Surgical Outcomes of Laparoscopic Versus Open Abdominoperineal Resection for Anorectal Cancer: A Comparative Study

Abstract

Introduction: There has been no large, randomized prospective trial and few retrospective studies to clarify the surgical outcomes of laparoscopic abdominoperineal resection (Lap-APR) for anorectal cancer. The aim of this study was to clarify the surgical outcomes of Lap-APR for anorectal cancer. Methods: A consecutive series of 39 patients who underwent abdominoperineal resection for anorectal cancer was studied: 24 underwent Lap-APR, and 15 open abdominoperineal resection (Open-APR). Patient characteristics, tumor characteristics and operative outcomes were compared between the groups. Results: There were no significant differences between the groups in patient and tumor characteristics.The mean number of harvested nodes in the Lap-APR group was significantly more than that in the Open-APR group (11.8 ± 8.7 vs.7.6 ± 3.6, p=0.046). Although the mean operation time was similar in the two groups (372.1 ± 79.0 vs.402.7 ± 118.4 min, N.S), the mean blood loss in the Lap-APR group was significantly less than that in the Open-APR group (244.6 ± 175.0 vs.795.3 ± 544.9 g, p=0.002). Additionally, time to start oral intake of solid foods and time to first education of stoma management were significantly less after Lap-APR than Open-APR. Conclusion: Lap-APR offered particular advantages to patients with anorectal cancer,including less blood loss, rapid oral intake of solid foods and education of stoma care.