Evaluation of Endoscopic Surgery by a Prediction Scoring System 'E-PASS' for Postsurgical Risk

Yoshio Haga, Satoshi Ikei, Shigeru Katafuti, Junichi Mizutani, Yuichi Hirano and Ryoko Nishioka

Department of Surgery, Kumamoto National Hospital

Purpose: Whether laparoscopic surgery (LS) is actually less invasive than other procedures remains controversial. We studied the invasiveness of LS using E-PASS prediction scoring for postoperative complications. Methods: Postoperative morbidity and mortality, length of hospital stay, hospital stay costs, surgical stress score (SSS) and comprehensive risk score (CRS) of E-PASS were evaluated and compared to open surgery (OS) in 1,754 patients electing to undergo LS. Results: When SSS was evaluated for each surgical procedure, SSS for LS generally decreased compared to OS. LS had 3.0% postoperative morbidity 0% mortality, similar to E-PASS prediction. When LS and OS were evaluated together, there was a significant correlation between CRS and the severity of postoperative complications. A significant correlation was also observed between CRS and the cost of hospital stay. LS had a lower CRS, a shorter length of stay, lower cost, and less severe complications than OS. Conclusion: Our results suggest that LS is less invasive than OS and is applicable even to poor risk patients.

Key words
laparoscopic surgery, complication, E-PASS

Reprint requests
Yoshio Haga Department of Surgery, Kumamoto National Hospital 1-5 Ninomaru, Kumamoto, 860-0008 JAPAN

Accepted
December 19, 2000

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