoperative LOS (8.21 days 9.46 days, P < 0.001) were shorter in the Lap-CRS group than in the Open-CRS group. The mean duration of antibiotic use was shorter in the Lap-CRS group (2.91 days 3.64 days, P = 0.033). The rate of SSI was lower in the Lap-CRS group, but there was no significant difference between the groups (3.57% 5.01%, P = 0.133). Among the SSI group, the mean LOS (19.5 days 24.9 days, P = 0.081), duration of antibiotic use (12.62 days 15.46 days, P = 0.097), and medical costs showed no significant difference between the 2 groups.

Conclusion: Lap-CRS is significantly associated with reduced hospital LOS and the duration of antibiotic use in this study. However, we could not identify significant differences in the incidence of SSI according to the type of surgery. To assess the overall benefits of Lap-CRS, studies including the rate of SSI up to 30 days postoperatively will be needed in the future.