Minimally Invasive Versus Open Surgery in Colorectal Cancer: A Comparative Study of Recovery and Complication Rates

This retrospective cohort study compares perioperative outcomes, recovery parameters, and complication rates between minimally invasive surgery (MIS) and open surgery (OS) for colorectal cancer (CRC). Analyzing 350 patients (175 MIS, 175 OS) undergoing elective resection at a tertiary center (2018-2022), matched for age, BMI, ASA score, and tumor stage, we assessed operative time, estimated blood loss (EBL), length of hospital stay (LOS), time to return of bowel function (ROBF), postoperative pain scores, 30-day complications (Clavien-Dindo classification), and readmission rates. MIS techniques included laparoscopic (n=142) and robotic-assisted (n=33) procedures. Results demonstrated significantly reduced EBL in MIS (150ml vs. 300ml, p<0.001), shorter LOS (5.2 days vs. 8.7 days, p<0.001), earlier ROBF (2.8 days vs. 4.1 days, p<0.001), and lower pain scores (VAS 3.1 vs. 5.6, p<0.001). While operative time was longer in MIS (218min vs. 185min, p=0.002), overall complication rates were lower (22.9% vs. 38.3%, p=0.002), particularly for surgical site infections (SSI) (5.7% vs. 14.3%, p=0.008) and ileus (4.0% vs. 10.9%, p=0.016). Anastomotic leak rates were comparable (3.4% vs. 4.6%, p=0.78). Multivariate analysis confirmed MIS as an independent predictor of reduced LOS (OR 0.42, 95% CI 0.28-0.63) and overall complications (OR 0.57, 95% CI 0.35-0.92). MIS offers significant advantages in recovery metrics and reduces specific complication risks without compromising oncologic safety in appropriately selected CRC patients.