Laparoscopic rectal resection versus open rectal resection with minilaparotomy for invasive rectal cancer.
BACKGROUND
The minilaparotomy approach is technically feasible for the resection of rectal cancer in selected patients with rapid postoperative recovery and small incision. The study aimed to compare the clinical and oncological outcomes of minilaparotomy and laparoscopic approaches in patients with rectal cancer.


METHODS
The 122 included patients with rectal cancer were assigned to either minilaparotomy group (n=65) or laparoscopic group (n=57) which ran from January 2005 to January 2008. Clinical characteristics, perioperative outcomes, postoperative and long-term complications, pathological results and survival rates were compared between the groups.


RESULTS
The demographic data of the two groups were similar. The time to normal diet (P=0.024) and the hospital stay (P=0.043) were less in the laparoscopic group than that in the minilaparotomy group. Compared with the minilaparotomy group, the mean operation time was significantly longer [low anterior resection (LAR), P=0.030; abdominoperineal resection (APR), P=0.048] and the direct costs higher for laparoscopic group (P<0.001). The morbidity and mortality were comparable between the two groups. Local recurrence was similar (5.3% laparoscopic, 1.5% minilaparotomy, P=0.520). The 5-year overall and disease-free survival rates were also similar (overall survival is 87.1% in laparoscopic group, and 82.5%in minilaparotomy group, P=0.425; disease-free survival is 74.2% in the laparoscopic group, and 71.4% in mini- laparotomy group, P=0.633).


CONCLUSIONS
The minilaparotomy approach was similarly safe and oncologically equivalent to laparoscopic approach for patients with rectal cancer. At the expense of a longer operative time and higher cost, laparoscopic surgery was associated with faster postoperative recovery.
The First Department of General Surgery, Institute of Hepatobiliary, Pancreas and Intestinal Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
Tong
T
Zhou
The First Department of General Surgery, Institute of Hepatobiliary, Pancreas and Intestinal Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
Guangjun
G
Zhang
The First Department of General Surgery, Institute of Hepatobiliary, Pancreas and Intestinal Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
Hongpeng
H
Tian
The First Department of General Surgery, Institute of Hepatobiliary, Pancreas and Intestinal Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
Zuoliang
Z
Liu
The First Department of General Surgery, Institute of Hepatobiliary, Pancreas and Intestinal Disease, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
Shusen
S
Xia
Minilaparotomy; laproscopic surgery; rectal cancer