title: Comparison of hand-assisted laparoscopic surgery and conventional laparotomy for rectal cancer: Interim results from a single center.
abstract: Minimally invasive laparoscopic surgery has become widespread and the indications for such surgery have recently been extended to various conditions, including rectal cancer. The objective of this study was to compare the clinical outcome of hand-assisted laparoscopic surgery (HALS) and conventional laparotomy (CL) in patients with rectal cancer. Patients who underwent radical resection of stage I-III primary rectal cancer (n=111) were classified into those receiving HALS (n=57) and those receiving CL (n=54); the two groups were matched for stage and postoperative treatment. The 3-year relapse-free survival (3Y-RFS) and 3-year overall survival (3Y-OS) were calculated and compared between the two groups. Intraoperative blood loss, operating time, postoperative hospital stay and complications were also compared between the two groups. There were no significant differenceS in 3Y-RFS or 3Y-OS between the HALS and CL groups for patients with all-stage (I, II and III) rectal cancer. The mean (median) intraoperative blood loss was 344.0 (247.0) ML in the HALS group vs. 807.5 (555.5) ML in the CL group (P<0.001). The mean (median) postoperative hospital stay was 19.8 (17) and 25.5 (18.3) days, respectively (P=0.039). There were no significant differences in the operating time or the incidence of complications between the two groups. Based on these results, HALS was found to be comparable to CL regarding survival, while achieving less blood loss and a superior cosmetic outcome. However, longer follow-up is required to confirm these findings.
authors.affiliation: Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tajima
authors.affiliation: Department of Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Mukai
authors.affiliation: Department of Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Noguchi
authors.affiliation: Department of Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Higami
authors.affiliation: Department of Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
authors.forename: Shuuji
authors.initials: S
authors.lastname: Uda
authors.affiliation: Department of Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
authors.forename: Souichirou
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
authors.forename: Sayuri
authors.initials: S
authors.lastname: Hasegawa
authors.affiliation: Department of Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Nomura
authors.affiliation: Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan.
authors.forename: Sotaro
authors.initials: S
authors.lastname: Sadahiro
authors.affiliation: Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan.
authors.forename: Seiei
authors.initials: S
authors.lastname: Yasuda
authors.affiliation: Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan ; Department of Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
keywords: conventional laparotomy; hand-assisted laparoscopic surgery; laparoscopic surgery; laparoscopy-assisted colorectal surgery; rectal cancer