A case-control-study comparing laparoscopic versus open surgery for rectosigmoidal and rectal cancer.

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Colorectal cancer treatment often involves surgical resection.
• Minimally invasive techniques like laparoscopy are increasingly adopted.
• The oncological safety and efficacy of laparoscopic surgery for rectal cancer require further investigation.

Purpose of the Study:

• To compare laparoscopic surgery with open surgery for curative treatment of rectosigmoid and rectal cancer.
• To evaluate short-term oncological outcomes, postoperative recovery, and morbidity between the two surgical approaches.
• To assess the feasibility and safety of laparoscopic techniques in rectal cancer surgery.

Main Methods:

• A comparative study involving 32 laparoscopic procedures and 32 matched controls undergoing open surgery.
• Procedures included laparoscopic-assisted anterior resections and laparoscopic abdominoperineal resections.
• Outcomes assessed included morbidity, surgical radicality (lymph node yield, margins), survival, recurrence, mortality, blood transfusion, bowel function, and operative time.

Main Results:

• Identical morbidity rates (31.3%) and equally radical surgery in both groups.
• No statistical differences in survival, recurrence, or cancer-related mortality; no port-site recurrence observed.
• Laparoscopic surgery demonstrated reduced perioperative blood transfusion and earlier return of bowel function, but with significantly longer operative times.

Conclusions:

• Laparoscopic surgery is technically feasible for colorectal cancer with comparable short-term oncological outcomes to open surgery.
• Laparoscopic rectal cancer surgery offers benefits in recovery but requires longer operating times.
• Prospective randomized trials are essential to definitively establish the role of laparoscopic surgery in managing rectal malignancy.