title: Comparative analysis of open and laparoscopic colectomy for malignancy in a developing country.
abstract: OBJECTIVE
  To compare the short-term, including oncologic, outcomes of open vs laparoscopic colectomy for cancer in a developing country.
  
  
  METHODS
  The records of patients who underwent elective open and laparoscopic colectomies for cancer at the University Hospital of the West Indies between January 2005 and December 2010 were retrospectively reviewed. Demographic (age, gender, Charlson comorbidity index score), peri-operative, post-operative and oncologic data were collected for each patient. Specific oncologic variables included lymph node yield, pathologic stage, grade, proximal, distal and circumferential margin involvement. Fisher's exact, Mann-Whitney, and binary logistic regression tests were used for analysis. Significance level was set at P < 0.05.
  
  
  RESULTS
  There were 87 cases for open colectomy (OC) and 17 cases for laparoscopic colectomy (LC). Demographics did not significantly differ between OC and LC groups. Intra-operative blood loss and post-operative analgesic requirements did not significantly differ between groups. There was a trend towards longer operating times in OC group and shorter hospital stay in the LC group. Lymph node yield (14 vs 14, P = 0.619), proximal (10 cm vs 7 cm, P = 0.353) and distal (8 cm vs 8 cm, P = 0.57) resection margin distance and circumferential margin involvement (9 vs 0, P = 0.348) did not significantly differ between groups. Thirty-day morbidity was equivalent between groups (22 vs 6, P = 0.774). There were 6 deaths within 30 d of initial procedure, all in the OC group (6.9%).
  
  
  CONCLUSIONS
  Laparoscopic colectomy in a developing country is oncologically safe and represents a option for colonic malignancies in these regions. Such data encourage the continued laparoscopic development.
authors: Pierre-Anthony Leake, Patrick O Roberts, Joseph M Plummer, Department of Surgery, Radiology, Anaesthesia and Intensive Care, Faculty of Medical Sciences, University of the West Indies, Kingston 7, Jamaica.
authors: Pierre-Anthony
authors: PA
authors: Leake
authors: Pierre-Anthony Leake, Patrick O Roberts, Joseph M Plummer, Department of Surgery, Radiology, Anaesthesia and Intensive Care, Faculty of Medical Sciences, University of the West Indies, Kingston 7, Jamaica.
authors: Kristen
authors: K
authors: Pitzul
authors: Pierre-Anthony Leake, Patrick O Roberts, Joseph M Plummer, Department of Surgery, Radiology, Anaesthesia and Intensive Care, Faculty of Medical Sciences, University of the West Indies, Kingston 7, Jamaica.
authors: Patrick O
authors: PO
authors: Roberts
authors: Pierre-Anthony Leake, Patrick O Roberts, Joseph M Plummer, Department of Surgery, Radiology, Anaesthesia and Intensive Care, Faculty of Medical Sciences, University of the West Indies, Kingston 7, Jamaica.
authors: Joseph M
authors: JM
authors: Plummer
keywords: Cancer; Colectomy; Colorectal; Developing country; Laparoscopy; Oncology; Outcomes; Short-term