LAPAROSCOPIC VERSUS OPEN RESECTION FOR COLORECTAL CANCER: SHORT-TERM SURGICAL OUTCOMES AND ONCOLOGIC QUALITY IN A RESOURCE CONSTRAINED TERTIARY CENTRE

Abstract

Objective: To compare short-term outcomes and oncologic quality after laparoscopic-intent versus planned open resection. Study Design: Prospective comparative observational study. Settings: Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan. Period: December 2025–May 2026. Material & Methods: Eighty adults undergoing resection formed two equal groups and were analysed by intention to treat. Continuous outcomes used Welch t or Mann–Whitney U tests; categorical outcomes used Pearson chi-square or Fisher exact tests. p≤0.05 was significant. Results: Operative time was longer with laparoscopic intent (188.5±27.6 vs 153.0±27.3 minutes; difference 35.5, 95% CI 23.3–47.7; p<0.001), while blood loss was lower (median 150 [IQR 100–200] vs 312.5 [250–375] mL; p<0.001). First flatus occurred earlier (2.06±0.57 vs 3.08±0.55 days; p<0.001) and stay was shorter (median 6 [5–7] vs 7 [6–8] days; p<0.001). Thirty-day morbidity was not significantly different (20.0% vs 32.5%; OR 0.52, 95% CI 0.19–1.44; p=0.204). Lymph-node yield (18.2±4.8 vs 17.1±4.2; p=0.268), adequate harvest (92.5% vs 90.0%; p=1.000), and R0 resection (95.0% in both groups; p=1.000) were comparable. Conclusion: In this study, laparoscopic-intent resection improved blood loss and recovery while preserving oncologic quality, despite longer operating time. Genuine prospective data are required before clinical inference or submission.