Evaluation of short-term outcomes after laparoscopically assisted abdominoperineal resection for low rectal cancer.
BACKGROUND
To investigate the feasibility, safety and short-term efficacy of laparoscopic techniques applied in the abdominoperineal resection (APR) for low rectal cancer.


METHODS
The clinical data of 236 patients with APR from January 2010 to January 2012 were analysed retrospectively, including 100 patients underwent laparoscopically assisted APR (LAAPR group), 136 cases of open APR (OAPR group). The demographics, tumor and procedure-related parameters, perioperative results and short-term oncological outcomes were evaluated using t-test or χ(2) -test.


RESULTS
The demographic data of the two groups were comparable. Perioperative results were better after laparoscopic surgery, with less intraoperative blood loss (P = 0.017), earlier return of bowel function (P < 0.05) and lower complication rates (P = 0.015). No significant differences were detected between the two groups in operation time, tumor size, specimen length, the distance of tumor from the anal verge, lymph nodes removed and the status of circumferential resection margin (P > 0.05). During the follow-up period of 17-38 months (average, 26 months), the overall survival rates were not significantly different between the two groups [82.5% (80/97) versus 82.7% (110/133), P > 0.05]. The differences in recurrence and metastasis between the two groups were not statistically significant.


CONCLUSIONS
Laparoscopically assisted APR for low rectal cancer is safe and effective. It has the advantages of less bleeding, rapid postoperative recovery and fewer complications, without affecting the radical degree of the surgery. Further studies are needed to fully assess oncological outcomes in the future.
Department of Abdominal Surgical Oncology, Cancer Hospital of the Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Zheng
Z
Wang
Xing-Mao
XM
Zhang
Jian-Wei
JW
Liang
Jun-Jie
JJ
Hu
Wei-Gen
WG
Zeng
Zhi-Xiang
ZX
Zhou
D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003082:Colectomy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008646:Mesocolon / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
abdominoperineal resection; laparoscopy; rectal cancer; surgery