Retrospective Study of Surgical Outcome and Predictive Factors for Anastomotic Complications after Laparoscopic Colectomy at South Egypt Cancer Institute

Abstract

Background: Colorectal cancer is the second-and third-most common cancer in men and women. In general, colorectal cancer is the third-most common cancer in both male and female. After exclusion of non-melanoma skin cancer accounts it accounts for 9.7% of all cancers. Developed countries account for more than half of the cases. The main curative treatment for non-metastasized CRC is the surgery. Todays, colectomy using laparoscopy is considered effective and safe procedure regarding oncologic, short and long term outcomes. Several trials confirm safety and feasibility of laparoscopy in colorectal surgeries. Laparoscopic technique has many advantages as reduction of postoperative pain and operative blood loss. The incidence of anastomotic leakage after colectomy is about 5% -6%. Anastomotic leakage usually associated with high morbidity and mortality after colonic resection. Objective: To evaluate surgical outcome and anastomotic complications after laparoscopic colectomy as regards to treatment results in South Egypt Cancer Institute (SECI) in the period from 1/2014 to 12/2019. Patients and Methods: This thesis is a retrospective study of colon cancer to rule out the predictive factors for anastomotic complications and surgical outcomes in laparoscopic colectomy among patients with cancer colon in the period from 1/2014 to 12/2019. After reviewing patients files, a sample size of 40 cases of colon cancer patients that had underwent laparoscopic colectomy (14 cases of right cancer colon, 11 cases of left cancer colon, 10 cases of cancer sigmoid, 5 cases of multicentric lesion) was randomly selected from our South Egypt Cancer Institute (SECI) tumor registry during the period from 1/2014 to 12/2019. Results: Showed no significant difference regarding hypertension, diabetes, IHD, but it showed significant results for increased incidence of complications especially anastomotic leakage with asthma low preoperative albumin(<3mg) and the overall comorbidities. Results showed no significant difference regarding grade of tumor, histology, site of the lesion or the anastomosis but there is a significant result regarding duration of operation as decrease in the duration of operation decreases the hospital stay duration. Results showed no significant difference regarding hypertension, diabetes, IHD, but it showed significant results for increase the duration of hospital stay with asthma, low preoperative albumin(<3mg) and the overall comorbidities. Conclusion: Our studies confirm that age, performance status, duration of the operation and the patient`s comorbidities (asthma, serum albumin level) can predict the incidence of the anastomotic complications postoperative and prolonged hospital stay as a consequence. On the other hand, our findings demonstrate that gender predilection, grade of the tumor, histological type of the tumor, site of the lesion and technique of anastomosis had no effect neither on the incidence of anastomotic complications nor the hospital stay duration.