title: Short-term outcomes of laparoscopic intersphincteric resection for lower rectal cancer and comparison with open approach.
abstract: OBJECTIVE
  To evaluate the short-term surgical outcomes of laparoscopic intersphincteric resection (ISR) for lower rectal cancer, and to compare them with a case-control series of open ISR.
  
  
  METHODS
  Between July 2002 and March 2011, 29 patients with lower rectal cancer underwent laparoscopic ISR, and 22 of 29 patients who underwent laparoscopic ISR were compared with the control open ISR group of patients matched for age, gender, operative procedure and pathological stage.
  
  
  RESULTS
  There was no perioperative mortality, 8 complications occurred in 7 patients, and the morbidity rate was 24.1% (7/29). Leakage occurred in 1 patient (3.4%) in the laparoscopic ISR group. Regarding the matched case-control study, the operative time was significantly longer (p = 0.0007), but blood loss was significantly lower (p = 0.0003) in the laparoscopic ISR group. The median postoperative hospital stay was 8 days in the laparoscopic ISR group, which was significantly shorter than in the open ISR group (14 days). Postoperative complication rates were similar. In the laparoscopic ISR group, the levels of C-reactive protein on postoperative days 1-3 were significantly lower than in the open ISR group.
  
  
  CONCLUSIONS
  Laparoscopic ISR for lower rectal cancer provides benefits in the early postoperative period without increasing morbidity or mortality.
authors.affiliation: Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan. seyamamo@ncc.go.jp
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Shin
authors.initials: S
authors.lastname: Fujita
authors.forename: Takayuki
authors.initials: T
authors.lastname: Akasu
authors.forename: Ryo
authors.initials: R
authors.lastname: Inada
authors.forename: Masashi
authors.initials: M
authors.lastname: Takawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Moriya
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D057868:Anastomotic Leak / Q000209:etiology; D016063:Blood Loss, Surgical; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000097:blood / Q000601:surgery*; D012189:Retrospective Studies
chemical_list: D002097:C-Reactive Protein