Laparoscopic or open surgery for the cancer of the middle and lower rectum short-term outcomes of a comparative non-randomised study

Abstract

Less morbidity and faster recovery is offered after laparoscopic TME. Quality of surgery assessed by histopathology is similar between the approaches. Neoadjuvant chemoradiation seems to have significant impact on blood loss but results in longer operation times of the OPEN group.

Laparoscopic versus open surgery for rectal cancer after neoadjuvant chemoradiation: a matched case-control study of short-term outcomes

“…Many nonrandomized [1][2][3][4] and randomized [5][6][7] studies have shown it to be associated with less blood loss, earlier recovery of bowel function, and shorter hospital stay without compromised oncologic outcomes. Metaanalyses comparing the two approaches for patients with rectal cancer have shown less postoperative morbidity [8] and earlier postoperative recovery [9, 10] after laparoscopic surgery, with comparable oncologic adequacy between the two [9, 11].…”

Evaluating the Efficacy of Open Versus Laparoscopic Abdominoperianal Resection in Management of Patients with Low Rectal Cancer

“…Several studies compared long-term outcomes of patients with low rectal cancer between laparoscopic and open procedures. Almost all these studies demonstrated that long-term oncologic outcome of laparoscopic approach is comparable with open APR (10)(11)(12)(13)(14)(15)(16)(20)(21)(22). The problem for addressing this issue is relative rarity of the procedure.…”

“…Nonetheless, the laparoscopic APR requires appropriate equipment and a skilled surgeon. Shortand long-term outcomes of laparoscopic APR have been evaluated extensively (9)(10)(11)(12)(13)(14)(15). It has been demonstrated that laparoscopic APR is associated with better and faster bowel function recovery, less blood loss, shorter hospitalization and better rectal cancer prognosis and outcome (13)(14)(15).…”

“…Shortand long-term outcomes of laparoscopic APR have been evaluated extensively (9)(10)(11)(12)(13)(14)(15). It has been demonstrated that laparoscopic APR is associated with better and faster bowel function recovery, less blood loss, shorter hospitalization and better rectal cancer prognosis and outcome (13)(14)(15). Several meta-analyses compared the laparoscopic and open APR regarding short-and long-term outcomes (16)(17)(18)(19).…”

Implementation of Fast-Track Protocols in Open and Laparoscopic Sphincter-Preserving Rectal Cancer Surgery: A Multicenter, Comparative, Prospective, Non-Randomized Study

“…In cases with a very low rectal carcinoma and favorable T-stage (I or II), an intersphincteric resection of the rectum and a handsewn coloanal anastomosis were offered. The laparoscopic approach has been previously described in detail [13,14,16]. Conversion of a laparoscopic procedure to open was defined as inability to complete the operation laparoscopically and an abdominal incision other than the initially planned was performed to complete the procedure.…”