Laparoscopic surgery for rectal cancer: review of published literature 2000-2009

We reviewed seven reports of laparoscopic low anterior resection (LAR) alone for rectal cancer and 18 reports of laparoscopic surgery, including LAR. We examined the length of surgery, blood loss during surgery, conversion rate to open surgery, incidence of anastomotic leakage, morbidity, mortality, and local recurrence, and the 5-year overall survival rates. The values were as follows (range): length of surgery, 107-540 min vs 23-780 min; blood loss, 0-600 ml vs 0-1800 ml; conversion to open surgery, 0%-14.0% vs 1.0%-21.9%; anastomotic leakage, 0%-23.0% vs 3.0%-17.0%; morbidity, 6.1%-38.6% vs 5.8%-40.0%; mortality, 0%-2.0% vs 05-5.8%; and local recurrence, 1.4%-6.8% vs 0.95%-20.8%, respectively, in the LAR alone vs laparoscopic surgery groups. The 5-year overall survival rates of patients with stage I, II, III, and IV disease were 92%-98%, 79%-81%, 67%-89%, and 0%-15%, respectively, in the LAR alone group versus 85.4%-100%, 61.7%-94.4%, 53.7%-78%, and 0%-44.6%, respectively, in the laparoscopic surgery group. Thus, we demonstrated the safety and efficacy of laparoscopic surgery for rectal cancer.