Laparoscopic colectomy is superior to laparotomy for reduction of disability in patients with colorectal adenoma.

Abstract

Background: This study was to evaluate disability after laparoscopic colectomy in patients with colorectal adenomas as compared to disability after laparotomy.

Methods: Patients who underwent laparoscopic colectomy for colorectal adenoma were compared to patients who underwent laparotomy for the same problem by the same surgeons during the same time period in Cleveland Clinic Florida. A standard questionnaire was used to assess disability which included the number of days to return to partial activity, full activity, and work.

Results: Twenty-nine patients who underwent laparoscopy were compared with 31 patients who underwent laparotomy. There were no significant differences in age (70.4 vs 72.5 years) (p = 0.405) or gender (M:F 13:16 vs 20:11) (p = 0.126) between the laparoscopy and laparotomy groups. The operative time was longer for the laparoscopy group than the laparotomy group: 170 vs 131 minutes (p = 0.014). However, the duration of postoperative ileus, hospitalization, time until return to partial activity, time until return to full activity, and time off of work were significantly shorter in the laparoscopy group than in the laparotomy group: 3.3 vs 5.2 days, 6.2 vs 8.7 days, 2.3 vs 4.2 weeks, 4.4 vs 9.3 weeks, and 3.7 vs 7.3 weeks, respectively (p < 0.041 for all). Although the incidence of postoperative complications was not significantly different (24% for laparoscopy vs 29% for laparotomy, p = 0.325), the incidence of postoperative prolonged ileus was statistically significantly lower in the laparoscopy group (3% vs 26%, p = 0.027).

Conclusion: Laparoscopic colectomy for patients with colorectal adenoma can reduce postoperative ileus, postoperative hospitalization, and disability in terms of a quicker return to partial activity, full activity, and employment. Laparoscopic colectomy should be considered for all patients who have colorectal adenomas which require resection.