Laparoscopic versus open fast-track surgery in colon cancer - a comparative study

The aim of the study was a comparative analysis between open colic surgery with fast-track protocols and laparoscopic surgery regarding postoperative results. MATERIAL AND METHODS: The study was conducted in a prospective manner in a period of 3 years (January 2009 - December 2011) and included patients with diagnosis of colon adenocarcinoma. Patients were included in 2 groups: one with open approach with fast-track protocols (OPEN-FT group) and the other, laparoscopic approach with traditional perioperative care (LAP group). RESULTS: There were no statistical differences between the two groups regarding demographic data, co-morbdities, tumor site, stage (Dukes) and type of surgery. Applicability of fast-track protocols was between 66.6% and 100%. We noted the following postoperative complications: wound infection 15.4% (n=6) in group OPEN-FT vs 6.89% (n=3) in group LAP; hemoperitoneum 2.6% (n=1) vs 0%; anastomotic leakeage 0% vs 2.6% (n=1); postoperative ileus 0% vs 2,6% (n=1). The time to first gas or stool passage was 48±15.92 hours in group OPEN-FT and 32.1±16.9 hours in group LAP as well the average length of hospital stay was 6.1±1.5 vs 5.6±2.1 days. The mortality rate was in first group 2.5% (n=1) vs 0% in laparoscopic group. All these results were no statistical significance. CONCLUSION: Applicability of fast-track protocols in open surgery of colon cancer reduces the gap from laparoscopic surgery in terms of postoperative results.