Laparoscopic resection of extraperitoneal rectal cancer: a comparative analysis with open resection.
OBJECTIVE
The aim of this study was to compare the outcomes of laparoscopic surgery with those of open resection in patients with extraperitoneal rectal cancer.


METHODS
Five hundred forty-four patients with extraperitoneal rectal cancer who underwent curative resection between 1996 and 2007 were included. Patients were divided into a laparoscopic surgery group (LAP, n = 170) and an open surgery group (OPEN, n = 374).


RESULTS
Morbidity requiring surgical correction was 5.8% in the LAP group and 4.8% in the OPEN group (p = 0.75). The anastomotic leakage rate was similar in both groups (5.7% in both; p = 0.98). Differences were found in preoperative carcinoembryonic antigen (CEA) (LAP group 4.6 ng/ml, OPEN group 7.7 ng/ml, p = 0.001), sphincter preservation (LAP group 82.9%, OPEN group 69.8%, p = 0.001), and mean distance from anal verge (LAP group 4.6 cm, OPEN group 5.2 cm, p = 0.002). Local recurrence and metastasis were similar by stage.


CONCLUSIONS
The results of this study show that laparoscopic resection of extraperitoneal rectal cancer was safe and effective.
Park
In Ja
IJ
Division of Colorectal Surgery, Department of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, 50 Samduk-dong 2ga Jung-gu, Daegu, South Korea. ijpark7@gmail.com
Choi
Gyu-Seog
GS
Lim
Kyung-Hoon
KH
Kang
Byung-Mo
BM
Jun
Soo-Han
SH
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D017558:Elective Surgical Procedures; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D007978:Levamisole / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome
D005641:Tegafur; D007978:Levamisole; D005472:Fluorouracil