Laparoscopic vs open total mesorectal excision in the treatment of low rectal cancer / 中华普通外科杂志

ABSTRACT

Objective To evaluate the feasibility,safety and outcome of laparoscopic total mesorectal excision with sphincter preservation in the treatment of low rectal cancer.Methods From April 2004 to April 2007,laparoscopic total mesorectal excision with sphincter preservation for low rectal carcinoma was performed in 25 cases.The intraoperative risk.recovery,short-term and oncological outcomes of these patients were compared with 25 cases of conventional Dixon's operation.The controls,matched for age,sex,mass margin distance from the anus,Dukes stage,were selected from conventional Dixon's operations performed at the same period as laparoscopic group.T test and Chi-square test were used.Results Laparoscopic procedure was successful in 24 cases while one was converted to Bacon operation.The mean operation time(197±36)min in laparoscopic group was significantly longer than those(172±51)min in open group(t=2.12,P=0.04).The mean operative blood loss was(157±105)ml in laparoscopic group and(304±237)ml in open group(t=-2.95,P=0.01).No significant differences were detected between two groups in specimen length and number of lymph nodes excised.The bowel function was restored earlier in laparoseopic group than that in open group.The overall morbidity rates were 16%and 28%,and the local recurrence rates were 8%and 4%in the two groups respectively.Conclusion Laparoscopic total mesorectal excision is a feasible,safe,minimally invasive technique for rectal cancer.which provides better short-term outcomes and similar oncological outcomes compared with the traditional open procedure.