P-377 - Laparoscopic vs open resection for rectal cancer. A lower middle income country experience

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Introduction: To measure the short and long term surgical outcomes of laparoscopic rectal cancer surgery at a cancer hospital in a lower middle income country Methods: All patients with a diagnosis of rectal cancer from Jun 2006 to Jun 2015 were studied. Patient demographics were recorded. Short term surgical outcomes were recorded. Oncological factors indicating an adequate surgical resection were identified. Successful resection was defined as having negative linear and radial margins and a complete TME. LN yield was also recorded. Post op complications were also compared. Results: A total of 440 surgeries were performed. 154 abdominoperineal resections, 35 extra levator abdominoperineal resections, 151 anterior resections, 40 ultralow resections, 40 Hartmann's procedures and 20 total colectomies were performed. 262 were laparoscopic and 178 were open. There were 27 conversions (10%). Tumours in the open group were more aggressive and more advanced. There were more T4 lesions (5.2% vs 0.6%), more mucinous (38.7 vs 26.7%) and more nodal involvement (45% vs 34%). Distal resection margins were negative in all open and laparoscopic resections. CRM was clear in 83.9% in open resections vs 88.8% in laparoscopic resections. TME was complete in in 86% in open surgery and 91% in laparoscopic surgery. Median number of LNs excised were similar in both groups (median of 13). Complications were seen in 8.4% patients in open group versus 5.7% patients in laparoscopic group. Conclusion: Laparoscopic surgery is similar to open surgery in terms of early surgical and oncological outcomes. A long term comparison of oncological outcomes in terms of recurrence and survival is required.