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.

laparoscopic colorectal surgery

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