A Clinical Analysis Between Laparoscopic And Open Personalized Extralevator Abdominoperineal Resection For Low Rectal Cancer

Objective:The aim of this study was to evaluate the short-term surgical outcomes of laparoscopic extralevator abdominoperineal resection(ELAPR) for rectal cancer, by comparing it with a case–control series of open ELAPRR.Methods:Eighteen patients with rectal cancer who underwent laparoscopic ELAPR between January 2009 and December 2014 were compared with the open ELAPR group of eighteen patients matched for age, gender, and surgical procedure. We performed a retrospective analysis of the clinical data, intraoperative, and postoperative recovery indicators, the number of lymph node dissection, change of white blood cells and serum CRP levels after operation of two groups.Results:2 groups of operation were successful, no patient was dead.We found no statistically significant difference between the two groups in age, gender, BMI, TNM stage, the size of tumor etc(p>0.05). The median operation was longer(P = 0.019),but the median amount of blood loss was smaller(P = 0.012), in the laparoscopic APR group.And,there had significant differences between the two group in laparoscopic group and laparotomy group the eating liquid / semifluid diet time and postoperative hospitalization time(P<0.05). There were no significant differences in the number of harvested lymph nodes between the two groups(P>0.05). There were night cases of morbidity in the laparoscopic ELAPR group, and eleven cases in the open ELAPR group, with no significant differences between the two groups. There were also no complications resulting in reoperation. One patient in the laparoscopic APR group was readmitted within 30 days due to intestinal obstruction, and another in the open APR group was readmitted due to anemia after postoperative pelvic bleeding. Both patients were treated conservatively. The increase in the WBC count and the serum level of CRP in the open ELAPR group were significantly higher than those of the laparoscopic APR group on the first and second postoperative days.Conclusion:laparoscopic ELAPR for rectal cancer showed superior short-term surgical outcomes to that of open ELAPR. We should be carefully chose to adapt to the operation in the patients with laparoscopic ELAPR...