Result of Laparoscopic Surgery of Colorectal Cancer in Buddhasothorn Hospital
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Abstract
Background and Objective
Colorectal cancer ranks as the third most common malignancy globally and the fourth leading cause of cancer-related mortality. Laparoscopic surgery has emerged as a standard treatment modality for non-metastatic colorectal cancer, offering potential advantages over open surgery including reduced hospital stay, decreased wound infection rates, and faster recovery. Buddhasothorn Hospital initiated laparoscopic colorectal surgery in 2019. This study aimed to evaluate the outcomes of laparoscopic colorectal cancer surgery at our institution.
Methods
A retrospective study was conducted reviewing medical records of all patients who underwent laparoscopic colorectal cancer surgery at Buddhasothorn Hospital from January 1, 2019, to March 31, 2024. A total of 54 patients with non-metastatic colorectal cancer were included. Emergency surgery cases were excluded. Patient demographics, perioperative data, pathological results, and follow-up outcomes were analyzed.
Results
Of 54 patients, 26 were male and 28 were female with a mean age of 65.02 years old and mean BMI of 23.24 kg/m². The most common procedures were Laparoscopic low anterior resection (35.18%) and Laparoscopic sigmoidectomy/anterior resection (31.48%). Mean operative time was 4.22 hours, mean blood loss was 117.17 mL, and mean hospital stay was 10.57 days. Node retrieval was less than 12 node 18 case (33.33%)
Twenty-five percent of patients (n=14) received neoadjuvant concurrent chemoradiotherapy (CCRT), which significantly increased operative time (5.57 vs 3.75 hours, p<0.001), blood loss (159.29 vs 102.43 mL, p=0.014), and hospital stay (12.29 vs 9.98 days, p=0.016).
Overall complication rate was 5.56% (3 patients), including anastomotic leakage in 2 patients (3.7%) - one managed conservatively and one requiring reoperation. Conversion to open surgery occurred in 1 patient (1.85%) due to large tumor size (n=1).
Pathological staging revealed T3-T4 disease in 64.8% of patients. At follow-up (mean 2 years), no local recurrence was observed. Overall Distant metastasis occurred 16%
Conclusions
Laparoscopic colorectal cancer surgery at Buddhasothorn Hospital demonstrated acceptable outcomes with low complication (5.56%) and conversion rates (1.85%). No local recurrence was observed during the follow-up period. CCRT significantly increased operative complexity but remains an important treatment modality for locally advanced cases. These results are comparable to international standards, though operative times were longer than reported averages and node retrieval less than 12 node , likely due to case complexity and learning curve factors.
Article Details
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