Colorectal Surgery: Single Tertiary Center Experience

Abstract

Objectives: Laparoscopic approach is nowadays being used widely for the treatment of various surgical diseases in many centers, but it has not considered as the gold standard in colorectal surgery yet.The aim of this study was to examine and compare the postoperative clinical and oncological outcomes of laparoscopic and open colorectal surgery in the light of literatüre. Methods: 526 patients who had colorectal cancer surgery in our clinic in between May 2015 and March 2023 were enrolled in this retrospective comparative study. Patients treated with open surgery were included in Group 1 (OS group) and ones treated laparoscopically includedin Group 2 (LS group). Demographics (age,sex), types of operations, ASA scores, evaluation of resected specimen, dissected lymph nodes, T invasion of tumors in groups, postoperative complications, operation time and hospital stay times and short-term morbidity and mortality were noted and compared with each other. Results: Patients in LS group had less blood loss compared with those in OS group (median 80 mL (range 0-1300) vs 155 mL (0–2000),p<0•0001), although laparoscopic surgery lasted longer than did open surgery (p<0•0001). The patients who underwent the laparoscopic surgery showed faster recovery then those who underwent open surgery, regarding first passing bowel gas (p=0.045), time of first bowel motion (p=0.04), time to resume normal diet (p=0.041), and time to ambulate independently (p=0.037). Hospital stay time was significantly shorter in Laparoscopy group (p<0.001). Oncological satisfaction of resection as assessed by number of removed lymph nodes, distal resection margin did not differ between groups (p=0.564, p=0.698). Although wound infection was significantly higher in OS group (p<0.001), other morbidity parameters and mortality after colectomy did not differ between two groups. Conclusion: Laparoscopic colorectal surgery gives satisfactory outcomes as compared to open surgery in many aspects such as clinical and oncological outcomes and early recovery. Considering the short-term outcomes of the present study, laparoscopic colorectal surgery in experienced hands seems to be safe and feasible for the treatment of the colorectal cancers.