Short-term outcome of laparoscopic versus open resections for rectal cancer in 165 unselected patients / 第三军医大学学报

ABSTRACT

Objective To compare the short-term results of rectal cancer treated either by laparoscopic or open total mesorectal excision(TME). Methods A series of 165 unselected consecutive patients with rectal cancer from August 2002 to December 2005, who decided to accept the laparoscopic or open TME, were included in this study. The following parameters were compared between the two groups length of the surgical specimen, distance between the distal incisal edge of the rectum and the inferior margin of the tumor, the number of the lymph nodes resected, local recurrence rate, incidence of distant metastases, and 2 year survival rate. The mean follow-up period for both groups was 26.9 months (range, 6-46 months). Results Demographic data and Dukes stage were matched in two groups. The mean length of the resected specimens was 24.4 cm in the laparoscopic TEM group and 25.2 cm in the open TEM group. The distance from the distal incisal edge of the rectum to the inferior margin of the tumor was 2.9 cm in the laparoscopic TEM group and 2.7 cm in the open TEM group, and the mean number of lymph nodes scavenged was 11.5 in the laparoscopic TEM group and 10.6 in the open TEM group. The local recurrence rate after laparoscopic resection was 9.6%, as compared with 11% after open resection. Distant metastases occurred in 11.5% of the patients in the laparoscopic group, whereas it was 14.6% in the open group. Two year survival rate was 85.7% and disease free survival was 76.2% after laparoscopic resection and compared to 78.8% and 69.7% after open resection. All above parameters did not show statistically different between the two groups. Conclusion The oncologic resection and the early outcomes are comparable between the two surgical approaches.