title: Laparoscopic versus open surgery for stage I rectal cancer: long-term oncologic outcomes.
abstract: BACKGROUND
  Laparoscopic resection is increasingly being performed for rectal cancer. However, few data are available to compare long-term outcomes after open versus laparoscopic surgery for early-stage rectal cancer.
  
  
  METHODS
  Included in this retrospective study were 160 patients who underwent surgery for stage I rectal cancer between 2001 and 2008. Perioperative outcomes, overall survival (OS), and disease-free survival (DFS) were compared for open versus laparoscopic surgery.
  
  
  RESULTS
  Altogether, 85 patients were treated using open surgery and 80 with laparoscopic surgery. Postoperative mortality (0 vs. 1.3%; p = 1.00), morbidity (31.3 vs. 25.0%; p = 0.38), and harvested lymph nodes (22.5 vs. 20.0; p = 0.84) were similar for the two groups. However, operating time was longer (183.8 vs. 221.0 min; p = 0.008), volume of intraoperative bleeding was less (200.0 vs. 150.0 ml; p = 0.03), time to first bowel movement was shorter (3.54 vs. 2.44 days; p < 0.001), rate of superficial surgical-site infection was lower (7.5 vs. 0%; p = 0.03), and postoperative hospital stay was shorter (11.0 vs. 8.0 days; p < 0.001) in the laparoscopy group than in the open surgery group. At 5 years, there was no difference in OS (98.6 vs. 97.1%; p = 0.41) or DFS (98.2 vs. 96.4%; p = 0.30) between the open and laparoscopy groups.
  
  
  CONCLUSIONS
  Long-term outcomes of laparoscopic surgery for stage I rectal cancer were comparable to those of open surgery. Laparoscopic surgery, however, produced more favourable short-term outcomes than open surgery.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. lsd@ncc.re.kr
authors.forename: Seung Duk
authors.initials: SD
authors.lastname: Lee
authors.forename: Sung Chan
authors.initials: SC
authors.lastname: Park
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Park
authors.forename: Dae Yong
authors.initials: DY
authors.lastname: Kim
authors.forename: Hyo Seong
authors.initials: HS
authors.lastname: Choi
authors.forename: Jae Hwan
authors.initials: JH
authors.lastname: Oh
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D009367:Neoplasm Staging; D061646:Operative Time; D010149:Postoperative Pain / Q000503:physiopathology; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011351:Proctoscopy / Q000009:adverse effects / Q000379:methods; D011379:Prognosis; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D013995:Time