Laparoscopic versus open total mesorectal excision: a comparative study on short-term outcomes. A single-institution experience regarding anterior resections and abdominoperineal resections.
BACKGROUND
Laparoscopic total mesorectal excision (TME) is being used in rectal cancer more frequently. The aim of this study was to analyze the differences in short-term outcomes between open and laparoscopic TME.


METHODS
In this nonrandomized consecutive study, the short-term outcomes of 100 patients undergoing TME for proven rectal cancer were analyzed.


RESULTS
Two groups of 50 patients underwent an open or laparoscopic TME for rectal cancer. Both groups were comparable. Laparoscopic surgery took longer to perform (250 vs. 197.5 min, p < 0.01), but was accompanied by less blood loss (350 vs. 800 ml, p < 0.01). Enteric function recovered sooner after laparoscopy. The numbers of major and minor complications were comparable between both groups, although fewer patients had major complications in the laparoscopic group (6 vs. 15 patients, p = 0.03). Hospital stay was shorter for patients who underwent a laparoscopic abdominoperineal resection (10 vs. 12 days, p = 0.04). Median follow-up was 17 months for the laparoscopic group and 22 months for the open group. Survival analyses between the groups showed no statistical difference in disease-free and overall survival.


CONCLUSIONS
This study shows that laparoscopic TME for rectal cancer is a safe and feasible technique with some short-term benefits over open TME.
Veenhof
A A F A
AA
Department of Surgery, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Engel
A F
AF
Craanen
M E
ME
Meijer
S
S
de Lange-de Klerk
E S M
ES
van der Peet
D L
DL
Meijerink
W J H J
WJ
Cuesta
M A
MA
D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D016063:Blood Loss, Surgical; D003082:Colectomy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome