Robbert J I Bosker1, Esther Van't Riet2, Mirre de Noo3, Maarten Vermaas4, Tom M Karsten5, Jean-Pierre Pierie6,7. 1. Department of Surgery, Deventer Hospital, Deventer, The Netherlandsr.bosker@dz.nl. 2. Department of Epidemiology, Deventer Hospital, Deventer, The Netherlands. 3. Department of Surgery, Deventer Hospital, Deventer, The Netherlands. 4. Department of Surgery, IJsselland Hospital, Capelle aan den IJssel, The Netherlands. 5. Department of Surgery, Onze Lieve Vrouwen Gasthuis, Amsterdam, The Netherlands. 6. Department of Surgery, Medical Center Leeuwarden, Leeuwarden Institute for Minimally Invasive Surgery (LIMIS), Leeuwarden, The Netherlands. 7. Postgraduate School of Medicine University Medical Center Groningen and University Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND: There is ongoing debate whether laparoscopic right colectomy is superior to open surgery. The purpose of this study was to address this issue and arrive at a consensus using data from a national database. METHODS: Patients who underwent elective open or laparoscopic right colectomy for colorectal cancer during the period 2009-2013 were identified from the Dutch Surgical Colorectal Audit. Complications that occurred within 30 days after surgery and 30-day mortality rates were calculated and compared between open and laparoscopic resection. RESULTS: In total, 12,006 patients underwent elective open or laparoscopic surgery for right-sided colorectal cancer. Of these, 6,683 (55.7%) underwent open resection and 5,323 (44.3%) underwent laparoscopic resection. Complications occurred within 30 days after surgery in the laparoscopic group in 26.1% of patients and in 32.1% of patients in the open group (p < 0.001). Thirty-day mortality was also significantly lower in the laparoscopic group (2.2 vs. 3.6% p < 0.001). CONCLUSION: In this non-randomized, descriptive study conducted in the Netherlands, open right colectomy seems to have a higher risk for complications and mortality as compared to laparoscopic right colectomy, even after correction for confounding factors.
BACKGROUND: There is ongoing debate whether laparoscopic right colectomy is superior to open surgery. The purpose of this study was to address this issue and arrive at a consensus using data from a national database. METHODS:Patients who underwent elective open or laparoscopic right colectomy for colorectal cancer during the period 2009-2013 were identified from the Dutch Surgical Colorectal Audit. Complications that occurred within 30 days after surgery and 30-day mortality rates were calculated and compared between open and laparoscopic resection. RESULTS: In total, 12,006 patients underwent elective open or laparoscopic surgery for right-sided colorectal cancer. Of these, 6,683 (55.7%) underwent open resection and 5,323 (44.3%) underwent laparoscopic resection. Complications occurred within 30 days after surgery in the laparoscopic group in 26.1% of patients and in 32.1% of patients in the open group (p < 0.001). Thirty-day mortality was also significantly lower in the laparoscopic group (2.2 vs. 3.6% p < 0.001). CONCLUSION: In this non-randomized, descriptive study conducted in the Netherlands, open right colectomy seems to have a higher risk for complications and mortality as compared to laparoscopic right colectomy, even after correction for confounding factors.