title: Impact of laparoscopic surgery on the long-term outcomes for patients with rectal cancer.
abstract: BACKGROUND
  This 20-year retrospective study compared the results of laparoscopic surgery with open surgery for patients with rectal cancer to evaluate the impact of laparoscopic surgery on long-term oncological outcomes for rectal cancer.
  
  
  METHODS
  We analysed survival data collected over 20 years for patients with rectal cancer (n= 407) according to surgical methods and tumour stage between those treated with laparoscopic surgery (n= 272) and those with open surgery (n= 135). Clinical factors were analysed to ascertain possible risk factors that might have been associated with survival from and recurrence of rectal cancer. A multivariate analysis was applied by using Cox's regression model to determine the impact of laparoscopic surgery on long-term oncological outcomes.
  
  
  RESULTS
  Overall survival, disease-specific survival and disease-free survival rates were statistically higher in the laparoscopic group than in the open-surgery group. The incidence of local recurrence in the laparoscopic group (7.9%; 95% confidence intervals (CI), 4.2-11.5) was significantly lower than that for the open-surgery group (30.2%; 95% CI, 21.0-39.3; P < 0.001). By using a multivariate analysis, laparoscopic surgery for rectal cancer appeared not to be an independent factor for disease-specific survival or disease-free survival. However, the laparoscopic surgery was an independent factor associated with reduced local recurrence (Hazard ratio (HR), 3.408; 95% CI, 1.890-6.149; P < 0.001).
  
  
  CONCLUSIONS
  Laparoscopic surgery did not adversely affect the long-term oncological outcome for patients with rectal cancer.
authors.affiliation: Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea. jgkim@catholic.ac.kr
authors.forename: Jun-Gi
authors.initials: JG
authors.lastname: Kim
authors.forename: Youn-Jung
authors.initials: YJ
authors.lastname: Heo
authors.forename: Gyung-Mo
authors.initials: GM
authors.lastname: Son
authors.forename: Yoon-Suk
authors.initials: YS
authors.lastname: Lee
authors.forename: In-Kyu
authors.initials: IK
authors.lastname: Lee
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Suh
authors.forename: Hyeon-Min
authors.initials: HM
authors.lastname: Cho
authors.forename: Chung-Soo
authors.initials: CS
authors.lastname: Chun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012004:Rectal Neoplasms / Q000401:mortality* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome