Rbeihat Haitham S, Abu Anzeh Abdullah A, Shannaq Ruba Y, Abu Alanaz Mohammad A, Khamaiseh Alaa M, Abu Alghawai Ghaseb A, Swalqa Mahmoud, Lababneh Muhannad F, ALoun Ali, Alqaisi Majed, Uraiqat Ahmad A
Department of General Surgery, King Hussein Medical Center, Royal Medical Services, Amman, JOR.
Cureus. 2024 Nov 15;16(11):e73746. doi: 10.7759/cureus.73746. eCollection 2024 Nov.
Introduction The use of laparoscopic surgery has increased in the treatment of colorectal cancer (CRC). However, achieving oncological outcomes similar to those of open surgery remains challenging, particularly for CRC. In this comparative, retrospective study, we aim to investigate and compare the postoperative complications of open and laparoscopic CRC surgery in Jordan. Methods Using a retrospective study design, patients' records were obtained from the electronic hospital database of King Hussein Medical Center, Amman, Jordan, during the period between 2016 and 2024. Demographic data were collected for age and gender. Clinical data were collected for tumor site, tumor grade, body mass index, American Society of Anesthesiologists (ASA) score, lymph node ratio (LNR), postoperative complications such as ileus, anastomosis, stoma, renal complications, pain, wound infection, and death, and length of hospital stay. Results We included 857 CRC patients, with 437 (51.0%) undergoing laparoscopic resection and 420 (49%) undergoing open resection. The mean age was 58 years, with no age difference between the study groups. Most patients (507, 59%) were in good health based on the ASA score. The majority (671, 78%) had moderately differentiated tumors, with 320 (76%) in the open surgery group and 351 (80%) in the laparoscopy group. The mean LNR was 0.19, trending higher in the group that underwent open surgery (0.33 vs. 0.09, p = 0.065). The open surgery group had a significantly longer hospital stay (5.28 days) relative to the laparoscopic group (3.77 days, p < 0.001). Postoperative complications included wound infection (33, 3.9%), ileus (19, 2.2%), stoma (15, 1.8%), anastomosis (10, 1.2%), renal complications (9, 1.1%), and pain (6, 0.7%). The mortality rate was higher in the open surgery group (p = 0.035). Most patients (711, 83%) did not experience postoperative complications. Conclusion This is the first Jordanian study to compare long-term outcomes of CRC patients undergoing open versus laparoscopic surgical resection. Our findings suggested that the laparoscopic group had a shorter hospital stay, with no differences in postoperative complications rate between the study groups. Mortality rates were low overall but significantly higher in the open surgery group. These results suggest that laparoscopic resection may be superior for CRC surgery, though further multicenter studies are warranted to confirm our findings.
引言 腹腔镜手术在结直肠癌（CRC）治疗中的应用有所增加。然而，要实现与开放手术相似的肿瘤学治疗效果仍然具有挑战性，尤其是对于结直肠癌而言。在这项对比性回顾性研究中，我们旨在调查和比较约旦开放手术和腹腔镜结直肠癌手术的术后并发症。
方法 采用回顾性研究设计，从约旦安曼侯赛因国王医疗中心的电子医院数据库中获取2016年至2024年期间患者的记录。收集年龄和性别的人口统计学数据。收集肿瘤部位、肿瘤分级、体重指数、美国麻醉医师协会（ASA）评分、淋巴结比率（LNR）、术后并发症如肠梗阻、吻合口、造口、肾脏并发症、疼痛、伤口感染和死亡情况以及住院时间等临床数据。
结果 我们纳入了857例结直肠癌患者，其中437例（51.0%）接受了腹腔镜切除术，420例（49%）接受了开放切除术。平均年龄为58岁，研究组之间无年龄差异。根据ASA评分，大多数患者（507例，59%）健康状况良好。大多数患者（671例，78%）患有中度分化肿瘤，开放手术组有320例（76%），腹腔镜组有351例（80%）。平均LNR为0.19，在接受开放手术的组中呈上升趋势（0.33对0.09，p = 0.065）。与腹腔镜组（3.77天）相比，开放手术组的住院时间明显更长（5.28天，p < 0.001）。术后并发症包括伤口感染（33例，3.9%）、肠梗阻（19例，2.2%）、造口（15例，1.8%）、吻合口（10例，1.2%）、肾脏并发症（9例，1.1%）和疼痛（6例，0.7%）。开放手术组的死亡率更高（p = 0.035）。大多数患者（711例，83%）未经历术后并发症。
结论 这是约旦第一项比较接受开放手术与腹腔镜手术切除的结直肠癌患者长期治疗效果的研究。我们的研究结果表明，腹腔镜组的住院时间较短，研究组之间的术后并发症发生率无差异。总体死亡率较低，但开放手术组明显更高。这些结果表明，腹腔镜切除术对于结直肠癌手术可能更具优势，不过需要进一步的多中心研究来证实我们的发现。
