The role of laparoscopy in emergency colorectal surgery.

Saudi Med J

From College of Medicine (Alselaim, Altoub, Bin Gheshayan), King Saud bin Abdulaziz University for Health Sciences; from the Research Unit (Almutairi), College of Applied Medical Science, King Saud bin Abdulaziz University for Health Sciences; from the College of Medicine (Alhassan), King Saud University Medical City; from the Department of Surgery (Alselaim, Almutairi, Bin Gheshayan), King Abdullah International Medical Research Center; from the Department of General Surgery (Alselaim, Bin Gheshayan), Ministry of National Guard- Health Affairs; from College of Medicine (Almomen), Imam Mohammad Ibn Saud Islamic University, Riyadh; and from College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia (Alhussain, Alsubaie).

Published: December 2022

Objectives: To assess the outcomes of the laparoscopic approach compared to those of the open approach in emergency colorectal surgery.

Methods: This retrospective cohort study included all patients aged >15 years who underwent emergency colorectal surgery from 2016-2021 at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Patients were divided based on the surgical approach into laparoscopic and open groups.

Results: A total of 241 patients (182 open resections, 59 laparoscopic approaches) were included in this study. The length of stay in the intensive care unit was shorter in the laparoscopic than in the open group (1±3 days vs. 7±16 days). After multivariable logistic regression, patients undergoing laparoscopic resection had a 70% lower risk of surgical site infection than those undergoing open surgery (adjusted odds ratio=0.33, 95% confidence interval: [0.06-1.67]), a difference that was not significant (=0.18). Lastly, patients who underwent open surgery had a high proportion of 30-day mortality (n=26; 14.3%), compared to those who underwent laparoscopic resection (n=2; 3.4%, =0.023).

Conclusion: Laparoscopy in emergency colorectal surgery is safe and feasible, with a trend toward better outcomes. Colorectal surgery specialization is an independent predictor of an increased likelihood of undergoing laparoscopy in emergency colorectal surgery.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994520PMC
http://dx.doi.org/10.15537/smj.2022.43.12.20220658DOI Listing

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