Laparoscopic Resection For Rectal Cancer: An Institutional Clinical Study Comparing The Technique’s Safety And Short-term Efficacy To Open Resection

Objective: Surgical treatment of rectal cancer has undergone significantrefinement since the adoption of the laparoscopic technique. The possibilityof a laparoscopic approach to rectal cancer remains controversial. The mainaim of this study is to investigate the safety and short-term efficacy oflaparoscopic surgery for rectal cancer in non-selected patients byevaluating characteristics including age, gender, comorbidity, distance andstage of tumor.Methods: In total,278consecutive, randomly assigned patients withupper, middle and lower rectal cancer underwent surgical treatment usingeither laparoscopic surgery or conventional open surgery betweenSeptember2010and May2013at the Department of General Surgery at theFirst Affiliated Hospital of Chongqing Medical University. All dataregarding patient details and preoperative, operative and postoperativeoutcomes were collected retrospectively. All pathological data and surgicaltechniques were reviewed retrospectively. Patients were followed in anoutpatient department. Pathological and peri-operative results werestatistically analyzed. Results: Of the278patients,112were treated using conventional openresection, and166were treated using laparoscopic resection. Themale-to-female sex ratios of the conventional and laparoscopy groups was1:1.04vs.1.81:1, respectively, and the patient ages were62.15±11.297years vs.61.20±11.678years, respectively. Age, gender, medicalmorbidity, and ASA status were similar in both the laparoscopic and opengroup patients. There were no significant differences in the generalcharacteristics of the laparoscopic and open groups. Laparoscopic resectionwas associated with significantly shorter hospital stay, less blood loss,smaller incision length, earlier ambulation, earlier passed flatus, and earlierfeeding with similar hospital cost; laparoscopy provided advantages of aclear circumferential margin and sphincter-preserving surgery, with similaroncologic outcomes and survival rates.Conclusion: Laparoscopic excision provides safe and feasibleshort-term efficacy with radicality similar to open resection. The techniquedoes not increase complications, and provides smaller incisions, fasterrecovery times, and shorter hospital stays while achieving similaroncologic outcome and local recurrence. The long term efficacy of thelaparoscopy for rectal cancer up has yet to be studied in a prospectiverandomized controlled trial.