INTRODUCTION: Laparoscopic surgery has become the gold standard for surgical treatment of diseases of the gastrointestinal tract. In terms of results, it is comparable and has established itself as a reliable alternative to conventional surgery, both in benign and malignant diseases. The minimally invasive approach enjoys all the short-term advantages, such as less postoperative pain, better cardiopulmonary function, faster recovery of the gastrointestinal passage, faster mobilization and recovery, shorter intensive care, and hospital stay. Long-term oncological outcomes still remain debatable.
AIM: Our study aims to demonstrate the advantages of the laparoscopic approach and highlight some of its limiting factors in terms of operative time and postoperative stay in the conditions of the Clinic of Anesthesiology and Intensive Care (CAIL).
MATERIALS AND METHODS: A total of 42 patients with histologically proven colorectal cancer (CRC) and resection with primary anastomosis were retrospectively included. We divided the patients into two groups according to the surgical technique: Group A: 21 patients operated by laparoscopic surgery (LS), and Group B: 21 patients operated by conventional open surgery (OS). Some of the basic characteristics: sex, age, body mass index (BMI), preoperative staging, mean operative time, postoperative period in CAIL, and analgesia, were examined.
RESULTS: The mean operative time (MOT) in the LS group was 201 min and 189 min in the OS group. With respect to the gender factor, the MOT in LS was 211 min in men and 185 min in women, while in OS, there was no difference in MOT in relation to the gender factor. The mean operative time in patients compared to BMI was examined. In patients with normal weight, it was 160 min in LS and 351 min in OS, 220 min and 164 min in overweight patients, and 218 min and 197 min in obese patients, respectively. In the OS group, all patients had a stay in CAIL of more than 72 hours, while in LS only 57% of patients stayed for 72 hours. Regarding intraoperative and postoperative analgesia, natural opioid analgesics, including morphine, were administered to 10% of the LS group and 100% of the OS patients. Semi-synthetic opioid analgesics were administered in 60% of LS patients and 100% of OS patients.
CONCLUSION: Laparoscopic colorectal surgery does not show an advantage in terms of mean operative time, but patients have a shorter stay in the CAIL setting, less postoperative pain, and enjoy all the advantages of a minimally invasive approach with equivalent oncological outcomes
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