Laparoscopic vs Open Colorectal Surgeries in Urgent Surgical Situations

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Gertallah L.M.; Abdelaziz A.M.; Elagrody A.I.; Allam A.S.; Elbaz M.; Ghoname M.; Sherbeiny M.; Sharaf A.L.; Harb O.A.; Abdelaziz M.; Negm M.

Journal: World Journal of Laparoscopic Surgery

Publisher: Jaypee Brothers Medical Publishers (P) Ltd

Publication Date: 2024

Volume / Issue: Volume 17 / Issue 1

Pages: 38–43

ISSN: 9745092

DOI: 10.5005/jp-journals-10033-1607

Scopus: View on Scopus

Document Type: Article

Authors and Affiliations

Gertallah L.M., Department of General Surgery, Zagazig University, Zagazig, Egypt; Abdelaziz A.M., Department of General Surgery, Zagazig University, Zagazig, Egypt; Elagrody A.I., Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt; Allam A.S., Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt; Elbaz M., Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; Ghoname M., Department of Hepatogastroenterology and Infectious Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Sherbeiny M., Department of Hepatology and Gastroenterology, Theodor Bilharz, Research Institute, Giza, Egypt; Sharaf A.L., Department of Tropical Medicine, Zagazig University, Zagazig, Egypt; Harb O.A., Department of Pathology, Zagazig University, Zagazig, Egypt; Abdelaziz M., Department of General Surgery, Surgical Oncology, Oncology Center, Mansura University, Egypt; Negm M., Department of General Surgery, Zagazig University, Zagazig, Egypt

Abstract

Background: Using minimally invasive surgeries (MISs) in non-elective and urgent cases was assessed by many previous studies and found to be nearly similar to and even better than open surgeries. There was no sufficient data regarding long-term, follow-up, tumor recurrence, or survival data of studied patients in those studies. Aim of our study is to compare performing MIS and open colectomy in patients undergoing urgent (nonemergency, non-elective) colectomies, regarding primary outcomes of 30-day morbidity and mortality, secondary short-term outcomes, long-term and follow-up findings of included patients. Patients and methods: A total of 200 patients were included, and we divided them into two groups according to the performed surgical approach: The first group included 100 patients who underwent MISs and the second group underwent open surgery and included 100 patients. We evaluated the primary patients’ outcome which was 30-day postoperative morbidity and mortality. Secondary evaluated patients’ outcomes included; ICU admissions, surgical reintervention, wound infection or dehiscence, postoperative ileus, postoperative leakage at an anastomotic site, and occurrence of intra-abdominal infections. Long-term evaluated patients’ outcomes included the occurrence of incisional hernias and oncological outcomes as overall survival rates and recurrence rates. Results: Regarding demographic and baseline data, patients who underwent open surgery were older (65 years vs 58 years, p < 0.001). More females underwent open surgery (54% vs 50%, p = 0.002). Overweight and obese patients were more likely to have MIS colectomy (p < 0. 001). There is a statistically significant relation between approach and all histopathological types (24.2% within the laparoscopic approach vs 11.6% within the open approach had mucoid carcinoma), N stage (82.8% within the laparoscopic approach vs 43.8% within open the approach had N stage 0), American Joint Committee on Cancer (AJCC) stage (63.8% within laparoscopic approach vs 20.8% within open approach had AJCC stage II) Open colectomy were liable to be diagnosed with acute diverticulitis and volvulus (p < 0.001). Operative time is longer in MIS patients in comparison to open colectomy patients the median time to complete an MIS colectomy was 21 minutes longer (p < 0.001). Postoperative mortality is less in MIS patients than the open surgery patients. On univariable analysis, 30-day postoperative mortality following MIS colectomy was lower than that after open surgery (p < 0.05). Conclusions: Using MIS in urgent colectomy is associated with less postoperative, morbidity, mortality, short-term complications, and long-term complications than open colectomy. © The Author(s). 2024 Open Access.

Keywords

Advanced laparoscopic surgery; Laparoscopic; Minimally invasive surgeries; Open; Open surgery; Urgent colectomy; abdominal infection; adult; Article; colectomy; colorectal surgery; comparative study; female; hernia; hospitalization; human; human tissue; laparoscopy; length of stay; major clinical study; male; minimally invasive surgery; operation duration; outcome assessment; overall survival; recurrence risk; retrospective study; surgical mortality; survival rate; treatment outcome; wound dehiscence; wound infection

Citation Information

Scopus Citations: 0

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