Comparison of laparoscopic and open radical resection for rectal cancer

Abstract

Objective To compare the results of laparoscopic and open radical operation for rectal cancer.Methods Three hundred and twelve patients with laparoscopic operation and 226 cases with open operation during the period of June 2004 to August 2009 were included.The long-term survival,operative data,postoperative recovery and complications were compared between the two grougs.Results There were no significant differences in age,sex,tumor stage and histologic types between the two groups.The 3 and 5- year-survival rate was 84.5％ and 66.7％ in laparoscopic group,83.3％ and 64.8％ in traditional operation group with no significant difference by Life-table method.The intraoperative blood loss in laparoscopic group was obviously less than that in open group (61 ± 13 nl vs 174 ±84 ml,t =23.24,P ＜0.05).The time of p assage of gas by anus and hospital stay in laparoscopic group were significantly shorter than those in openg roup (2.7 ±1.3 d vs 3.6 ±1.8 d,t =6.61,P ＜0.05;9.1 ±2.4 d vs 12.0 ±3.4 d,t =11.8,P ＜0.05).No significant difference was observed between the two groups in the lymph nodes clearance ( 11.0 ± 2.7 vs 12±3.6,t=1.72,P ＞0.05),specimen length (16.0 ±3.4 cm vs 16.0 ±4.3 cm,t =0,P＞0.05) and distal margin (3.2 ± 1.3 cm vs 3.2 ± 1.7 cm,t =0,P ＞0.05).Surgical site infection of incision developed in 28 cases in open surgery group and in 8 cases in laparoscopic group (P ＜ 0.05 ).Conclusions Laparoscopic surgery for rectal cancer can achieve similar long-term survival as conventional laparotomy with minimal invasion,quicker recovery and less complications. Key words: Rectal neoplasms; Laparoscopes; Colorectal surgery; Comparative study; Treatment outcome