Comparison of laparoscopic vs. open surgery for rectal cancer

Ding,Zihai; Wang,Zheng; Huang,Shijie; Zhong,Shizhen; Lin,Jianhua

doi:10.3892/mco.2016.1112

Comparison of laparoscopic vs. open surgery for rectal cancer

Authors:
- Zihai Ding
- Zheng Wang
- Shijie Huang
- Shizhen Zhong
- Jianhua Lin
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Affiliations: Anatomical Institute of Minimally Invasive Surgery, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China, Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of Jinan University, Guangzhou Red Cross Hospital, Guangzhou, Guangdong 510220, P.R. China, Department of Hepatobiliary Surgery, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
Published online on: December 15, 2016 https://doi.org/10.3892/mco.2016.1112
Pages: 170-176
Copyright: © Ding et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

This study was conducted to evaluate the safety of laparoscopic radical resection for rectal cancer. A total of 64 cases of rectal cancer patients undergoing radical surgery between January, 1998 and March, 2010 were collected. The patients were divided into the laparoscopic rectal surgery group (LS group, n=31) and the open surgery group (OS group, n=33). Operation time, postoperative recovery, complications and tumor‑free survival rate were compared between the two groups. The inclusion criteria were as follows: Standard Karnofsky score >70 prior to surgery, definitive pathological diagnosis and complete clinical data. The exclusion criteria were concomitant tumors affecting survival. With the Dixon operation, the LS group had a longer operation time compared with the OS group (271.2±56.2 vs. 216.0±62.7 min, respectively; P=0.036), and an earlier time of oral intake (3.0±0.9 vs. 4.7±1.0 days, respectively; P=0.000). There were no significant differences between the LS and OS groups in terms of intraoperative blood loss, number of lymph nodes retrieved, duration of postoperative hyperthermia and hospitalization time (P>0.05). With the Miles operation, there were no obvious differences between the LS and OS groups regarding operation time, intraoperative blood loss, number of lymph nodes retrieved, time of oral intake, duration of postoperative hyperthermia and hospitalization time (P>0.05). Furthermore, there were no significant differences between the LS and OS groups with the Dixon or Miles operation in terms of 3‑year tumor‑free survival rate (P>0.05). Thus, laparoscopic surgery appears to be a safe and feasible option for the treatment of rectal cancer.

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1	Lai SQ, Ju FH and Wang GQ: The clinical epidemiological characteristics of 704 cases of colorectal cancer from 2004–2008. China Cancer. 19:111–113. 2010.
2	Zhou XY, Zhang JL and Wang ZK: Comparative study of laparoscopic and open surgery for colorectal cancer: Short-term results. J Laparosc Surg. 17:199–203
3	Wang SY and Chen ZY: Short-term outcomes of laparoscopy surgery for colorectal cancer: A comparative study. Fudan Univ J Med Sci. 37:92–99. 2010.
4	Pugliese R, DiLernia S, Sansonna F, Ferrari GC, Maggioni D, Scandroglio I, Costanzi A, Magistro C and De Carli S: Outcomes of laparoscopic Miles' operation in very-low rectal adenocarcinoma. Analysis of 32 cases. Eur J Surg Oncol. 33:49–54. 2007. View Article : Google Scholar : PubMed/NCBI
5	Jacobs M, Verdeja JC and Goldstein HS: Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc. 1:144–150. 1991.PubMed/NCBI
6	Lezoche E, Feliciotti F, Paganini AM, Guerrieri M, De Sanctis A and Campagnacci R: Laparoscopic colonic resection. J Laparoendose Adv Surg Tech A. 11:401–408. 2004. View Article : Google Scholar
7	Bipat S, Glas AS, Slors FJ, Zwinderman AH, Bossuyt PM and Stoker J: Rectal cancer: Local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging-a meta-analysis. Radiology. 232:773–783. 2004. View Article : Google Scholar : PubMed/NCBI
8	Dural AC, Keskin M, Balik E, Akici M, Kunduz E, Yamaner S, Asoglu Q, Gulluoglu M and Bugra D: The role of the laparoscopy on circumferential resection margin positivity in patients with rectal cancer: Long-term outcomes at a single high-volume institution. Surg Laparosc Endosc Percutan Tech. 25:129–137. 2015. View Article : Google Scholar : PubMed/NCBI
9	Lujan J, Valero G, Hernandez Q, Sanchez A, Frutos MD and Parrilla P: Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer. Br J Surg. 96:982–989. 2009. View Article : Google Scholar : PubMed/NCBI
10	Keller DS, Champagne BJ, Reynolds HL Jr, Stein SL and Delaney CP: Cost-effectiveness of laparoscopy in rectal cancer. Dis Colon Rectum. 57:564–569. 2014. View Article : Google Scholar : PubMed/NCBI
11	Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM and Brown JM: MRC CLASICC trial group: Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): Multicentre, randomised controlled trial. Lancet. 365:1718–1726. 2005. View Article : Google Scholar : PubMed/NCBI
12	Kang SB, Park JW, Jeong SY, Nam BH, Choi HS, Kim DW, Lim SB, Lee TG, Kim DY, Kim JS, et al: Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): Short-term outcomes of an open-label randomised controlled trial. Lancet Oncol. 11:637–645. 2010. View Article : Google Scholar : PubMed/NCBI
13	Zhou ZG, Hu M, Li Y, Lei WZ, Yu YY, Cheng Z, Li L, Shu Y and Wang TC: Laparoscopic versus open total mesorectal excision with anal sphincter preservation for low rectal cancer. Surg Endosc. 18:1211–1215. 2004. View Article : Google Scholar : PubMed/NCBI
14	Braga M, Frasson M, Vignali A, Zuliani W, Capretti G and Di Carlo V: Laparoscopic resection in rectal cancer patients: Outcome and cost-benefit analysis. Dis Colon Rectum. 50:464–471. 2007. View Article : Google Scholar : PubMed/NCBI
15	Pollett WG and Nicholls RJ: The relationship between the extent of distal clearance and survival and local recurrence rates after curative anterior resection for carcinoma of the rectum. Ann Surg. 198:159–163. 1983. View Article : Google Scholar : PubMed/NCBI
16	Bernstein TE, Endreseth BH, Romundstad P and Wibe A: Norwegian Colorectal Cancer Registry: What is a safe distal resection margin in rectal cancer patients treated by low anterior resection without preoperative radiotherapy? Colorectal Dis. 14:e48–e55. 2012. View Article : Google Scholar : PubMed/NCBI
17	Fitzgerald TL, Brinkley J and Zervos EE: Pushing the envelope beyond a centimeter in rectal cancer: Oncologic implications of close, but negative margins. J Am Coll Surg. 213:589–595. 2011. View Article : Google Scholar : PubMed/NCBI
18	Tan WS, Tang CL, Shi L and Eu KW: Meta-analysis of defunctioning stomas in low anterior resection for rectal cancer. Br J Surg. 96:462–472. 2009. View Article : Google Scholar : PubMed/NCBI
19	Huser N, Michalski CW, Erkan M, Schuster T, Rosenberg R, Kleeff J and Friess H: Systematic review and meta-analysis of the role of defunctioning stoma in low rectal cancer surgery. Ann Surg. 248:52–60. 2008. View Article : Google Scholar : PubMed/NCBI
20	Kim JS, Cho SY, Min BS and Kim NK: Risk factors for anastomotic leakage after laparoscopic intracorporeal colorectal anastomosis with a double stapling technique. J Am Coll Surg. 209:694–701. 2009. View Article : Google Scholar : PubMed/NCBI
21	Ito M, Sugito M, Kobayashi A, Nishizawa Y, Tsunoda Y and Saito N: Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection. Int J Colorectal Dis. 23:703–707. 2008. View Article : Google Scholar : PubMed/NCBI
22	Park JS, Choi GS, Kim SH, Kim HR, Kim NK, Lee KY, Kang SB, Kim JY, Lee KY, Kim BC, et al: Multicenter analysis of risk factors for anastomotic leakage after laparoscopic rectal cancer excision: The Korean laparoscopic colorectal surgery study group. Ann Surg. 257:665–671. 2013. View Article : Google Scholar : PubMed/NCBI
23	Ng SS, Lee JF, Yiu RY, Li JC, Hon SS, Mak TW, Leung WW and Leung KL: Long-term oncologic outcomes of laparoscopic versus open surgery for rectal cancer: A pooled analysis of 3 randomized controlled trials. Ann Surg. 259:139–147. 2014. View Article : Google Scholar : PubMed/NCBI
24	Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM and Brown JM: UK MRC CLASICC Trial Group: Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol. 25:3061–3068. 2007. View Article : Google Scholar : PubMed/NCBI
25	Laurent C, Leblanc F, Wütrich P, Scheffler M and Rullier E: Laparoscopic versus open surgery for rectal cancer: Long-term oncologic results. Ann Surg. 250:54–61. 2009. View Article : Google Scholar : PubMed/NCBI
26	Yamamoto S, Ito M, Okuda J, Fujii S, Yamaguchi S, Yoshimura K, Sugihara K and Watanabe M: Japan Society of Laparoscopic Colorectal Surgery: Laparoscopic surgery for stage 0/I rectal carcinoma: Short-term outcomes of a single-arm phase II trial. Ann Surg. 258:283–288. 2013. View Article : Google Scholar : PubMed/NCBI
27	Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM and Visa J: Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: A randomised trial. Lancet. 359:2224–2229. 2002. View Article : Google Scholar : PubMed/NCBI