ABSTRACT
BACKGROUND: Laparoscopic colectomy is associated with modest short-term benefits compared to equivalent open surgery. However, most published data comes from specialist colorectal units. We aimed to evaluate outcomes of laparoscopic colectomy in a provincial hospital setting. METHODS: Retrospective review of all patients who underwent laparoscopic colectomy at Palmerston North Hospital (a provincial New Zealand hospital) between March 2001 and April 2010 was performed. Demographic data, intraoperative parameters, postoperative outcome data, and pathological data were compared with published results from the Australasian Laparoscopic Colon Cancer Surgical trial (ALCCaS). RESULTS: Of 138 laparoscopic colonic resections performed, 76 satisfied criteria for inclusion. More left sided resections were performed in the PNH group versus the ALCCaS group (55% vs 40%). The intraoperative complication rate was significantly lower in the PNH group (2.6% vs 10.5%, P=0.039), and patients tolerated fluids one day earlier (P=0.0001), but mean days to passage of flatus, passage of bowel motion, and discharge were nearly identical. There were no statistically significant differences in the postoperative complication rate or in-hospital mortality. CONCLUSION: Short-term outcomes of laparoscopic colonic surgery for neoplasia in a secondary level provincial setting are equivalent to those from specialist colorectal units.
