LAPAROSCOPIC COLORECTAL SURGERY;

DISTRICT GENERAL HOSPITAL EXPERIENCE

Abstract

Objective: The aim of this study was to assess the outcome of laparoscopic
colorectal procedures performed in a district general hospital within 5 years period and to
compare it with patients who had an open procedure during the same period. Patients and
Methods: Data were collected retrospectively from patient’s case notes retrieved from hospital
medical records. One hundred consecutive cases of laparoscopic colonic resection including
both benign and malignant diseases between 2005 and 2010 were analysed for perioperative
and long term outcome and were compared with consecutive one hundred cases of open
colectomies. Results: Overall conversion rate was 6% for laparoscopic group. The mean major
complication rates in laparoscopic group were 5% (3% in open group) and minor complications
occurred in 18% (28% in open group). There was no mortality in either group. The overall
morbidity rate was 23% in laparoscopic group as compared to 31% in open colectomy group. In
64 cases, curative laparoscopic resections were performed for colorectal malignancy while 72
patients had resections for cancer in open group. The mean lymph node harvest in laparoscopic
group was 13.2 nodes as compared to 12.4 in open group; no port-site recurrence was
documented at a mean follow-up of 26 months. Average duration of surgery was 180 minutes as
compared to 140 minutes in open group. Mean postoperative hospital stay was reduced from 13
days to 7 days. (Open Vs. Lap). There was no statistically significant difference in major
complication rates and mortality. Conclusions: Laparoscopic colorectal surgery is safe and
feasible in elective colorectal cases and reduces the hospital stay without any added morbidity.