Resumo

VACCAREZZA, Hernán  e  VACCAREZZA, Daniel R. Laparoscopic colorectal resections in a rural community. Rev. argent. cir. [online]. 2018, vol.110, n.4, pp.195-201. ISSN 2250-639X.

Of benign tumors and colorectal cancer. However, its use is low and limited to large urban centers. Objective: The aim of this study was to analyze the feasibility of a laparoscopic colorectal surgery program in a rural community center. The secondary outcome was to compare these results with those of conventional open surgery. Material and methods: We analyzed a prospective data base of all the patients undergoing scheduled and consecutive surgery between June 2012 and December 2016. A standardized discharge criterion was used. The patients were divided into two groups: laparoscopic surgery (group A) and conventional surgery (group B). The variables were analyzed with the chi-square test or Student's t test, as applicable. Results: A total of 129 colorectal resections were performed; median age was 64 years, 60% were men and 83% belonged to neighbor communities. The ASA physical status classification system was grade 1 in 35% of the patients, grade 2 in 56% and grade 3 in 9%. The average distance between patients' place of residence was of 75 km comprising an area of 24,000 km2. Patients were hospitalized for a median of 4 days. The applicability of laparoscopy was 74% with a conversion rate of 6%. There were no significant differences in sex, BMI, diagnosis, ASA grade, proportion of ASA grade 3-4 patients, clinical history, previous surgeries and distance from the place of residency. Compared to group B, patients in group A were younger (61.6 years vs. 69 years; p < 0.01). There were no differences in terms of type of surgery and surgery duration. Postoperative morbidity was 18% and the readmission rate was 4%, with no differences between the groups. Conclusions: Laparoscopic colorectal surgery can be performed in a rural center with low readmission rate and complications; these results are similar to those of conventional open surgery.

Palavras-chave : Laparoscoppy; Colorrectal surgery; Colorrectal cancer.

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