A retrospective chart review study comparing in-hospital morbidity and mortality associated with laparoscopic versus open surgery amongst colorectal cancer patients in Mulago National Referral Hospital

Abstract

Background: Colorectal cancer is a common cancer worldwide that causes significant morbidity and mortality. It relatively has a lower prevalence in Africa but with an increasing incidence. Surgery is the mainstay of management for early disease with other remedies playing major roles in advanced disease. However, surgery is associated with a lot of morbidity and in some cases mortality. The invention of laparoscopic surgery has been seen to provide better outcomes in comparison to the traditional open surgery worldwide. Study Objective: The major objective of this study was to compare the in-hospital morbidity and mortality between laparoscopic and open colorectal cancer surgery amongst CRC patients in MNRH. Methodology: Following ethical approval, hospital files of patients that underwent either open or laparoscopic colorectal surgery were reviewed consecutively from 2019 to 2023 and data on morbidity and mortality obtained. Data Analysis: Data was entered into an excel sheet and later transferred to STATA version 17 for analysis. Results: The prevalence of in-hospital morbidity and mortality (unfavourable outcomes) was found to be 56.7% (34/60) among participants who underwent open surgery compared to 29.3% (12/41) among those that underwent laparoscopic surgery, and this was statistically significant, p-value = 0.018. Neoadjuvant therapy and non-stage 3 cancer were found to be associated with unfavourable outcomes. Conclusion: Laparoscopic colorectal surgery is associated with more favourable outcomes than open colorectal cancer surgery.