[Clinical control study of laparoscopic versus open surgery for rectal cancer].
OBJECTIVE
To evaluate the safety and short-term outcomes of laparoscopic-assisted surgery for rectal cancer by comparing the efficacy of laparoscopy and open surgery.


METHODS
Clinical data of patients with rectal cancer treated by laparoscopy or open surgery in Zhongshan Hospital from April 2011 to June 2012 were analyzed retrospectively, and the clinical outcomes between the two groups were compared.


RESULTS
Ninety-six rectal cancer patients undergoing laparoscopic surgery(LS) were enrolled. A total of 216 rectal cancer patients underwent open surgery(OS). There was no operative death in both groups. In LS and OS group, the overall completion rates of TME were 86.4%(83/96) vs. 89.3%(193/216)(P>0.05) respectively, and the overall anal reservation rates were 78.1%(75/96) vs. 75.0%(162/216)(P>0.05) respectively. The mean distance to proximal resection margin and distal resection margin respectively were (10.3±4.1) cm vs.(10.0±4.3) cm(P>0.05) and (3.4±0.9) cm vs. (3.6±1.4) cm(P>0.05) respectively. The mean number of harvested lymph nodes respectively were (12.8±5.2) vs.(13.7±6.4)(P>0.05). Compared to OS, LS presented less blood loss [(98.0±28.7) ml vs. (175.0±41.0) ml, P<0.05], shorter postoperative hospital stay [(9.4±4.9) d vs.(11.6±6.2) d, P<0.05], quicker postoperative recovery of bowel function[(2.7±0.9) d vs. (3.4±0.9) d, P<0.05], shorter postoperative time to intake semi-solid[(3.7±1.2) d vs. (4.4±1.5) d, P<0.05], less postoperative complications(15.6% vs. 25.9%, P<0.05), but longer operative time[(155.7±48.4) min vs. (120.0±26.7) min, P<0.05]. Postoperative follow-up was 6 to 24 months, and the local recurrence of LS and OS was 2.1% and 2.3%(P>0.05).


CONCLUSIONS
Laparoscopic surgery can obtain the same radical efficacy for rectal cancer as compared to open surgery.
Department of General Sugery, Zhongshan Hospital, Fudan University, Shanghai 200032, China. wu.guohao@zs-hospital.sh.cn.
Yandong
Y
Sun
Guohao
G
Wu
Bo
B
Zhang
Yi
Y
Jiang
Yusong
Y
Han
Guodong
G
He
Qiulin
Q
Zhuang
Xinyu
X
Qin
D001003:Anal Canal; D013505:Digestive System Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D008198:Lymph Nodes; D009364:Neoplasm Recurrence, Local; D061646:Operative Time; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome