title: Laparoscopic vs open resection for rectal carcinoma--a prospective analysis.
abstract: In the recent years, laparoscopic surgery has established itself worldwide as a method of treatment for colorectal cancer. Several prospective randomized trials comparing laparoscopic with open resection of the colon, showing the advantages of laparoscopic surgery in terms of a shorter hospital stay, faster recovery of intestinal transit and physical activity in equivalent survival and recurrence rate. However, in many of the studies the data on laparoscopic resection for rectal cancer are scarce and it is still controversial.
  
  
  OBJECTIVE
  In this report, we aimed to make a comparative analysis of the clinical and oncological outcomes after laparoscopic and open rectal resection in patients with a rectal cancer.
  
  
  METHODS
  We compare and analyze prospectively data from two groups of patients with rectal cancer--66 undergoing laparoscopic and 47 undergoing open rectal resection respectively. Both groups were selected with comparable demographic characteristics (gender, age, body mass index), ASA class (American Society of Anesthesiologists), tumor stage, type of neoadjuvant radiochemotherapy and operations. The data were statistically processed.
  
  
  RESULTS
  The mean age was 61, body mass index ranged from 18 to 42. The frequency of conversion was 6.06%. Postoperative complications were similar in both groups, except for wound infection was lower for the laparoscopic group (p = 0.02). The laparoscopic group had a shorter hospital stay (7 and 5 days respectively p < 0.01), faster recovery of intestinal motility (3 and 4.5 days respectively, p < 0.001) compared with the open group. Three-year survival rate and the rate of local and late recurrences were identical in both groups.
  
  
  CONCLUSIONS
  Laparoscopic surgery is applicable in the treatment of rectal cancer with similar oncologic outcomes compared with conventional surgery and has all the advantages of miniinvasive methods. There is a need for further randomized studies to refine the applicability of laparoscopic rectal resection for cancer.
authors.affiliation: Clinic of Endoscopic, Endocrine Surgery and Coloproctology, Military Medical Academy, Sofia, Bulgaria.
authors.forename: P
authors.initials: P
authors.lastname: Ivanov
authors.forename: K
authors.initials: K
authors.lastname: Vasilev
authors.forename: G
authors.initials: G
authors.lastname: Kotashev
authors.forename: G
authors.initials: G
authors.lastname: Grigorov
authors.forename: V
authors.initials: V
authors.lastname: Kiossev
authors.forename: V
authors.initials: V
authors.lastname: Hristova
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology; D015996:Survival Rate