| AIM:To classify and valuate of postoperative complications between laparoscopic and open radical resection for colorectal cancer.Methods:From June 2009 to August 2011,316 case with colorectal cancer were divided into two groups prospectively and nonrandomly, and received radical laparoscopic operation (LP, n=158) and open operation (OP, n=158). The postoperative complications at 4 weeks was compared between the two groups. A three-step methodology was used to assign severity weights to complications. First,each complication was graded using Clavein classification. Second, five reviewers were asked to independently and directly rate their perception of the severity of each class using a non-categorized visual analog cale.Zero represented an uncomplicated postoperative course,while 100 represented postoperative death.Third,the median, lowest, and highest values assigned to each class of complications were used to derive weights complications scores for LP group and OP group.Result:LP group had less complications than OP group (23.4%vs.13.9%, P=0.032). There were no differences in stoma leak, stoma bleeding, stoma stricture, chyle leak, incisional hernia, incision rupture, deep venous thrombosis,heart complication, abdominal abscess, urinary infection, pulmonary infection, bacteremia, post-operative death except post-operative intestinal obstruction (7.5% vs.0.8%, P=0.018) and incision infection (6.9% vs.1.3%,P=0.029)between OP and LP groups. The complications of OP group were more severe than those of LP group.In the sensitivity analysis, similar resulets were obtained using the median, highest, and lowest weights.Conclusion:LP group had less complications than OP group,and complications of OP group were more severe than those of LP group.The methodology for the valuation of complications following resection for colorectal cancer can allows a direct outcome comparison of procedures with different complication profiles. |
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