Laparoscopic and Open Subtotal Colectomies Have Similar Short-Term Results

Abstract

Background: Laparoscopic subtotal colectomy (STC) is a complex procedure. It is possible that short-term benefits for segmental resections cannot be attributed to this complex procedure. This study aims to assess differences in short-term results for laparoscopic versus open STC during a 15-year single-institute experience. Methods: We reviewed consecutive patients undergoing laparoscopic or open elective or subacute STC from January 1997 to December 2012. Results: Fifty-six laparoscopic and 50 open STCs were performed. The operation time was significantly longer in the laparoscopic group, median 266 min (range 121-420 min), compared to 153 min (range 90-408 min) in the open group (p < 0.001). Median hospital stay showed no statistical difference, 14 days (range 1-129 days) in the laparoscopic and 13 days (range 1-85 days) in the open group. Between-group postoperative complications were not statistically different. Conclusions: Laparoscopic STC has short-term results similar to the open procedure, except for a longer operation time. The laparoscopic approach for STC is therefore only advisable in selected patients combined with extensive preoperative counseling.

Laparoscopic and Open Subtotal Colectomies Compared in a High-Volume Laparoscopic Center

“…Hoogenboom et al [7] describe a relatively high mortality of 8% and a high conversion rate of 20% compared to 0.4 and 5.5%, respectively, as reported by Bartels et al [6]. This difference can be explained by a worse clinical condition of the patients in the study of Hoogenboom et al [7].…”

“…In this edition of Digestive Surgery , Hoogenboom et al [7] compare short-term outcomes of LSC with OSC by analyzing data from a prospectively maintained database. Fifty-six patients who had LSC were compared to 50 patients who underwent OSC performed during a 15-year period in a large teaching hospital that also serves as a training center for laparoscopic colorectal surgery.…”

“…What does the study of Hoogenboom et al [7] add to the current literature? In contrast to most studies on minimally invasive surgery, the length of stay was the same for the open and laparoscopic groups as well as other short-term results.…”

“…This difference can be explained by a worse clinical condition of the patients in the study of Hoogenboom et al [7]. Previously the Dutch group reported low complication and conversion rates after segmental colonic resections, illustrating the experience of the surgical team [8,9].…”