Surgical and Early Oncological Outcomes of Laparoscopic Versus Open Rectal Surgery: A Comparative Study

Abstract

Aim:In this study, we aimed to evaluate the short-term clinicopathological outcomes of laparoscopic versus open surgery in patients undergoing rectal cancer surgery.Method:Between May 2015 and July 2017, 46 patients who underwent curative surgery for rectal cancer were retrospectively analyzed. The patients receiving neoadjuvant therapy were administered long-term fractional chemoradiotherapy. All patients were divided into two groups as open surgery (Group 1, n=21) and laparoscopic surgery (Group 2, n=25). Data including demographic characteristics, type of surgery, postoperative complications, duration of surgery, length of hospital stay, the amount of intraoperative bleeding, and short-term oncological outcomes were recorded.Results:Of the patients, 34 were males, and 14 were females. The median age was 55 (range= 28 to 82) years. The median follow-up was 20 months in Group 1 and 19 months in Group 2. The tumor was located in the upper rectum in 19 patients, in the mid-rectum in 14 patients, and the lower rectum in 13 patients. The median length of hospital stay was six days, and the median duration of surgery was 202.5 min. The recurrence rate was 13%, and the mortality rate was 6.5%. The rate of conversion from laparoscopic to open surgery was 21.8%. The complication rate was 54.3%. Anastomotic leak was detected in two patients. The amount of intraoperative bleeding was statistically significantly higher, and the length of the proximal surgical margin was statistically significantly longer in the open surgery group.Conclusion:Our study results suggest lower hemorrhage with laparoscopic surgery and similar oncological outcomes with both laparoscopic and open rectal surgery.

Keywords

• rectal cancer
• open surgery
• laparoscopy
• oncological outcomes