title: Laparoscopic versus open total mesorectal excision: a case-control study.
abstract: OBJECTIVE
  Because definitive long-term results are not yet available, the oncological safety of laparoscopic surgery for treatment of rectal cancer remains unproven. The aim of this prospective non-randomised study was to assess the feasibility and short-term outcome of laparoscopic total mesorectal excision (LTME) after 25--30 Gy preoperative radiotherapy and to compare the results with a matched-control group of open TME (OTME).
  
  
  METHODS
  A series of 41 patients with primary rectal cancer underwent LTME for rectal cancer and were matched with a historical control group of 41 patients who underwent OTME. Both groups received preoperative short-term radiotherapy.
  
  
  RESULTS
  There was no mortality in the LTME group and 2% mortality in the OTME group. The overall postoperative morbidity was 37% in the LTME group and 51% in the OTME group, including an anastomotic leakage of 9 and 14% in the LTME and OTME groups respectively. A positive circumferential margin was found in 7% of patients in the LTME group and in 12% of the patients in the OTME group.
  
  
  CONCLUSIONS
  This study shows that LTME is technically feasible and can be performed safely. We show at least a similar surgical completeness using a laparoscopic technique compared with open surgery.
authors.affiliation: Department of Surgery, Groningen University Hospital, Groningen, The Netherlands. S.Breukink@planet.nl
authors.forename: S O
authors.initials: SO
authors.lastname: Breukink
authors.forename: J P E N
authors.initials: JP
authors.lastname: Pierie
authors.forename: A J K
authors.initials: AJ
authors.lastname: Grond
authors.forename: C
authors.initials: C
authors.lastname: Hoff
authors.forename: T
authors.initials: T
authors.lastname: Wiggers
authors.forename: W J H J
authors.initials: WJ
authors.lastname: Meijerink
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D016022:Case-Control Studies; D013505:Digestive System Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D054047:Surgical Stomas; D016019:Survival Analysis; D016896:Treatment Outcome