Laparoscopic colorectal surgery performed in tertiary care centers show improved short-term outcomes and comparable long-term outcomes to the conventional open approach.
However, laparoscopic colorectal surgery performed in a community hospital setting has not been well studied.
Dr Singh and colleagues from Canada previously presented the short-term outcomes of 100 laparoscopic colorectal surgery performed by 2 community surgeons with no formal training in laparoscopic colorectal surgery.
In this follow-up study, the research team evaluated both short- and longer-term outcomes for 250 patients who underwent laparoscopic colorectal surgery.
The researchers prospectively studied 250 consecutive patients.
The patients underwent laparoscopic colorectal surgery at the North Bay District Hospital, a 200-bed community hospital located 350 km away from the nearest tertiary care center.
The researchers found that between 2000 and 2006, 250 consecutive patients underwent laparoscopic colorectal surgery for benign and malignant disease.
Median operating time was 215 minutes and the conversion rate was 7%.
The intraoperative complication rate was 3%.
The researchers noted that 8% had major postoperative complications, and 17% had minor postoperative complications.
The team found there was no intraoperative mortality.
|Disease-free survival for stages 1 to 4 colorectal cancer was 100% for a follow-up time of 37 months|
There were six 30-day mortalities due to ischemic bowel, stroke, myocardial infarction, and pneumonia.
The median length of stay was 4 days.
Disease-free survival for stages 1 to 4 colorectal cancer was 100%, 97%, 71%, and 10% for a mean follow-up time of 37, 29, 28, and 21 months, respectively.
The research team found that the mean number of resected lymph nodes was 12.
Dr Singh’s team concluded, “We note that both our short and longer-term outcomes are similar to tertiary care centers.”
“We therefore conclude that laparoscopic colorectal surgery can be performed in a community hospital setting with both short- and longer-term outcomes similar to tertiary care centers.”