Inflammatory response and Patient characteristics in Open and Laparoscopic Sigmoidectomy

Sammanfattning: Background and Aims Colorectal cancer is the third most common type of cancer in Sweden, male and female, with 6500 (4500 colonic/2000 rectal) new cases each year. Surgery remains the treatment of choice. Previous studies show that laparoscopic procedure may lead to fewer complications, shorter postoperative stays and a lesser inflammatory response compared to open procedure. The study examines whether laparoscopic surgery of sigmoid cancer differs from open surgery, regarding inflammatory response through analysis of routine measurements. It also investigates differences in peri- and postoperative quality data from Swedish Colorectal Cancer Registry. Material and Methods 307 consecutive patients underwent surgical sigmoidectomy from February 2007- February 2017, from which elective patients with sigmoid cancer were included. Pre-and postoperative CRP and postoperative WBC, Haemoglobin and Creatinine were collected from medical records at the Department of Surgery, Örebro University hospital. Patient related and perioperative variables were collected from SCRCR (e.g. postoperative stay, bleeding, complications). Results 158 patients fulfilled the inclusion criteria. There was a marked increase in CRP postoperative in both laparoscopic (89) and open (69) groups, but no significant difference comparing the groups. There was a significant difference in perioperative bleeding (p<0.05) and length of stay (p<0.05). Conclusion Sigmoidectomy, laparoscopic or open, cause an increase in CRP. No significant difference in inflammatory response was noted between the groups. Patients undergoing laparoscopic, compared to open sigmoidectomy has: less perioperative bleeding, shorter postoperative stay and a longer duration of surgery, like previous studies.