title: Open versus laparoscopic colorectal surgery in the era of multimodality treatment of cancer.
abstract: OBJECTIVE
  To compares the efficacy and safety of laparoscopic surgery (LS) and open surgery (OS). To analyze early results of a single institution experience using adjuvant intraoperative radiation therapy (IORT) presacral boost in locally advanced cancer.
  
  
  METHODS
  264 patients with curable colorectal cancer undergoing laparoscopic (97) or open colorectal resection (167). In 41 patients (31 open and 10 laparoscopic resection) with locally advanced rectal cancer we performed IORT. Primary endpoints were the evaluation of postoperative clinical and oncologic results.
  
  
  RESULTS
  Twenty (21%) patients underwent conversion from laparoscopic to open surgery. The overall morbidity rates were 17.5% in the LS group and 20.9% in the OS group (P= 0.5). Average operative time was shorter in the OS than in the LS series (P= 0.01). Use of parenteral narcotics was shorter in LS than in OS group (P <0.001), but there were more stoma creations in LS group than in OS group (P= 0.001). All patients are alive at different followup periods.
  
  
  CONCLUSIONS
  Colorectal cancer is the second leading cause of death from malignancy in the industrialized world. The risk of local recurrence after treatment increases with tumor stage. The roles of radiochemotherapy and surgical procedures have been investigated extensively in the last decades, especially in locally advanced rectal cancer.
  
  
  CONCLUSIONS
  Laparoscopic techniques can be applied to colorectal malignancies without sacrificing oncologic results. Multimodality treatment with LS and IORT is safe and feasible.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Brisinda
authors.forename: Serafino
authors.initials: S
authors.lastname: Vanella
authors.forename: Piero
authors.initials: P
authors.lastname: Giustacchini
authors.forename: Camillo
authors.initials: C
authors.lastname: Cavicchioni
authors.forename: Anna
authors.initials: A
authors.lastname: Crocco
authors.forename: Giorgio
authors.initials: G
authors.lastname: Maria
mesh_terms: D015179:Colorectal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy; D018714:Radiotherapy, Adjuvant