Does laparoscopic surgery decrease complications after colorectal cancer surgery?

This study investigated if laparoscopic surgery (LS) is associated with fewer complications in colorectal cancer compared to classic, open surgery. Researchers suggested that LS decreases the odds of having a complication after colorectal cancer surgery. 

Colorectal cancer is one of the most common cancer worldwide. The standard treatment consists of surgery and chemotherapy. Conventional (open) surgery can be very invasive and is commonly associated with complications. LS consists of the insertion of a thin tube with a camera through a body opening. This tube, which is guided by the doctor, is used to remove the tumor. 

It has been shown that LS has the same effectiveness as open surgery. LS is also associated with fewer complications when compared to open surgery. However, too little is known about complications such as incisional hernia (caused by a poorly healed surgical wound) and bowel blockage. An incisional hernia involves abdominal organs such as the bowel squeezing through a week spot in the abdomen such as a poorly healed scar.

This study analyzed the results of 15 other studies. Overall, it included information about 84,172 patients with colorectal cancer. Of these, 13,390 underwent LS and 70,782 received open surgery. The main outcomes evaluated were the occurrence of complications such as incisional hernia and bowel blockage due to adhesions.

Patients who received LS had a 21% lower risk of developing a hernia. LS also decreased the risk of a blocked bowel by 19%. However, the need for surgery due to these complications was not different between patients who had LS and those who had open surgery.

This study concluded that LS is associated with a decrease in the risk of incisional hernia and bowel obstruction after colorectal cancer surgery. 

This study involved smaller studies with different protocols. Incisional hernia and bowel obstruction were poorly defined in some studies. This might have influenced the results.