A comparison of short-term outcomes between elective laparoscopic and open surgery in patients with colorectal cancer: The first five-year experience at Nakornping Hospital, Chiang Mai, Thailand
Keywords:
laparoscopic surgery, open surgery, colorectal cancer, postoperative outcomes, risk ratioAbstract
Introduction: Laparoscopic surgery has become increasingly popular as an alternative to open surgery for colorectal cancer. However, the comparative short-term outcomes following advancements in surgical techniques at Nakornping Hospital have not been systematically evaluated. This study aimed to compare short-term outcomes of laparoscopic versus open elective colorectal surgery over the hospital’s initial five-year experience.
Objective: To compare laparoscopic and open elective colorectal cancer surgeries in terms of operative time, blood loss, lymph node yield, time to soft diet, length of hospital stays, postoperative complications, and operative costs.
Study Method: A retrospective cohort study was conducted using medical records of patients who underwent elective colorectal cancer surgery between April 1, 2018, and July 25, 2022, at Nakornping Hospital, Chiang Mai, Thailand. Comparative analyses were performed using Student’s t-test and regression analysis. Postoperative complications were assessed using binary regression analysis. Univariable analysis reported crude risk ratios, while multivariable analysis reported adjusted risk ratios with 95% confidence intervals (CI). A p-value of <0.05 was considered statistically significant.
Results: Two hundred and ninety-four cases were recruited, a total of 66 patients met the final inclusion criteria—31 underwent laparoscopic and 35 underwent open surgery. Laparoscopic surgery was associated with significantly longer operative time (mean difference: 108.99 minutes, 95% CI: -148.98, -68.99), but faster resumption of soft diet (49.93 hours earlier, 95% CI: 19.74, 80.11), shorter hospital stays (2.12 days shorter, 95% CI: 0.41, 3.83), and fewer postoperative complications (adjusted RR: 0.40, 95% CI: 0.16, 0.99). However, it yielded fewer lymph nodes (mean difference: -8.11 nodes, 95% CI: 2.77, 13.46) and incurred higher operative costs (mean difference: 34,046.97 THB, 95% CI: -49,624.82, -18,469.11). No significant difference in blood loss was observed.
Conclusions: Elective laparoscopic surgery for colorectal cancer is associated with faster postoperative recovery, shorter hospitalization, and lower complication rates compared to open surgery. Despite a longer operative time, fewer lymph nodes harvested, and increased healthcare costs, laparoscopic surgery may be considered the preferred approach in patients for whom rapid recovery and reduced postoperative risks are prioritized.
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