Prospective comparison of laparoscopic versus open resection for benign colorectal disease.
Laparoscopic surgery is not being applied in a widespread manner in the management of benign or malignant colorectal disorders. This is a prospective comparison of 279 patients who underwent elective colorectal surgery. Colorectal diseases included inflammatory bowel, diverticular disease, colonic inertia, polyps, and rectal prolapse. Data included 136 patients who underwent laparoscopic surgery (mean age, 51.3 years) and 143 who underwent open surgery (mean age, 56.0 years). Thirteen patients' procedures were converted to open, but their results were included in the laparoscopic surgery group. There was no significant difference in operative time, postoperative complications, morbidity, or mortality between the laparoscopic and open surgery groups. More patients in the laparoscopic group had significant cardiac disease (6.0%, laparoscopic; 0.7%, open; = 0.01). More patients in the open group had undergone previous gastrointestinal surgery (3.7%, laparoscopic; 11.2%, open; = 0.02). The laparoscopic group used less postoperative analgesia and resumed oral feeding quicker ( < 0.05). In addition, time to first flatus and bowel movement was faster ( < 0.05), and the length of postoperative hospital stay (7.7 +/- 15.8 versus 11.0 +/- 8.3; = 0.03) was shorter in the laparoscopic surgery group. There are significant advantages in postoperative recovery with the laparoscopic technique. If proven to be cost-effective, laparoscopic colorectal surgery for benign diseases should become the standard of surgical care.
Hong
Dennis
D
Department of Surgery, St. Joseph's Hospital, McMaster University, 50 Charlton Avenue East, Hamilton, Ontario, Canada L8N 4A6.
Lewis
Mark
M
Tabet
Jeanine
J
Anvari
Mehran
M
D000328:Adult; D003108:Colonic Diseases / Q000601:surgery*; D003111:Colonic Polyps / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery*