The effect of laparoscopically assisted versus open resection of rectal cancer on short-term and pathological outcomes: a randomized controlled trial

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Abstract

Background
Laparoscopic surgery in colon cancer is well established, but its use in rectal cancer is still controversial as it needs a long duration of learning curve; moreover, its oncological adequacy is questionable. This study was conducted to compare laparoscopic and open approaches regarding the short term as well as the oncological outcomes.
Materials and methods
A prospective randomized study was conducted to compare between open and laparoscopic surgeries regarding short-term and oncological outcomes. Two groups (31 patients in LAP group and 32 patients in the OPEN group) were classified in the study.
Results
A total of 63 patients with rectal cancer included in the study in the period between January 2015 and March 2016 were classified into two groups: LAP group (31 patients) and OPEN group (32 patients). They underwent rectal cancer resection according to the allocated surgery. There was a longer operative time in LAP group with a significant improved short-term outcomes (blood loss, postoperative pain, postoperative hospital stay, and rapid gastrointestinal tract recovery). There was no difference in morbidities and local and distant recurrence between the two groups. The conversion rate was 12.9% in the LAP group, whereas the median number of removed lymph nodes was 12 in the LAP group and 10 in the OPEN group, with no significant difference.
Conclusion
Laparoscopy can be used safely in rectal cancer resection with an acceptable short-term outcomes, but it is a difficult technique and needs a learning curve. Its oncological outcomes are still a matter of debate.

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