Evaluation of the efficacy of laparoscopic surgery in treatment of advanced mid-low rectal cancer following a long-term neoadjuvant chemoradiotherapy

Abstract

Objective: To explore the efficacy of laparoscopic surgery in treatment of advanced mid-low rectal cancer following a long-term neoadjuvant chemoradiotherapy. Methods: Clinicopathologic and perioperative data were collected retrospectively from 74 patients with advanced mid-low rectal cancer, who received both neoadjuvant chemoradiotherapy and resections between January 2010 and January 2013 at Xinjiang tumor hospital. Routine follow-up was conducted. The safety and long-term survival of 36 patients who underwent laparoscopic resection were compared with those of 38 patients who received conventional resection. Results: The laparoscopic group had less amount of blood loss during surgery (50 ml vs 100 ml, P<0.05). The time needed for recovery of gastrointestinal function in the laparoscopic group was significantly shorter than that in the open surgery group (2.0 d vs 3.0 d, P<0.05). The rate of postoperative complication was 19.4% and 42.1% (P<0.05), respectively. In terms of the range of radical surgery and the numbers of dissected lymph nodes (8 and 10, P>0.05), no significant difference were found in the two groups. The operation duration and hospital stay in the laparoscopic group was longer than that in the open surgery group (240.0 min vs 231.5 min , P>0.05) (22.0 d vs 21.5 d , P>0.05), but no significant difference was found between the two groups. There were no significant difference in the incidence of 3 disease-free survival rate (53.0% vs 43.8%, P>0.05) and overall survival rate (70.0% vs 62.9%, P>0.05) between two groups. Conclusion: Laparoscopic surgery is a safe and feasible option for advanced mid-low rectal cancer patients who undergone the neoadjuvant chemoradiotherapy because of the similar rate of radical resection and satisfied long-term outcomes, which will have a better prospect in the future.