title: Short-term outcomes of laparoscopically assisted surgery for rectal cancer following neoadjuvant chemoradiotherapy: a single-center experience.
abstract: OBJECTIVE
  The efficacy of laparoscopic treatment of rectal cancer remains unclear, and little is known about its effect on sphincter preservation. We compared short-term outcomes of laparoscopically assisted and open surgeries following neoadjuvant chemoradiotherapy (CRT) for mid and low rectal cancer.
  
  
  METHODS
  This study enrolled 137 patients with mid-low rectal cancer who underwent curative resection, 51 by laparoscopically assisted (Lap group) and 86 by conventional open (Open group) surgeries, following neoadjuvant CRT from July 2007 to July 2012. The clinical and surgical findings of the two groups of patients were prospectively collected and analyzed.
  
  
  RESULTS
  Three patients (5.9%) in the Lap group were converted to an open procedure. The mean operating times were similar in both groups. The Lap group had a significantly higher rate of sphincter preservation (62.7% versus 41.9%, P = 0.018) and significantly lower mean blood loss than the Open group. Mean times to first flatus, start of a normal diet, and overall postoperative hospitalization were longer for open surgery. The complication rate (11.8% versus 31.4%, P = 0.009) was significantly lower in the Lap group. Mean distal resection margin, involvement of the circumferential resection margin (2.0% versus 3.5%, P = 1.000), and mean lymph nodes harvested (12 versus 11; P = 0.242) were equivalent in the two groups.
  
  
  CONCLUSIONS
  Laparoscopically assisted surgery following neoadjuvant CRT is safe for patients with rectal cancer and provides favorable short-term benefits but without compromising oncologic outcomes. This sphincter-preserving procedure may be a treatment of choice for patients with lower rectal cancer.
authors.affiliation: Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Hu
authors.affiliation: Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Liang
authors.affiliation: Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Xing-Mao
authors.initials: XM
authors.lastname: Zhang
authors.affiliation: Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Zhou
authors.affiliation: Comprehensive Planning Office, Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
authors.forename: Hui-rong
authors.initials: HR
authors.lastname: Hou
authors.affiliation: Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. Electronic address: zhouzhixiang01@yahoo.com.cn.
authors.forename: Zhi-Xiang
authors.initials: ZX
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods*; D061887:Conversion to Open Surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D061646:Operative Time; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome
keywords: Laparoscopy; Neoadjuvant chemoradiotherapy; Rectal cancer; Short-term outcome; Sphincter-preserving surgery; Total mesorectal excision