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Laparoscopic versus conventional open surgery in T4 rectal cancer: A case-control study
Xubing Zhang1, Qingbin Wu1, Tao Hu1
1Department of Gastrointestinal Surgery, West China Hospital; West China School of Medicine, Sichuan University, Chengdu, China.
Laparoscopic surgery (LAS) for T4 rectal cancer offers better perioperative outcomes and survival comparable to open surgery. LAS is safe and feasible for selected patients, demonstrating reduced blood loss and faster recovery.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Minimally Invasive Surgery
Background:
- Laparoscopic surgery (LAS) for advanced T4 rectal cancer (RC) remains controversial.
- Comparison between LAS and open surgery for T4 RC is essential.
Purpose of the Study:
- To compare the safety and efficacy of LAS versus conventional open surgery for T4 RC.
- To evaluate perioperative outcomes and long-term survival in patients with T4 RC.
Main Methods:
- Retrospective analysis of 125 patients with T4 RC undergoing LAS or open surgery (Jan 2010-Sep 2014).
- Comparison of clinicopathological characteristics, operative parameters, and survival outcomes.
- Statistical analysis using SPSS 22.0.
Main Results:
- LAS group showed significantly less blood loss, smaller incision length, and faster return to diet.
- LAS had a lower incidence of post-operative complications, though not statistically significant.
- No significant difference in operative time, 3-year overall survival (OS), or 3-year disease-free survival (DFS) between groups.
Conclusions:
- Laparoscopic surgery (LAS) is a safe and feasible option for selected T4 rectal cancer patients.
- LAS provides improved perioperative outcomes without compromising long-term survival compared to open surgery.
- Further prospective studies are recommended to minimize selection bias.
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