Key result
Laparoscopic emergency colorectal surgery was associated with lower unadjusted 30-day mortality (3.4% vs 14.3%) compared to open surgery, though the adjusted difference was not statistically significant.
Why the study?
The study was conducted to assess the outcomes of the laparoscopic approach compared to the open approach in emergency colorectal surgery.
Does the laparoscopic approach improve postoperative outcomes compared to the open approach in patients undergoing emergency colorectal surgery?
Cohort (n=241)
No
Does the laparoscopic approach improve postoperative outcomes compared to the open approach in patients undergoing emergency colorectal surgery?
Laparoscopy in emergency colorectal surgery appears safe and feasible, with a trend toward better outcomes such as shorter ICU stay and lower unadjusted 30-day mortality compared to open surgery.
Answers are grounded in this paper and cite their sources.
May support laparoscopic feasibility in emergency colorectal surgery; leaves open confirmation of adjusted benefits in randomized trials.
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 (p=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%, p=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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Alselaim et al. (2022) conducted a cohort in Emergency colorectal surgery (n=241). Laparoscopic approach vs. Open approach was evaluated on 30-day mortality (adjusted OR 0.15, 95% CI 0.01-1.8, p=0.13). Laparoscopic emergency colorectal surgery was associated with lower unadjusted 30-day mortality (3.4% vs 14.3%) compared to open surgery, though the adjusted difference was not statistically significant.
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