Comparison of open and laparoscopic surgical techniques in colorectal cancer surgery: Early and late results

Colorectal cancer is the third most common malignancy worldwide and a leading cause of cancer-related mortality. Surgical resection remains the gold standard for curative treatment, while laparoscopic surgery offers potential advantages in postoperative recovery and complication rates. This study aimed to compare open and laparoscopic colorectal surgery in terms of perioperative, postoperative, pathological, oncological, and survival outcomes in a retrospective cohort. A retrospective analysis was conducted on 462 patients who underwent colorectal cancer surgery between January 2015 and June 2020. Patients were divided into open (n = 271) and laparoscopic (n = 191) groups. Demographic data, surgical characteristics, postoperative complications, pathological findings, and survival outcomes were analyzed. Survival analysis was performed using the Kaplan-Meier method, and comparisons were made using the log-rank test. Laparoscopic surgery was associated with significantly lower rates of surgical site infection (9.4% vs 31.0%, P < .001), intra-abdominal abscess (odds ratio = 7.17, P = .001), and shorter hospital stay (median 6 vs 10 days, P < .001). Early postoperative mortality was lower in the laparoscopic group (1.1% vs 4.8%, P = .026). Oncological parameters were comparable between groups, including resection margins and lymph node harvest. Distant metastasis was less frequent in the laparoscopic group (7.3% vs 16.3%, P = .022). Median overall survival was longer in the laparoscopic group (88.3 vs 73.2 months, P < .001); however, these crude survival differences are likely confounded by significant baseline imbalances between groups. Laparoscopic colorectal surgery is associated with improved short-term postoperative outcomes and comparable oncological parameters compared with open surgery. However, the groups were not balanced, with emergency cases and more advanced-stage disease predominantly present in the open surgery group; therefore, crude survival comparisons are subject to selection bias and should be interpreted cautiously. Laparoscopic surgery appears to be a safe and effective approach in selected patients with colorectal cancer.