| Objective: To compare the long-term outcomes of lapaparoscopic and open radical resection for rectal cancer.Methods: From January 2000 to December 2008, 602 patients with consecutive radical operation for rectal cancer, by the same surgical team in General Surgery Department in Fujian Union Hospital, were recruited and nonrandomly divided into laparoscopic group (324 cases) and open group (278 cases). 16 cases with conversion to open procedure were assigned into open group. The number of lymph nodes removed, the length of resection margin, the overall survival rate, the disease-free survival rate, the local recurrence and the distant metastasis were compared between the two groups.Results: There were no statistical differences in gender, age, adjuvant chemotherapy and TNM stage between the two groups. The mean follow-up was 27 (range, 1-114) months. The number of lymph nodes removed by laparoscopic group (21.2±8.0) was similar to that by open group (20.5±8.9), (P=0.263). The length of proximal margin in laparoscopic group (15.1±1.3cm) was similar to that in open group (16.2±11.8cm), (P=0.095). The length of distal margin resected by laparoscopic surgery (4.0±1.6cm ) was longer than that by open sugery (3.3±1.4cm), (P<001). The 3-year local recurrence of the laparoscopic surgery and open surgery were 9.8% and 6.1% respectively (P=0.139). The 3-year distant metastasis rate was 17.6% and 13.9% in the laparoscopic and open groups respectively (P=0.18). No statistical differences were found in those endpoints. The 5-year over-all survival was 83.0% in the laparoscopic group, and 79.3% in the open group, (P=0.377). The 5-year disease-free survival was 69.2% in the laparoscopic group, and 73.1% in the open group, (P=0.842). Both show no significant differences. Conclusion: The laparoscopic radical resection for rectal cancer is reliable in the oncological efficacy, and is possible to achieve the similar long-term outcomes to the open procedure.
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