Long-Term Oncologic Outcomes of Laparoscopic versus Open Surgery for Middle and Lower Rectal Cancer.
BACKGROUND
Laparoscopic surgery for middle and lower rectal cancer remain controversial because anatomical and complex surgical procedures specifically influence oncologic outcomes. This study analyzes the long-term outcomes of laparoscopic versus open surgery for middle and lower rectal cancer.


METHODS
Patients (laparoscopic: n = 129, open: n = 152) who underwent curative resection for middle and lower rectal cancer from 2003 to 2008 participated in the study. The same surgical team performed all operations. The mean follow up time of all patients was 74.3 months.


RESULTS
No statistical difference in local recurrence rate (7.8% vs. 7.2%; log-rank = 0.024; P = 0.876) and distant recurrence rate (20.9% vs.16.4%; log-rank = 0.699; P = 0.403) between laparoscopic and open groups were observed within 5 years. The 5-year overall survival rates of the laparoscopic and open groups were 72.9% and 75.7%, respectively; no significant statistical difference was observed between them (log-rank = 0.163; P = 0.686). The 5-year survival rates between groups were not different between stages: Stage I (92.6% vs. 86.7%; log-rank = 0.533; P = 0.465); stage II (75.8% vs. 80.5%; log-rank = 0.212; P = 0.645); and Stage III (63.8% vs. 69.1%, log-rank = 0272;P = 0.602). However, significant statistical difference amongst different stages were observed (log-rank = 1.802; P = 0.003).


CONCLUSIONS
Laparoscopic and open surgery for middle and lower rectal cancer offer equivalent long-term oncologic outcomes. Laparoscopic surgery is feasible in these patients.
Department of General Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejian, People's Republic of China.
Shaotang
S
Li
Department of General Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejian, People's Republic of China.
Feizhao
F
Jiang
Department of General Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejian, People's Republic of China.
Jingfu
J
Tu
Department of General Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejian, People's Republic of China.
Xiaofeng
X
Zheng
D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*