Abstract
Abstract
Background
Despite its established benefits in elective colorectal surgery, the adoption of laparoscopy in the emergency setting remains limited. This retrospective international multicentre study assesses laparoscopic and open colonic resection in patients with acute benign or malignant colonic obstruction.
Methods
Patients were included between 2022 and 2023. Intraperitoneal free air on imaging was an exclusion criterion. Primary outcomes were the Comprehensive Complication Index (CCI) and length of stay (LOS). Secondary outcomes included postoperative pain management, re-operation, 30- and 90-day mortality, R0-resection and lymph node yield when applicable, intraoperative bleeding, anastomosis and operative time.
Results
Out of 144 patients, 73 were eligible. Forty-three (58.9%) patients underwent open and 30 (41.1%) laparoscopic resections. Obstructions were equally distributed between the right and left colon. Patients in the open group were older (77.1 vs. 61.7 years,
p
p
= 0.002) and the CCI was higher (27.1 vs. 7.9,
p
p
p
Conclusion
Laparoscopic emergency resection in patients with acute benign or malignant colonic obstruction was associated with lower postoperative morbidity, shorter LOS and less intensive postoperative analgesic requirements in a selected cohort. However, these findings should be interpreted cautiously given substantial differences in baseline characteristics and surgeon specialization between groups.