title: [Short-term efficacy comparison of laparoscopic versus open transabdominal intersphincteric resection for low rectal cancer].
abstract: OBJECTIVE
  To compare the short-term efficacy of laparoscopic and open transabdominal intersphincteric resection (ISR) for low rectal cancer.
  
  
  METHODS
  Clinicopathological data of 246 patients with low rectal cancer undergoing transabdominal ISR in our department from January 2005 to January 2015 were retrospectively analyzed. According to gender, age, ASA score, neoadjuvant chemoradiotherapy or not, pathological T stage, pathologic N stage, and tumor differentiation, propensity score matching was performed by R plug-in(version 2.8.1). Finally, 74 cases treated by laparoscopic transabdominal ISR(laparoscopic group) and 74 cases by open transabdominal ISR(open group) were enrolled. Short-term efficacy and anal function were compared between two groups.
  
  
  RESULTS
  No perioperative death was found in the two groups. Compared to open group, laparoscopic group had longer operation time [(236±45) minutes vs. (200±46) minutes, P=0.000], less median blood loss [50(10 to 200) ml vs. 100(20 to 400) ml, P=0.000] and shorter hospital stay [(7.8±2.4) days vs. (10.5±6.9) days, P=0.002]. Laparoscopic group and open group had similar morbidity of total complication [17.6%(13/74) vs. 28.4%(21/74), P=0.118]. Incidence of pneumonia was significantly lower in laparoscopic group [4.1%(3/74) vs. 13.5%(10/74), P=0.042), while incidence of anastomotic leakage and stenosis, and complication grading were not significantly different between the two groups (all P>0.05). During a mean follow-up of 52.0 months, anal function analysis was performed in 102 patients with stoma closure and the result showed that the ratio of patients with good continence was 87.1%(54/62) and 87.5%(35/40) in laparoscopic and open group respectively (P=0.066).
  
  
  CONCLUSIONS
  Laparoscopic transabdominal ISR is safe and feasible, which is minimally invasive with fast recovery, and is worth clinical application.
authors.forename: Shenghui
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, China. cp3169@163.com.
authors.forename: Pan
authors.initials: P
authors.lastname: Chi
authors.forename: Huiming
authors.initials: H
authors.lastname: Lin
authors.forename: Xingrong
authors.initials: X
authors.lastname: Lu
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
authors.forename: Zongbin
authors.initials: Z
authors.lastname: Xu
authors.forename: Yanwu
authors.initials: Y
authors.lastname: Sun
authors.forename: Daoxiong
authors.initials: D
authors.lastname: Ye
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Wang
authors.forename: Xiaohan
authors.initials: X
authors.lastname: Lin
mesh_terms: D000368:Aged; D057868:Anastomotic Leak; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D061646:Operative Time; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome