Laparoscopic Versus Open Surgery In Treating Colorectal Cancer:A Comparative Study Of Anastomotic Leakage And Clinical Effectiveness

Objective To analyze and evaluate the clincial effectiveness and the rate of anastomotic leakage between laparoscopic and open approach in treatment of colorectal cancer.Methods The clinical data of 243 cases of colorectal cancer underwent colorectal resections from April 2015 to April 2017 in Union Hospital of Huazhong University of Science and Technology were analyzed retrospectively.Rate of anastomotic leakage and clincial effectiveness were compared respectively between two groups.Results The overall anastomotic leakage rate of the colon cancer patients was 10.2%(14 of 137).The anastomotic leakage rate of laparoscopic surgery(LS)group was 8.7%(6 of 69),while the open surgery(OS)group was11.8%(14 of 137).There was no significant difference between OS and LS(P=0.553).Besides,the overall anastomotic leakage rate of the rectal ones was14.2%(15 of 106),the anastomotic leakage rate of the LS was 13.8%(13 of 94),while the OS group was 16.7%(2 of 12).There was no significant difference between OS and LS(P=1.000).The difference of wound infection rate(12.9% in LS and 26.8% in OS,P=0.038)between the two groups was significant.No significant differences were observed in Lymph node harvest(27.7 vs 30.0,P=0.328),Blood transfusion(12.9% vs43.8%,P=0.081),Operative time(3.80 h vs 3.74 h,P=0.674),Postoperative hospitalstay(14.05 d vs 15.41 d,P=0.231),Early reoperation(6.1% vs 8.8%,P=0.453),Bowel obstrucion(3.7% vs 6.3%,P=0.365),Cerebrovascular accident(0.6% vs2.5%,P=0.211),Thromboembolism(2.5% vs 0.0%,P=0.158)and Other postoperative complications(11.0% vs 17.5%,P=0.162).Conclusion The use of laparoscopy in colorectal surgery will not increase the incidence of anastomotic leakage.The efficacy and safety of laparoscopy are comparable to those of laparotomy.Besides,laparoscopy has the advantages of less trauma and lower infection rate,so it is worthy of clinical application.