Laparoscopic colorectal surgery for cancer in a regional service hospital: single surgeon experience

Aim: In spite of the demonstrated advantages, laparoscopic colorectal surgery is not adequately utilised in regional service hospitals. Purpose of the research was to document the findings of patients managed by a gastroenterological surgeon for colorectal neoplasms using laparoscopic surgery at a service hospital of the Central Black Sea Region, Turkey. Material and Method: Every sequential patient having laparoscopic colorectal surgery was registered prospectively and analysed retrospectively. Recorded parameters consisted of demographic characteristics, diagnostic work-up, surgical events, post-surgical morbidity, mortality and outcomes. Results: Seventy-five patients each underwent laparoscopic colorectal surgery for colorectal neoplasm within a period of forty months. Average age was 66.4 years and ratio of males to females was 11:4. Rectal cancer rate was 65.3%. Colon cancer rate was 34.6%. One patient had synchronous colorectal cancer. Mean time of surgery was 276 min and mean volume of haemorrhage was 75 ml. Conversion to open resection rate was 6.6%. Median day of hospitalization was six days. Postoperative complication rate (Clavien–Dindo grade ≥ III) was 8.5%. Two systemic recurrences were observed during the surveillance. Conclusion: Based on our results and those of other studies presented here, a trained surgeon with a high caseload can perform safe and adequate oncological laparoscopic colorectal resections in a regional service hospital of a developing country. The longer operative time is the drawback of the procedure, especially in crowded service hospitals. The results are also valuable in terms of showing the effect of health policies and regional conditions on surgical practices in our city and country. Under the current conditions, surgeons’ dedication and all relevant supports are required.