Laparoscopic-assisted and open high anterior resection within an ERAS protocol

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Outcomes Research

Background:

• Laparoscopic colorectal surgery shows promise for improved short-term outcomes compared to open procedures.
• Enhanced Recovery After Surgery (ERAS) programs are established to enhance recovery in open colorectal surgery.
• This study evaluates laparoscopic vs. open surgery outcomes within an ERAS protocol.

Purpose of the Study:

• To compare postoperative recovery outcomes between laparoscopic and open colorectal surgery.
• To assess the impact of ERAS protocol compliance on surgical outcomes.
• To analyze the association between surgical approach, ERAS compliance, and recovery metrics.

Main Methods:

• Prospective recording of 114 clinical variables for 114 consecutive patients undergoing elective high anterior resection.
• Patients were divided into laparoscopic-assisted (n=55) and open resection (n=59) groups.
• Analysis focused on surgical approach, ERAS protocol compliance, postoperative symptoms, complications, and length of stay.

Main Results:

• Preoperative ERAS protocol compliance was high and similar (77%) in both groups.
• Laparoscopic surgery demonstrated a significantly shorter length of stay (4 vs. 6 days) and earlier pain control (2 vs. 3 days).
• Laparoscopic approach showed improved mobilization and reduced inflammatory response (CRP) on postoperative day 1, though complication rates were not statistically significant.

Conclusions:

• Integrating laparoscopic techniques with ERAS protocols accelerates recovery in colorectal surgery.
• Laparoscopic colorectal surgery offers faster recovery benefits compared to open resection when ERAS is applied.
• The findings support the use of laparoscopy within ERAS for enhanced postoperative recovery.