title: Long-term Outcomes of Laparoscopic versus Open Surgery for Rectal Cancer: A Single-center Retrospective Analysis.
abstract: OBJECTIVE
  Laparoscopic surgery has been proven to be an effective alternative to open surgery in patients with colon cancer. However, data on laparoscopic surgery in patients with rectal cancer are insufficient. The aim of this study was to compare the long-term outcomes of laparoscopic and open surgery in patients with rectal cancer.
  
  
  METHODS
  A total of 307 patients with rectal cancer who were treated by open and laparoscopic curative resection at Kosin University Gospel Hospital (Busan, Korea) between January 2002 and December 2011 were reviewed retrospectively.
  
  
  RESULTS
  Regarding treatment, 176 patients underwent an open procedure and 131 patients underwent a laparoscopic procedure. The local recurrence rate after laparoscopic resection was 2.3%, compared with 5.7% after open resection (p = 0.088). Distant metastases occurred in 6.9% of the laparoscopic surgery group, compared with 24.4% in the open surgery group (p < 0.001). In univariate analysis, age (≥ 75 years vs. ≤ 60 years), preoperative staging, surgical approach (open vs. laparoscopic), elevated initial CEA level, elevated follow-up CEA level, number of positive lymph nodes, and postoperative chemotherapy affected overall survival and disease free survival. However, in multivariate analysis, the surgical approach apparently did not affect long-term oncologic outcome.
  
  
  CONCLUSIONS
  In this study, long-term outcomes after laparoscopic surgery for rectal cancer were not inferior to those after open surgery. Therefore, laparoscopic surgery would be an alternative operative tool to open resection for rectal cancer, although further investigation is needed.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Byung Kwon
authors.initials: BK
authors.lastname: Ahn
authors.forename: Seun Ja
authors.initials: SJ
authors.lastname: Park
authors.forename: Moo In
authors.initials: MI
authors.lastname: Park
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
authors.forename: Sung Uhn
authors.initials: SU
authors.lastname: Baek
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Si Sung
authors.initials: SS
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Conversion to open surgery; Laparoscopy; Rectal neoplasms