LAPAROSCOPIC, OPEN AND TRANSANAL MESORECTAL EXCISION IN RECTAL CANCER SURGERY

Abstract

INTRODUCTION: there are no studies comparing laparoscopic, open, and transanal mesorectal excision for rectal cancer.AIM: to compare quality of total mesorectal excision (TME) according to the P. Quirke protocol, to assess circular resection margins (CRM), to assess distal resection margins (DRM) and perioperative morbidity.PATIENTS AND METHODS: prospective study was performed to compare the effectiveness of different methods of TME.RESULTS: eighty-eight patients were included in the study, 29 – in the laparoscopic (LA TME) group, 29 – in the open TME group, 30 – in the transanal (TA TME) group. The groups were comparable in clinical, demographic and tumor parameters. There was no significant difference between LA TME, open TME and TA TME in quality of mesorectal excision (p=0.67). There was also no significant difference in rates of positive CRM and positive DRM (p=0.38). No significant difference was obtained between intraoperative and postoperative complications rates (p=0.38; p=0.45). CONCLUSION: all three methods of TME showed the same results for quality, circular and distal resection margins and perioperative morbidity.