Abstract
Background: Management of rectal cancer has been evolved over the past two decades with the introduction of total mesorectal excision (TME) and laparoscopic resection. Objective: This study aims to assess the difference in the long-term outcomes after laparoscopic and open resection for potentially curable, non-metastatic rectal cancer patients.Methods: This is a retrospective study which has been conducted in a single tertiary care center where the patients were recruited from the colorectal database of the Section of Colon and Rectal Surgery at King Faisal Specialist Hospital & Research Centre (KFSH&RC). It included all the patients who had non-metastatic rectal cancer and underwent laparoscopic or open curative resection regardless of their age or the comorbid status during the period from January 2012 – December 2015. We studied the long-term outcomes for those patients which included the completeness of resection of the tumor, overall 3-year survival, 3-year disease-free survival, local recurrence, and distal recurrence of cancer.Results:120 patients were included in this study, 69 of them were males and 51 were females. 86 (71.7%) of them underwent open surgery while 34 (28.3%) underwent laparoscopic surgery. After a mean follow-up of 32.4 months: 104 patients were alive, 7 deceased, and 9 were lost of follow-up. Local recurrence in the open approach (OA), and laparoscopic approach (LA) groups was 3/86 (3.5%) and 4/34 (11.8%) respectively. Distal recurrence occurred in 12/86 (14%) of OA and 5/34 (14.7%) of LA. Overall 3-years survival for OA and LA was 89% and 97% respectively and the 3-years disease-free survival was 49% and 57% respectively.Conclusion: Laparoscopic and open rectal excision were similar in their outcome.
Highlights
The management of rectal cancer has been evolved over the past two decades with the introduction of total mesorectal excision (TME) 1 as the standard operative approach and the establishment of multimodality protocols involving neoadjuvant chemo-radiation
The National Institute for Health and Clinical Excellence (NICE) in an updated report recommended minimally invasive surgery over traditional open surgery in patients with colorectal cancer who had no contraindications to laparoscopy.4Despite the near unanimous agreement on the safety and efficacy of the laparoscopic approach, the uniqueness of rectal cancer has raised some concerns in the surgical community
One hundred and twenty patients were included in this study, out of them 86 (71.67%) were operated by the open method and 34 (28.33%) underwent the laparoscopic approach. 69 of the involved patients were males and 51 were females
Summary
The management of rectal cancer has been evolved over the past two decades with the introduction of total mesorectal excision (TME) 1 as the standard operative approach and the establishment of multimodality protocols involving neoadjuvant chemo-radiation. The study aims to assess the differences in overall threeyear survival, 3-year disease free survival, local recurrence and distal recurrence after laparoscopic and open resection for potentially curable, non-metastatic rectal cancer. Methods: This is a retrospective study which has been conducted in a single tertiary care center where the patients were recruited from the colorectal database of the Section of Colon and Rectal Surgery at King Faisal Specialist Hospital & Research Centre (KFSH&RC) It included all the patients who had non-metastatic rectal cancer and underwent laparoscopic or open curative resection regardless of their age or the comorbid status during the period from January 2012 – December 2015. We studied the long-term outcomes for those patients which included the completeness of resection of the tumor, overall 3-year survival, 3-year disease free survival, local recurrence and distal recurrence of the cancer. Conclusion: Laparoscopic and open rectal excision were similar in their outcome
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