Laparoscopic <em>versus</em> Open Surgery in Colorectal Cancer: Is Laparoscopy Safe Enough?

Objective: To compare the early and long-term outcomes of laparoscopic and open surgery in colorectal cancer stages 1-3.

Study Design: Comparative study.

Place And Duration Of Study: Department of Gastroenterological Surgery, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey, from January 1, 2017 to January 1, 2021.

Methodology: A total of 142 patients, who underwent surgery for colorectal cancer with a follow-up period of at least 3 years, were included in the study. The groups of the patients; (Group A) treated with laparoscopic surgery, and (Group B) treated with open surgery, were compared in respect of general characteristics, short and long-term morbidity, mortality, and oncological outcomes.

Results: Body Mass Index (BMI) values were higher, and the duration of surgery was shorter in Group A patients compared to Group B (p<0.05). The re-operation rate (12.2%) was observed to be statistically and significantly high in Group B (p=0.040). In comparison of the oncological outcomes, a significantly greater number of metastatic lymph nodes were removed in Group B (p=0.004). Stage 2A (31.1%) was observed at a higher frequency in Group A, and Stage 3C was significantly higher in Group B (25.7%) (p=0.037). There was no statistically significant difference between the groups in terms of the number of lymph nodes removed, insufficient lymph nodes dissection (<12), surgical margin negativity, local recurrence, and distant metastasis.

Conclusion: For the selected patient group with early-stage colorectal tumours, laparoscopic surgery has short-term oncological outcomes similar to those of open surgery and relatively lower morbidity and mortality rates.

Key Words: Laparoscopic surgery, Colorectal cancer, Open surgery, oncological Outcomes.