Purpose: Tumors in the distal transverse, splenic flexure, and descending colon can be resected by standard open left hemicolectomy. The laparoscopic approach has become the gold standard approach for managing colorectal cancers. This study aims at comparing the results of both approaches regarding operative technique and postoperative complications and patient recovery.
Methods: seventy-two patients having cancer in the distal transverse, splenic flexure, and descending colon were operated on by laparoscopic (36 patients, LAP group) and open (36 patients, OS group) left hemicolectomy. They were admitted to Al- Azhar university hospitals during the period from 2019 to 2022. Both groups were compared regarding operative technique and postoperative recovery and complications.
Results: Comparable baseline variables between both groups included age, gender, BMI, a history of past abdominal surgeries, and the location of the tumor. The LAP and OS groups' average operating duration was 235 minutes. Both groups suffered from similar intraoperative blood loss. There were no variations between the two groups in the occurrence of postoperative complications (SSI, ileus, leak, and chest infection). Less pain, shorter time to restart a regular diet and pass flatus, and a shorter hospital time of stay are all signs of a quicker postoperative recovery in the LAP group. The two groups' surgeries were similarly radical, according to pathological analyses. There were no port-site or local recurrences during the LAP group's follow-up, which lasted an average of 12 months. However, there were 4 distant metastases (5.7%) during this time.
Conclusion: In the context of operating descending colon cancer, laparoscopic left hemicolectomy is superior to open approach in terms of less postoperative pain, shorter hospital stay and earlier restoration of bowel functions with comparable oncological safety profile. Further randomized controlled trials are warranted to consolidate our results.