Immediately recognizable benefits and drawbacks after laparoscopic colon resection for benign disease

Abstract

Background: A prospective assessment of the impact of laparoscopic colon resection (LCR) was carried out in order to quantify immediately recognizable benefits and limitations of this approach.

Methods: Elective LCR was attempted in 95 selected patients (mean age 64 years, range 39-81 years) presenting with benign disease of the colon. A completely intracorporeal approach was adopted. Results were compared with a control group of 90 patients who had previously undergone open colectomy (OC) by the same surgeons at the same institution.

Results: There were no perioperative deaths. Intraoperative complications included difficult extraction of accidentally detached anvil (n = 1), air leak at colonoscopy (n = 2), and conversion to OC (n = 1). Operating time was significantly longer after LCR compared with OC (180 +/- 10.3 vs 116 +/- 97, p < 0.001). Passage of flatus (3.5 +/- 1.2 days vs 4.4 +/- 1.4, p < 0.5) and morbidity (4 vs 3, p = 0.48) were not significantly different in the two groups. Hospital stay was significantly shorter after LCR (5.2 +/- 1.3 days vs 12.2 +/- 1.9 days, p < 0.001). Theater and ward costs were, respectively, significantly increased ($2,829.6 +/- 340 vs $1,422 +/- 318, p < 0.001) and decreased ($2,600 +/- 366 vs $6,022 +/- 916, p < 0.001) in LCR patients compared with the OC group. There was no significant difference in total hospital costs ($10,929 +/- 369 vs $9,944 +/- 1,014).

Conclusions: LCR does not appear to offer any immediately recognizable advantages.