World Journal of Laparoscopic Surgery

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VOLUME 17 , ISSUE 1 ( January-April, 2024 ) > List of Articles

Original Article

Laparoscopic vs Open Colorectal Surgeries in Urgent Surgical Situations

Loay M Gertallah, Ahmed M Abdelaziz, Ahmed I Elagrody, Ahmed S Allam, Mohamed Elbaz, Mahmod Ghoname, Mahmoud Sherbeiny, Ahmed L Sharaf, Ola A Harb, Mahmoud Abdelaziz, Mohamed Negm

Keywords : Advanced laparoscopic surgery, Laparoscopic, Open, Minimally invasive surgeries, Open surgery, Urgent colectomy

Citation Information : Gertallah LM, Abdelaziz AM, Elagrody AI, Allam AS, Elbaz M, Ghoname M, Sherbeiny M, Sharaf AL, Harb OA, Abdelaziz M, Negm M. Laparoscopic vs Open Colorectal Surgeries in Urgent Surgical Situations. World J Lap Surg 2024; 17 (1):38-43.

DOI: 10.5005/jp-journals-10033-1607

License: CC BY-NC 4.0

Published Online: 14-02-2024

Copyright Statement:  Copyright © 2024; The Author(s).


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.

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