Laparoscopic <em>versus</em> Open Surgery in Colorectal Cancer: Is Laparoscopy Safe Enough?

OBJECTIVE

To compare the early and long-term outcomes of laparoscopic and open surgery in colorectal cancer stages 1-3.

STUDY DESIGN

Comparative study.

PLACE AND DURATION OF STUDY

Department of Gastroenterological Surgery, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey, from January 1, 2017 to January 1, 2021.

METHODOLOGY

A total of 142 patients, who underwent surgery for colorectal cancer with a follow-up period of at least 3 years, were included in the study. The groups of the patients; (Group A) treated with laparoscopic surgery, and (Group B) treated with open surgery, were compared in respect of general characteristics, short and long-term morbidity, mortality, and oncological outcomes.

RESULTS

Body Mass Index (BMI) values were higher, and the duration of surgery was shorter in Group A patients compared to Group B (p<0.05). The re-operation rate (12.2%) was observed to be statistically and significantly high in Group B (p=0.040). In comparison of the oncological outcomes, a significantly greater number of metastatic lymph nodes were removed in Group B (p=0.004). Stage 2A (31.1%) was observed at a higher frequency in Group A, and Stage 3C was significantly higher in Group B (25.7%) (p=0.037). There was no statistically significant difference between the groups in terms of the number of lymph nodes removed, insufficient lymph nodes dissection (<12), surgical margin negativity, local recurrence, and distant metastasis.

CONCLUSION

For the selected patient group with early-stage colorectal tumours, laparoscopic surgery has short-term oncological outcomes similar to those of open surgery and relatively lower morbidity and mortality rates.

KEY WORDS

Laparoscopic surgery, Colorectal cancer, Open surgery, oncological Outcomes.