Annals of Surgical Oncology

, Volume 16, Issue 6, pp 1488–1493 | Cite as

Comparison of Outcome of Open and Laparoscopic Resection for Stage II and Stage III Rectal Cancer

  • Wai Lun Law
  • Jensen T. C. Poon
  • Joe K. M. Fan
  • Siu Hung Lo
Gastrointestinal Oncology

Abstract

Background

Laparoscopic resection for advanced rectal cancer has not been widely accepted, and there are only few studies with survival data. This study aimed to compare the survival of patients who underwent laparoscopic and open resection for stage II and III rectal cancer.

Materials and Methods

Consecutive patients (open resection: n = 310; laparoscopic resection: n = 111) who underwent curative resection for stage II and III rectal cancer from June 2000 to December 2006 were included. The operative details, postoperative complications, postoperative outcomes, and survival data were collected prospectively. Comparison was made between patients who had laparoscopic and open surgery.

Results

The age, gender, medical morbidity, types of operation, and American Society of Anesthesiologists (ASA) status were similar between the two groups. There was also no difference in the mortality, morbidity, and pathological staging. Laparoscopic resection was associated with significantly less blood loss and shorter hospital stay. With the median follow-up of 34 months, there was no difference in local recurrence rates. The 5-year actuarial survivals were 71.1% and 59.3% in the laparoscopic and open groups, respectively (P = .029). In the multivariate analysis, laparoscopic resection was one of the independent significant factors associated with better survival (P = .03, hazards ratio: 0.558, 95% confidence interval: 0.339–0.969). Other independent poor prognostic factors included lymph node metastasis, poor differentiation, perineural invasion, presence of postoperative complications, and no chemotherapy.

Conclusions

Laparoscopic resection for locally advanced rectal cancer is associated with more favorable overall survival when compared with open resection.

Keywords

Rectal Cancer Total Mesorectal Excision Oncologic Outcome Local Recurrence Rate Laparoscopic Resection 

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Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Wai Lun Law
    • 1
  • Jensen T. C. Poon
    • 1
  • Joe K. M. Fan
    • 1
  • Siu Hung Lo
    • 1
  1. 1.Department of Surgery, University of Hong Kong Medical CentreQueen Mary HospitalPokfulamHong Kong

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