engleski

Complications in laparoscopic and open colorectal resections: a single surgeon experience

Aims: Open or laparoscopic colorectal surgery burden risks of various complications. This prospective study was designed to examine the complications and outcome after open and laparoscopic colorectal resections done by a single surgeon. Methods: Laparoscopic colectomy patients from a prospective database were matched for age, gender, and disease-related grouping to patients who underwent the same operation by the open approach over the same period (2005 to 2010) in Clinical Hospital “Dubrava” Zagreb Croatia. Analysis and the 2 groups were compared for intraoperative and postoperative complications. Results: A total of 137 patients (119 for malignant and 18 for benign conditions) underwent elective laparoscopic (68) and open (69) resections. Conversion rate was 13.24% in laparoscopic resections (9 of 68). Majority of conversion (7 of 9) were preemptive and 2 of 9 due to intraoperative complications (1 uncontrolled bleeding and 1 lesion of the ureter). Reasons for conversion were T4 tumor in 5 pts and bulky tumors in 2 pts. Intraoperative complications developed only in 2 patients submitted to laparoscopic resection (2 /68, 2.94 %). In open surgery no intraoperative complications were detected. Postoperative complications occurred in 15 of 137 (10.95 %). Overall postoperative complication rate for laparoscopic resection was 6 of 68 (8, 82%) versus 9 of 69 (13, 04%) for open resection. Wound infection developed in 8 pts: 5 of 69 (7, 25%) in open and 3 of 68 (4, 41%) in laparoscopic surgery. Anastomotic leak occurred only after low rectal resections in 4 of 76 (5, 26%) ; 3 of 50 (6%) after laparoscopic and 1 of 26 (3.85%) after open approach. Other complications included postoperative paralytic ileus and small bowel obstruction in 3 pts all after open resections. The rate of complications requiring reoperation was similar in both groups ; 5 of 68 (8, 62%) in laparoscopic and 5 of 69 (7, 24%) in open group. Hospital stay for patients with complications was significantly longer (range 8-71 days). Conclusion: In our series laparoscopic colorectal surgery showed more intraoperative complications but overall postoperative complications occurred more frequent in open surgery. Although the number of patients is too small for serious conclusions but it seems that shows some trends.

laparoscopy ; colorectal surgery

Presented on 20th International Congress of the European Association for Endoscopic Surgery (EAES) Brussels, Belgium, 20–23 June 2012