Comparation of Laparoscopic Intersphincteric Resection and Abdominoperineal Resection for Ultra-Low Rectal Cancer Patients - a Retrospective Analysis, and a Meta-analysis of Oncology Outcome

Abstract

Purpose The aim of the study is to evaluate the surgical and oncology outcomes between laparoscopic Intersphincteric Resection (LISR) and laparoscopic-assisted Abdominoperineal Resection (LARC) for ultra-low rectal cancer patients by using a retrospective analysis, and a meta-analysis of the literature was carried out to further validate the oncology outcome. Patients and methods: Between April 2014 and December 2015, a total of 38 rectal cancer patients who underwent LISR and 41 LARC patients were enrolled in this study. The comparison between the groups was based on clinicopathological characteristics and surgical outcomes. Meta-analysis of published studies, exploring oncology outcome of between LISR and LARC, was carried out using STATA 12.0 software. Results Operating time, blood loss, length of hospital stay, and postoperative complication rates was similar between LISR group and LARC group; Patients undergoing LISR also had a similarly 5-year local recurrence and overall survival rate with LAPR. Meta-analysis showed that five studies, which included a total of 791 patients were final involved for this analysis. Comparing APR, ISR patients obtain similarly 5-years recurrence rate and 5-years survival rate. Conclusion This study suggests that LISR is as technically feasible, safe, and effective as LARC for treating patients with low rectal cancer. Additional high-powered randomized trials are needed to determine whether LISR truly offers any advantages.