Surgical and Oncological Outcomes of Laparoscopic Colon Resection for Colorectal Cancer.

Abstract

Abstract Background: Laparoscopy is one of the major advances in surgery in the last 30 years with many benefits including a lower incidence of postoperative ileus, less postoperative pain, shortened hospital stay, quicker return to daily activity, less wound-related complications and improved cosmetic results. Although initially laparoscopy was used for colon resection for benign cases, it’s now widely used for colorectal cancer resections after strong evidence has confirmed its safety and efficacy. We aim to report both surgical and oncological outcomes of our first series of laparoscopic colorectal cancer resections. Methods: Laparoscopic colorectal resection service was set up in 2013. Data of all consecutive colorectal cancers were collected prospectively. Patients with locally advanced diseases and who required emergency operations for bowel obstruction or perforation were excluded. We analysed demographic, operative, postoperative and histopathological data for all patients who were included in the study. Results: A total of 124 patients were presented to our unit between January 2013 and January 2023. Only 112 patients fulfilled the inclusion criteria and underwent laparoscopic resections. The median age of patients was 54.5 ( 19-92) years. Majority of patients were men, 55.4% of them. In 35% of cases, the cancer was located in the sigmoid and in the rectum in 33.5%. Laparoscopic anterior resection was the commonest procedure, 45%, followed by right hemicolectomy in 15% of cases. The conversion rate to open surgery was 8%. The commonest cause to convert to open were dilated bowel loops and tumour adherence to other structures. The mean operative time was 190 minutes (130-280). The mean hospital stay was 3 (2-7) days. No complication has been reported in 84% of patients. Among the complications, wound infection was the most common one, 6.3%. There were 6 anastomotic leaks (5.4%). The mean lymph node number harvested was 13 (3 – 66). In 62.5% lymph node count was 12 or more. The distal resection margin was over 2 cm in 89.3%. The 5 years disease-free survival rate was 87.3%. Conclusion: This study showed that initiation of laparoscopic colorectal resection is feasible and safe both surgically and oncologically with the benefits of short hospital stay, adequate resection margins and lymph node harvested