Comparative Analysis of Laparoscopic Versus Open Surgery in Colorectal Cancer: An Eight-Year Single-Center Experience From Jordan

Abstract

Introduction The use of laparoscopic surgery has increased in the treatment of colorectal cancer (CRC). However, achieving oncological outcomes similar to those of open surgery remains challenging, particularly for CRC. In this comparative, retrospective study, we aim to investigate and compare the postoperative complications of open and laparoscopic CRC surgery in Jordan. Methods Using a retrospective study design, patients’ records were obtained from the electronic hospital database of King Hussein Medical Center, Amman, Jordan, during the period between 2016 and 2024. Demographic data were collected for age and gender. Clinical data were collected for tumor site, tumor grade, body mass index, American Society of Anesthesiologists (ASA) score, lymph node ratio (LNR), postoperative complications such as ileus, anastomosis, stoma, renal complications, pain, wound infection, and death, and length of hospital stay. Results We included 857 CRC patients, with 437 (51.0%) undergoing laparoscopic resection and 420 (49%) undergoing open resection. The mean age was 58 years, with no age difference between the study groups. Most patients (507, 59%) were in good health based on the ASA score. The majority (671, 78%) had moderately differentiated tumors, with 320 (76%) in the open surgery group and 351 (80%) in the laparoscopy group. The mean LNR was 0.19, trending higher in the group that underwent open surgery (0.33 vs. 0.09, p = 0.065). The open surgery group had a significantly longer hospital stay (5.28 days) relative to the laparoscopic group (3.77 days, p < 0.001). Postoperative complications included wound infection (33, 3.9%), ileus (19, 2.2%), stoma (15, 1.8%), anastomosis (10, 1.2%), renal complications (9, 1.1%), and pain (6, 0.7%). The mortality rate was higher in the open surgery group (p = 0.035). Most patients (711, 83%) did not experience postoperative complications. Conclusion This is the first Jordanian study to compare long-term outcomes of CRC patients undergoing open versus laparoscopic surgical resection. Our findings suggested that the laparoscopic group had a shorter hospital stay, with no differences in postoperative complications rate between the study groups. Mortality rates were low overall but significantly higher in the open surgery group. These results suggest that laparoscopic resection may be superior for CRC surgery, though further multicenter studies are warranted to confirm our findings.