117 Comparative Study Between Laparoscopic and Open Rectosigmoid Cancer Resection in Two Laparoscopic Naïve Centers in a Middle-Income Country

Abstract

Aim: The aim was to compare the short-term, oncologic, outcomes of laparoscopic and open resection for recto-sigmoid /upper rectal cancer in two centers with relatively newly adopted laparoscopic techniques in cancer. Method: Our patients were recruited from two centers in Damietta, Egypt; one of them is a laparoscopic naïve center which has not introduced MIS surgery until recently and the other has the main laparoscopic experience reserved primarily for benign Upper GI and Bariatric work. 50 patients with recto- sigmoid and upper rectal cancer diseases in the period between December 2016 and December 2018 were included. Patients were randomly divided into two groups: (LR Group: 25 patients) subjected to laparoscopic interventions, and (OR Group: 25 patients) subjected to open surgery. Data were collected and Short-term outcomes were analyzed. Results: The mean operative time was significantly increased in the LR group than OR group (LR 198.88± 18.7, OR 183.4± 20.5 minutes, p =0.01) as well as the hospital stay (LR 8.8± 2, OR 7.4± 2.9 days, p =0.013). However, LR group was quicker to recover in term of mobilizing early, recovery of bowel function, and early toleration of diet and fluid and this difference was only statistically significant for oral fluid but not for diet (p= 0.078; 0.17 respectively). There was no significant difference between both groups in tumor characteristics as locations, gross tumor morphology, staging, and distance to the distal margin. Also, both groups had comparable intraoperative and post-operative adverse events. Conclusion: Laparoscopic technique represents a feasible and sound oncological approach and should be considered as standard in low resource setting.