Benefits of a laparoscopic approach for second colorectal resection after colectomy or proctectomy

Abstract

Abstract Background: Alaparoscopic approach generally provides several benefits in patients who undergo colon or rectal surgery without jeopardizing oncological outcomes. However, there is a paucity of studies on comparative outcomes of laparoscopic versus open approaches for second primary colorectal lesions after colectomy or proctectomy. Methods: From patients with colorectal disease who underwent surgery between 2008 and 2021 at our hospital, we collected 73 consecutive patients who had previous colorectal surgery for this retrospective study. Based on the second surgery approach (laparoscopic or open), patients were classified into the Lap (n=38) or Op group (n=35). Patients’ baseline data and perioperative and postoperative outcomes were compared between the two groups. Results: Four patients (11%) of the Lap group needed conversion to laparotomy. The intraoperative blood loss was lower in the Lap group than the Op group (median: 50 ml vs 210 ml, p=0.0003). The time to first bowel movement was shorter in the Lap group than the Op group (median: 2.7 days vs 3.5 days, p=0.004). The operative time, frequencies of postoperative morbidities, andoverall survival did not differ between the two groups. Conclusion: Laparoscopic surgery appeared feasible and beneficial for selected patients undergoing second colorectal resection after colectomy or proctectomy regarding blood loss and bowel function recovery without affecting other outcomes.