Laparoscopic resection for rectal cancer:an institutional clinical study comparing the technique’s s

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Surgical treatment of rectal cancer has undergone significant refinement since the adoption of the laparoscopic technique.The possibility of a laparoscopic approach to rectal cancer remains controversial.The main aim of this study is to investigate the safety and short-term efficacy of laparoscopic surgery for rectal cancer in non-selected patients by evaluating characteristics including age, gender, comorbidity, distance and stage of tumor.Methods: In total, 278 consecutive, randomly assigned patients with upper, middle and lower rectal cancer underwent surgical treatment using either laparoscopic surgery or conventional open surgery between September 2010 and May 2013 at the Department of General Surgery at the First Affiliated Hospital of Chongqing Medical University.All data regarding patient details and preoperative, operative and postoperative outcomes were collected retrospectively.All pathological data and surgical techniques were reviewed retrospectively.Patients were followed in an outpatient department.Pathological and peri-operative results were statistically analyzed.Results: Of the 278 patients, 112 were treated using conventional open resection, and 166 were treated using laparoscopic resection.The male-to-female sex ratios of the conventional and laparoscopy groups was 1∶1.04 vs.1.81∶1, respectively, and the patient ages were 62.15 ± 11.297years vs.61.20 ± 11.678 years, respectively.Age, gender, medical morbidity, and ASA status were similar in both the laparoscopic and open group patients.There were no significant differences in the general characteristics of the laparoscopic and open groups.Laparoscopic resection was associated with significantly shorter hospital stay, less blood loss,smaller incision length, earlier ambulation, earlier passed flatus, and earlier feeding with similar hospital cost; laparoscopy provided advantages of a clear circumferential margin and sphincter-preserving surgery, with similar oncologic outcomes and survival rates.Conclusion: Laparoscopic excision provides safe and feasible short-term efficacy with radicality similar to open resection.The technique does not increase complications, and provides smaller incisions, faster recovery times, and shorter hospital stays while achieving similar oncologic outcome and local recurrence.The long term efficacy of the laparoscopy for rectal cancer up has yet to be studied in a prospective randomized controlled trial.
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