Abstract: Journal of Clinical Surgery Care Research

Abstract:
Objective: The advancement of colorectal surgery through a laparoscopic approach has represented one of the greatest challenges for digestive surgeons in the modern era. The lack of understanding of the oncological quality and radical nature of this approach has long been the cause of the delay in its implementation in colonic pathology, especially for malignancies. Our objective is to share the results and analysis of the oncological quality of the work we have done in the Coloproctology Section of Médica Uruguaya (MUCAM).

Methods: This was a descriptive, retrospective, observational study of a prospective database of patients over 15 years of age who underwent consecutive laparoscopic colon surgery. The plants were scheduled between December 2008 and December 2022 at the MUCAM. A total of 432 patients underwent surgery (377 cancer patients). Demographic population characteristics, hospital stay, suture leakage, reinterventions, 90-day mortality, nodal harvest, overall survival, cancer-related survival, disease-free survival.

Results: Our series included 53% women and 47% men, with an average age of 62.6 years (15-90 years). The average hospital stay was 4 days. We reported 5.5% suture leakage, 11.3% reintervention and 3.2% mortality at 90 days. The average nodal harvest was 16. Overall survival rates were 77.7% and 65.5% at 5 and 10 years, respectively, and cancer-related survival rates were 82.7% and 79.2% at 5 and 10 years, respectively. The median survival was 136.6 months. The 5-year survival rates for patients with stage 0 disease were 96.6%, 91.7% for those with EI, 92.8% for those with IBD, 80.3% for those with stage III, and 35.2% for those with EIV. Our study has the limitation of being a retrospective case series in a single health institution.

Conclusions: The above results show that laparoscopic colon surgery is feasible and safe in our environment and is comparable to large prospective, randomized, multicenter studies.